Evaluating Simulation-Based ACLS Education on Patient Outcomes: A Randomized, Controlled Pilot Study

Area of Science:

• Medical Education
• Cardiology
• Emergency Medicine

Background:

• Simulation training is a recognized method for teaching high-risk medical procedures.
• Advanced Cardiac Life Support (ACLS) is critical for managing cardiac arrest events.

Purpose of the Study:

• To evaluate if standardized, simulation-based ACLS training enhances resident performance in managing simulated and actual cardiac arrests.
• To compare the effectiveness of simulation training versus conventional training for ACLS.

Main Methods:

• A randomized controlled trial involving 103 internal medicine residents.
• Two groups: conventional ACLS training and standardized simulation ACLS training (two 2.5-hour sessions).
• Performance assessed via blinded evaluators during mock codes and actual inpatient cardiac arrests, measuring time to CPR, epinephrine/vasopressin, defibrillation, and guideline adherence.

Main Results:

• No significant differences in primary outcomes (time to CPR, medication, defibrillation, guideline adherence) between simulation and conventional training groups.
• The most frequent error in mock codes was misidentification of initial cardiac arrest rhythms (67% control vs. 58% simulation).
• No differences in primary outcomes were observed in 147 actual inpatient cardiac arrest events.

Conclusions:

• Standardized simulation-based ACLS training did not demonstrate a significant improvement in managing cardiac arrests compared to conventional training.
• A significant proportion of internal medicine residents frequently misidentified cardiac arrest rhythms, indicating a persistent knowledge or skill gap.