Evaluation of a cardiac arrest simulation

Prior to using a simulation strategy for educational and/or research purposes, it is essential to assess whether or not the simulation elicits responses one would expect in the "real" situation. The purpose of this study was to evaluate the stress-eliciting capacity of two variations of a simulated cardiac arrest situation. Twenty-seven senior baccalaureate students in nursing volunteered to participate in the study. Each subject was randomly assigned either to a simulation containing interpersonal stressors or a simulation containing environmental stressors. The simulations took place in a videotape studio equipped as an intensive care unit. All subjects were instructed via an audiotape recording to perform tasks similar to those undertaken by intensive care nurses in the context of a cardiac arrest situation. Pre-post measurements included: self-reported anxiety as measured by the State Trait Anxiety Inventory (A-State), pulse rate, and diastolic and systolic blood pressure. Task performance on cardiopulmonary resuscitation (CPR) and on a medication memory activity also were measured. Since no significant differences in the dependent measures were found between the two groups, data from both groups were analyzed together. Univariate analyses showed significant pre-post increases in pulse rate (p less than .0001), systolic blood pressure (p less than .03), and self-reported anxiety (p less than .0001). No significant change was noted in diastolic blood pressure. Ratings on CPR performance and a medication memory task were well below expected performance standards. The implications of these findings for educational and research purposes are discussed.