A High-Fidelity Simulation Mannequin to Introduce Pharmacy Students to Advanced Cardiovascular Life Support

Abstract

Objective. To design and implement an advanced cardiac life support (ACLS) workshop featuring a human patient simulator (HPS) for third-year pharmacy students. Design. The ACLS workshop consisted of a pre-session lecture, a calculation exercise, and a 40-minute ACLS session using an HPS. Twenty-four 5-member teams of students were assigned roles on a code team and participated in a ventricular fibrillation/pulseless ventricular tachycardia case. Assessment. Students completed an anonymous postactivity survey instrument and knowledge quiz. Most students who completed the ACLS workshop agreed they would like to participate in additional simulation activities and that the HPS experience enhanced their understanding of ACLS and the pharmacist responsibilities during an ACLS event (99.2% and 98.3%, respectively). However, the median score on the knowledge-based questions was 25%. Conclusion. Pharmacy students agreed HPS enhanced their learning experience; however, their retention of the knowledge learned was not consistent with the perceived benefits of HPS to education.Keywords: advanced cardiac life support, simulation, pharmacotherapy, ventricular fibrillation INTRODUCTIONAdvanced cardiovascular life support (ACLS) is a complex, team-based set of treatment strategies essential for the survival of patients experiencing a life-threatening cardiac event. As members of the ACLS team, pharmacists prepare medications at the bedside, provide pharmacotherapy consultations, and document medication administration.1 Pharmacist participation on a resuscitation team in United States hospitals is a core clinical pharmacy service, as their participation decreases adverse drug reactions and hospital mortality.2,3 From an educational standpoint, ACLS represents an ideal integration of patient assessment skills, drug preparation skills, and pharmacotherapeutic knowledge into a process that requires immediacy and accuracy. The Accreditation Council for Pharmacy Education (ACPE) recommends the integration of ACLS into the doctor of pharmacy (PharmD) curriculum. 4 However, the best methods for incorporating ACLS knowledge and skill competencies into the curriculum have not been established.Patient care simulators have been used with increasing acceptance by schools of medicine, nursing, and pharmacy to train students for a variety of clinical scenarios. 5One example is high-fidelity simulation, a unique way to introduce students to ACLS while creating an activity that allows students to apply ACLS pharmacotherapeutic knowledge and skill sets. Simulations are typically case studies of a physical reality in which participants assume a role and address problems that arise during the simulation. 6 The fidelity of the simulations refers to the degree to which the simulation reflects reality and can be further characterized by environmental, equipment, psychological, and factual accuracy.7 Human patient simulators (HPSs) are a type of high-fidelity simulator that uses a mannequin integrated with a computer to produce dynamic physiologic out...

Effectiveness of Educational Technology to Improve Patient Care in Pharmacy Curricula

“…Five articles were identified in which human-patient simulation (HPS) technology with mannequin models 17 The assessment of the HPS tool included presimulation and postsimulation quizzes, examination scores, grading of the simulation activity, and blood pressure and pulse assessments. Student satisfaction data was collected using postcourse/simulation surveys.…”

“…13 Grades specific to the simulation were high and significantly improved (p50.029), 14 including blood pressure measurement accuracy (p,0.05); 14 but in another study using HPS, median scores on knowledge-based questions in advanced cardiac life support were low. 17 Students were able to correctly calculate medication rates (78%), but struggled with concentration calculations (20%) and questions relating to asystole or pulseless electrical activity (21.8%) and ventricular tachycardia (11.7%). 17 Results from an HPS study on myocardial infarction were higher, with an average examination score of 88% reported.…”

“…17 Students were able to correctly calculate medication rates (78%), but struggled with concentration calculations (20%) and questions relating to asystole or pulseless electrical activity (21.8%) and ventricular tachycardia (11.7%). 17 Results from an HPS study on myocardial infarction were higher, with an average examination score of 88% reported. 15 The use of HPS was well-received by students in these studies.…”

“…13,[15][16][17] Students reported positive attitudes about simulation prior to and after their experiences, and 88% stated they enjoyed the simulation. [13][14][15] Students reported that using simulation enhanced learning, 13,17 that they enjoyed the realistic setting, 13,16 and that it increased their confidence. 14 Seventy to 94% of students stated they would like more simulation incorporated or would participate again if it was available.…”

“…14 Seventy to 94% of students stated they would like more simulation incorporated or would participate again if it was available. 15,17 Other student data resulting from how HPS was used included reports of enhanced understanding of the pharmacist's responsibilities during an advanced cardiac life support event, 17 learning of cardiovascular pharmacology and therapeutics, 17 improved dose calculations and medication preparation, 17 developed abilities to problem solve, 15 and better patient outcome realization of clinical decisions. 16 Simulation grades, with the exception of those related to advanced cardiac life support, were significantly improved with the implementation of HPS.…”