ObjectivesPaediatric cardiopulmonary arrest resuscitation is a critically important skill but infrequently used in clinical practice. Therefore, resuscitation knowledge relies heavily on formal training which is vulnerable to rapid knowledge decay. We evaluate knowledge and skill retention post-training using rapid cycle deliberate practice (RCDP).DesignPilot, non-blinded, single-arm study.SettingPediatric Simulation Center at Children’s of Alabama.Participants42 paediatric residents at a large, tertiary care, academic children’s hospital were enrolled in this simulation-based resuscitation study.InterventionsEach participant led a 7 min preintervention arrest scenario as a baseline test. After testing, participants were trained individually in the paediatric advanced life support (PALS) skills necessary for resuscitation of a patient in pulseless electrical activity and ventricular fibrillation using RCDP—a simulation method using frequent expert feedback and repeated opportunities for the learner to incorporate new learning. Immediately post-training, participants were retested as leaders of a different paediatric arrest scenario. 3 months post-training participants returned to complete a final simulation scenario.Main outcome measuresTo evaluate knowledge and skill retention following PALS training.ResultsPreintervention data demonstrated poor baseline resident performance with an average PALS score of 52%. Performance improved to 94% immediately post-training and this improvement largely persisted at 3 months, with an average performance of 81%. In addition to improvements in performance, individual skills improved including communication, recognition of rhythms, early chest compressions and rapid administration of epinephrine or defibrillation.ConclusionsRCDP training was associated with significant improvements in resident performance during simulated paediatric resuscitation and high retention of those improvements.
Introduction:The impact of booster training on pediatric resuscitation skills is not well understood. Rapid cycle deliberate practice (RCDP) to supplement pediatric advanced life support (PALS) training is beginning to be used to improve resuscitation skills. We tested the impact of booster RCDP training performed at 9 months after initial RCDP training on pediatric resuscitation skills of pediatric residents.Objective: This study evaluated the impact of a 9-month RCDP booster training on PALS skills compared with usual practice debriefing (plus/delta) after an initial RCDP training session for PALS-certified pediatric interns. Methods: All pediatric interns at a single institution were invited to a 45-minute RCDP training session after their initial PALS certification. The PALS performance score and times for key events were recorded for participants immediately before and after the RCDP training as well as 6, 9, and 12 months after the RCDP training. Learners were randomized to an RCDP intervention and usual practice (plus/delta) group. The intervention group received booster RCDP training after their 9-month assessment. Results: Twenty eight of 30 residents participated in the initial training with 22 completing randomization at 9 months. There was no significant difference in 12-month PALS median performance scores after the booster training between the intervention and usual practice groups (83% vs. 94%, P = 0.31). There was significant improvement in PALS performance score from 51 ± 27% pre-initial RCDP assessment to 93 ± 5% post-initial RCDP training (P < 0.001). There were significant improvements in individual skills from pre-to postinitial RCDP testing, including time to verbalize pulseless, start compressions, and attach defibrillation pads (P < 0.001). Conclusions: Rapid cycle deliberate practice booster training versus plus/delta training at 9-month post-initial RCDP training did not alter 12-month performance. However, RCDP is effective at improving PALS performance skills, and this effect is maintained at 6, 9, and 12 months. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.
Background Delayed or inadequate cardiopulmonary resuscitation during cardiopulmonary arrest is associated with adverse resuscitation outcomes in pediatric patients. Therefore, a “First Five Minutes” program was developed to train all inpatient acute care nurses in resuscitation skills. The program focused on steps to take during the first 5 minutes. Objective To improve response of bedside personnel in the first few minutes of a cardiopulmonary emergency. Methods A simulation-based in situ educational program was developed that focused on the components of the American Heart Association’s “Get With the Guidelines” recommendations. The program was implemented in several phases to improve instruction and focus on necessary skills. Results The program garnered positive feedback from participants and was deemed helpful in preparing nurses and other staff members to respond to a patient in cardiopulmonary arrest. Time to chest compressions improved after training, and postintervention responses to questions regarding future code performance indicated participant recognition of the priority of the interventions addressed, such as backboard use, timely initiation of chest compressions, and timely administration of medications. Preliminary data show staff improvements in mock code performance. Conclusions The First Five Minutes program has proved to be a successful educational initiative and is expected to be continued indefinitely, with additional phases incorporated as needed. A rigorous study on best teaching methods for the program is planned.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.