Expert raters judged students in a high-fidelity simulation-based AHA ACLS course as more competent than students in a low-fidelity course. On item level analysis, items focused on manual tasks or actions in the first 1 to 2 minutes of the cardiac arrest event were more likely to be nonsignificant. As the scenario grew longer and more complex, expert rater scores of the high-fidelity trained team leaders' confidence, knowledge, and treatment decisions were higher than the low-fidelity team leaders' score at a statistically significant level.

Research in integrated learning systems has demonstrated a need for rigorous studies that identify how such systems influence learning, and in particular that of low achieving students. No Child Left Behind legislation mandated evidence-based interventions as the standard for instructional approaches in American public schools. This quasi-experimental study investigated the impact of Merit literacy software on students in West Virginia. The study confirmed that the software supported the reading and language arts curriculum and significantly improved the scores of low achieving middle school students on three variables of the WESTEST, a criterion-referenced state test: reading and language arts, science, and social science. This integrated learning system was effective with rural and urban school populations.

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Merit Software, a publisher of software since the 1980's, has commissioned ongoing studies on the impact of Merit software on student achievement. This study is a follow-up and extension of an earlier study conducted at Calhoun County Middle School in rural West Virginia. The first study demonstrated that Merit Math software improved the achievement of students in grades six and eight on all nine of the SAT-9 variables. The current study investigated whether Merit software has improved the achievement of middle school students in an urban setting in southern West Virginia in science, mathematics,