Assessing the Accreditation Council for Graduate Medical Education Requirement for Temporary Cardiac Pacing Procedural Competency Through Simulation

Abstract

When measuring TVP alone, the number of attempts to achieve competency are comparable with that of the ACGME guidelines. When accounting for both TCP and TVP, the number of attempts required to achieve competency is greater than those delineated by the ACGME guidelines. The results of this trial warrant continuation and reproduction on a larger scale to revisit the ACGME guidelines.

An overview of research priorities in surgical simulation: what the literature shows has been achieved during the 21st century and what remains

“…Recently, Ahn et al used simulation to assess the appropriateness of the ACGME recommendation that residents perform 6 cardiac pacing attempts during training to qualify for graduation; they found that the actual number of cardiac pacing procedures (transcutaneous and transvenous) in the simulated environment needed by residents to become competent was 50% higher than the ACGME requirement 18 …”

Response

“…These aspects of the procedure could be nicely amenable to didactic and simulation training, which has been described in the education of emergency medicine trainees. 5 We also emphasize the importance of a reliable institutional pathway for expert consultation to supervise, teach, and perform TTP placement as necessary for patients presenting acutely. Ultimately, the combination of novel educational methods such as simulation coupled with educator and institutional commitment to teaching proper placement of TTP will best serve our patients.…”

Transcutaneous cardiac pacing competency among junior residents undergoing an ACLS course: impact of a modified high fidelity manikin

“…Transcutaneous cardiac pacing (TCP) is an effective treatment recommended by the 2010 American Heart Association (AHA) guidelines for unstable bradycardia [ 2 , 3 ]. It can, however, be difficult to implement: pitfalls must be avoided, and assessment of ventricular capture is complicated [ 4 – 6 ]. This low frequency but high-stakes procedure may pose a challenge for junior clinicians unfamiliar with unstable bradycardia.…”