Randomized trial of a novel ACLS teaching tool: does it improve student performance?

Area of Science:

• Medical Education
• Cardiovascular Medicine
• Simulation Technology

Background:

• High-fidelity mannequin-based simulation (HFMBS) and computer-based simulation are recognized as valuable adjuncts in advanced cardiac life support (ACLS) training.
• The study investigated the impact of a supplemental online ACLS simulator on medical students' performance in a standardized Mega Code scenario using HFMBS.

Purpose of the Study:

• To evaluate whether access to an online computer-based ACLS simulator enhances medical students' performance on a standardized Mega Code test.
• To assess the effect of the simulator on critical time-dependent interventions in ACLS.

Main Methods:

• Sixty-five third-year medical students were randomized into an intervention group (n=29) with two-week simulator access and a control group (n=36) without access.
• Primary outcomes included time to initiate chest compressions, defibrillate ventricular fibrillation, and pace symptomatic bradycardia.
• Secondary outcomes assessed subjective self-assessment of ACLS knowledge and confidence.

Main Results:

• The intervention group defibrillated ventricular fibrillation significantly faster (112s vs. 149.9s, p<.05) and paced symptomatic bradycardia faster (95.14s vs. 154.9s, p<.05).
• No significant difference was found in subjective self-assessment of ACLS knowledge between groups (mean 3.1 vs. 3.3, p=.21).
• Despite superior objective performance, the intervention group reported lower confidence (mean 2.5 vs. 3.2, p<.05).

Conclusions:

• The online computer-based ACLS simulator serves as an effective adjunctive instructional tool for ACLS.
• The simulator demonstrably improves the speed of critical interventions like defibrillation and pacing.
• While enhancing performance, the simulator's impact on student confidence warrants further investigation.