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

Ranger, C.; Paradis, Marie-Rose; Morris, Judy; Perron, Roger; Drolet, Pierre; Cournoyer, Alexis; Paquet, Jean; Robitaille, Arnaud

doi:10.1186/s41077-018-0082-5

Cited by 4 publications

(12 citation statements)

References 21 publications

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“…It has been described that the management of tachyarrhythmias can be learned quickly with skills training [ 22 ]. The treatment of critical bradycardia with external pacemaker therapy can be safely taught by skills training with the manikin we used in our study [ 23 , 24 ]. However, skills regarding resuscitation in general, basic live support of adults and children, basic neurological assessment, and the placing of intravenous lines are lost after a relatively short period of time [ 7 , 9 , 11 – 13 , 15 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study

2022

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Background Guideline-based therapy of cardiac arrhythmias is important for many physicians from the beginning of their training. Practical training of the required skills to treat cardiac arrhythmias is useful for acquiring these skills but does not seem sufficient for skill retention. The aim of this study was to compare different retention methods for skills required to treat cardiac arrhythmias with respect to the performance of these skills in an assessment. Methods Seventy-one final-year medical students participated in a newly designed workshop to train synchronized cardioversion (SC) and transcutaneous cardiac pacing (TCP) skills in 2020. All participants completed an objective structured clinical examination (OSCE 1) one week after the training. Afterwards, the participants were stratified and randomized into three groups. Nine weeks later, one group received a standard operating procedure (SOP) for the skills, one group participated in a second workshop (SW), and one group received no further intervention (control). Ten weeks after the first training, all groups participated in OSCE 2. Results The average score of all students in OSCE 1 was 15.6 ± 0.8 points with no significant differences between the three groups. Students in the control group reached a significantly (p < 0.001) lower score in OSCE 2 (-2.0 points, CI: [-2.9;-1.1]) than in OSCE 1. Students in the SOP-group achieved on average the same result in OSCE 2 as in OSCE 1 (0 points, CI: [-0.63;+0.63]). Students who completed a second skills training (SW-group) scored not significantly higher in OSCE 2 compared to OSCE 1 (+0.4 points, CI: [-0.29;+1.12]). The OSCE 2 scores in groups SOP and SW were neither significantly different nor statistically equivalent. Conclusions Partial loss of SC and TCP skills acquired in a workshop can be prevented after 10 weeks by reading an SOP as well as by a second workshop one week before the second assessment. Refreshing practical skills with an SOP could provide an effective and inexpensive method for skills retention compared to repeating a training. Further studies need to show whether this effect also exists for other skills and how frequently an SOP should be re-read for appropriate long-term retention of complex skills.

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Section: Discussionmentioning

confidence: 99%

“…All participants were trained for SC and TCP and tested (OSCE 1) by the same physician. The OSCE checklist was standardized and validated with the available literature [ 5 , 24 , 37 ]. The three examiners of OSCE 2 were blinded to group membership of the participants.…”

Section: Discussionmentioning

confidence: 99%

Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study

2022

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“…Simulation-based education has demonstrated many research benefits in improving skill performance, knowledge, and patient outcomes [ 3 , 4 ]. High-fidelity (HF) manikins are widely used as part of the experiential learning component of advanced life-support (ALS) courses [ 5 ]. HF simulation provides real-time feedback on chest compression rate, depth, and recoil during advanced cardiac life support (ACLS) training and pediatric advanced life support (PALS) [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Learners can assess physical findings and make clinical decisions regarding the simulated patients [ 5 ]. This may be ideal for providing opportunities for paramedics and medical students to practice their theoretical knowledge in simulated environments [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of high-fidelity simulation in advanced life support training: a systematic review and meta-analysis of randomized controlled trials

Zeng,

Wang,

Liu

et al. 2023

BMC Med Educ

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Background Simulation is an increasingly used novel method for the education of medical professionals. This study aimed to systematically review the efficacy of high-fidelity (HF) simulation compared with low-fidelity (LF) simulation or no simulation in advanced life support (ALS) training. Methods A comprehensive search of the PubMed, Chinese Biomedicine Database, Embase, CENTRAL, ISI, and China Knowledge Resource Integrated Database was performed to identify randomized controlled trials (RCTs) that evaluated the use of HF simulation in ALS training. Quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions version 5.0.1. The primary outcome was the improvement of knowledge and skill performance. The secondary outcomes included the participants’ confidence and satisfaction at the course conclusion, skill performance at one year, skill performance in actual resuscitation, and patient outcomes. Data were synthesized using the RevMan 5.4 software. Results Altogether, 25 RCTs with a total of 1,987 trainees were included in the meta-analysis. In the intervention group, 998 participants used HF manikins, whereas 989 participants received LF simulation-based or traditional training (classical training without simulation). Pooled data from the RCTs demonstrated a benefit in improvement of knowledge [standardized mean difference (SMD) = 0.38; 95% confidence interval (CI): 0.18–0.59, P = 0.0003, I2 = 70%] and skill performance (SMD = 0.63; 95% CI: 0.21–1.04, P = 0.003, I2 = 92%) for HF simulation when compared with LF simulation and traditional training. The subgroup analysis revealed a greater benefit in knowledge with HF simulation compared with traditional training at the course conclusion (SMD = 0.51; 95% CI: 0.20–0.83, P = 0.003, I2 = 61%). Studies measuring knowledge at three months, skill performance at one year, teamwork behaviors, participants’ satisfaction and confidence demonstrated no significant benefit for HF simulation. Conclusions Learners using HF simulation more significantly benefited from the ALS training in terms of knowledge and skill performance at the course conclusion. However, further research is necessary to enhance long-term retention of knowledge and skill in actual resuscitation and patient’s outcomes.

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“…Unstable bradycardia is an uncommon but critical emergency in the in-hospital setting ( 1 ). The American Heart Association’s advanced cardiovascular life support guide provides an algorithm for the evaluation and treatment of bradycardia ( 2 ); however, given the infrequency of these events, novice providers may not have frequent clinical exposure to treating bradycardia or performing transcutaneous pacing ( 3 , 4 ). Rapid responses require teamwork and leadership skill to provide timely and appropriate care.…”

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confidence: 99%

Rapid Response: Bradycardia

Collis,

Raikhel,

Wykowski

et al. 2023

ATS Scholar

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

Cited by 4 publications

References 21 publications

Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study

Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study

Efficacy of high-fidelity simulation in advanced life support training: a systematic review and meta-analysis of randomized controlled trials

Rapid Response: Bradycardia

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