Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation
Introduction: Most medical schools teach cardiopulmonary resuscitation (CPR) during the final year in course curriculum to prepare students to manage the first minutes of clinical emergencies. Little is known regarding the optimal method of instruction for this critical skill. Simulation has been sh...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2019-01-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/7sn3h2dd |
| _version_ | 1818873513073704960 |
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| author | Asif Rahman Juan C. Rendon Craig L. Anderson Mark I. Langdorf Shahram Lotfipour Bharath Chakravarthy |
| author_facet | Asif Rahman Juan C. Rendon Craig L. Anderson Mark I. Langdorf Shahram Lotfipour Bharath Chakravarthy |
| author_sort | Asif Rahman |
| collection | DOAJ |
| description | Introduction: Most medical schools teach cardiopulmonary resuscitation (CPR) during the final year in course curriculum to prepare students to manage the first minutes of clinical emergencies. Little is known regarding the optimal method of instruction for this critical skill. Simulation has been shown in similar settings to enhance performance and knowledge. We evaluated the comparative effectiveness of high-fidelity simulation training vs. standard manikin training for teaching medical students the American Heart Association (AHA) guidelines for high-quality CPR. Methods: This was a prospective, randomized, parallel-arm study of 70 fourth-year medical students to either simulation (SIM) or standard training (STD) over an eight-month period. SIM group learned the AHA guidelines for high-quality CPR via an hour session that included a PowerPoint lecture with training on a high-fidelity simulator. STD group learned identical content using a low-fidelity Resusci Anne® CPR manikin. All students managed a simulated cardiac arrest scenario with primary outcome based on the AHA guidelines definition of high-quality CPR (specifies metrics for compression rate, depth, recoil, and compression fraction). Secondary outcome was time to emergency medical services (EMS) activation. We analyzed data via Kruskal-Wallis rank sum test. Outcomes were performed on a simulated cardiac arrest case adapted from the AHA Advanced Cardiac Life Support (ACLS) SimMan® Scenario manual. Results: Students in the SIM group performed CPR that more closely adhered to the AHA guidelines of compression depth and compression fraction. Mean compression depth was 4.57 centimeters (cm) (95% confidence interval [CI] [4.30–4.82]) for SIM and 3.89 cm (95% CI [3.50–4.27]) for STD, p=0.02. Mean compression fraction was 0.724 (95% CI [0.699–0.751]) for SIM group and 0.679 (95% CI [0.655–0.702]) for STD, p=0.01. There was no difference for compression rate or recoil between groups. Time to EMS activation was 24.7 seconds (s) (95% CI [15.7–40.8]) for SIM group and 79.5 s (95% CI [44.8–119.6]) for STD group, p=0.007. Conclusion: High-fidelity simulation training is superior to low-fidelity CPR manikin training for teaching fourth-year medical students implementation of high-quality CPR for chest compression depth and compression fraction. |
| first_indexed | 2024-12-19T12:55:54Z |
| format | Article |
| id | doaj.art-74866efbd87d419ca58b331a62d08e6d |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-12-19T12:55:54Z |
| publishDate | 2019-01-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-74866efbd87d419ca58b331a62d08e6d2022-12-21T20:20:24ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182019-01-0120110.5811/westjem.2018.11.39040wjem-20-15Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary ResuscitationAsif RahmanJuan C. RendonCraig L. AndersonMark I. LangdorfShahram LotfipourBharath ChakravarthyIntroduction: Most medical schools teach cardiopulmonary resuscitation (CPR) during the final year in course curriculum to prepare students to manage the first minutes of clinical emergencies. Little is known regarding the optimal method of instruction for this critical skill. Simulation has been shown in similar settings to enhance performance and knowledge. We evaluated the comparative effectiveness of high-fidelity simulation training vs. standard manikin training for teaching medical students the American Heart Association (AHA) guidelines for high-quality CPR. Methods: This was a prospective, randomized, parallel-arm study of 70 fourth-year medical students to either simulation (SIM) or standard training (STD) over an eight-month period. SIM group learned the AHA guidelines for high-quality CPR via an hour session that included a PowerPoint lecture with training on a high-fidelity simulator. STD group learned identical content using a low-fidelity Resusci Anne® CPR manikin. All students managed a simulated cardiac arrest scenario with primary outcome based on the AHA guidelines definition of high-quality CPR (specifies metrics for compression rate, depth, recoil, and compression fraction). Secondary outcome was time to emergency medical services (EMS) activation. We analyzed data via Kruskal-Wallis rank sum test. Outcomes were performed on a simulated cardiac arrest case adapted from the AHA Advanced Cardiac Life Support (ACLS) SimMan® Scenario manual. Results: Students in the SIM group performed CPR that more closely adhered to the AHA guidelines of compression depth and compression fraction. Mean compression depth was 4.57 centimeters (cm) (95% confidence interval [CI] [4.30–4.82]) for SIM and 3.89 cm (95% CI [3.50–4.27]) for STD, p=0.02. Mean compression fraction was 0.724 (95% CI [0.699–0.751]) for SIM group and 0.679 (95% CI [0.655–0.702]) for STD, p=0.01. There was no difference for compression rate or recoil between groups. Time to EMS activation was 24.7 seconds (s) (95% CI [15.7–40.8]) for SIM group and 79.5 s (95% CI [44.8–119.6]) for STD group, p=0.007. Conclusion: High-fidelity simulation training is superior to low-fidelity CPR manikin training for teaching fourth-year medical students implementation of high-quality CPR for chest compression depth and compression fraction.https://escholarship.org/uc/item/7sn3h2dd |
| spellingShingle | Asif Rahman Juan C. Rendon Craig L. Anderson Mark I. Langdorf Shahram Lotfipour Bharath Chakravarthy Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation Western Journal of Emergency Medicine |
| title | Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation |
| title_full | Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation |
| title_fullStr | Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation |
| title_full_unstemmed | Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation |
| title_short | Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation |
| title_sort | randomized controlled trial of simulation vs standard training for teaching medical students high quality cardiopulmonary resuscitation |
| url | https://escholarship.org/uc/item/7sn3h2dd |
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