Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation

To increase cardiopulmonary arrest survival, the American Heart Association developed basic and advanced cardiac life support (ACLS) courses that expose participants to realistic learning situations. This experimental study compared results of two ACLS classes on measures of knowledge (content exam) and resuscitation skills (performance exam). Both the control and experimental groups consisted of physicians, nurses, emergency medical technicians, respiratory therapists, and advanced health care providers. The control group used low-fidelity simulation (LFS); the experimental group was exposed to enhanced realism via high-fidelity simulation (HFS). The findings showed a positive correlation between enhanced practice and learning but no significant correlation between posttest and skills test scores for the LFS and HFS groups. The HFS group did score higher on both cognitive and behavioral tests, but the difference was not statistically significant. Participants from both groups indicated satisfaction with their forms of simulation experience and course design. In addition, participants' self-confidence to care for a victim of cardiopulmonary arrest was increased after completing their course; profession and work experience had no effect on responses. The largest difference noted was in verbal responses to course satisfaction. The experimental group stated that learning using HFS was enjoyable and adamantly recommended that ACLS should only be taught using HFS. Further study is required to assess if practicing beyond the course enhances short- and long-term retention of ACLS techniques.