High Fidelity Simulation Improves Provider Confidence During ACLS Training Even Among Experienced Staff: Are We Missing an Opportunity?

Abstract

Citation ResearchPage 5 ABSTRACT Background: Advanced Cardiac Life Support (ACLS) resuscitation requires rapid assessment and intervention. It is unclear, however, whether high fidelity simulation improves confidence in providers who are experienced as most simulation training focuses on new graduates or hires. We tested the hypothesis that practicing providers undergoing high-fidelity simulation of cardiopulmonary arrest scenarios will express greater confidence in ACLS skills. Methods: We conducted a prospective cohort study at an urban level 1 trauma center from January to October, 2011 with a convenience sample of nurses, nurse practitioners, and physicians. They participated in high-fidelity (Laerdal 3G) simulation sessions of cardiopulmonary arrest about 3 months apart. Each session included two scenarios and lasted 30 minutes, including debriefing. We recorded demographics and confidence on a validated 5 point Likert scale confidence measurement tool before and after each session. Responses ranged from not at all confident (1) to very confident (5) in: recognizing signs and symptoms, appropriately intervening, and evaluating intervention effectiveness in cardiac and respiratory arrests. Descriptive statistics, paired t-tests, and ANOVA were used for data analysis. Sensitivity testing evaluated subjects who completed their second session at 6 months rather than 3 months. Results: Sixty-five subjects completed consent, 35 completed 1 session and 23 completed at least 2 sessions with no missing data. Ninety-two percent were registered nurses, median clinical experience was 11-15 years, and 59% were from an intensive care unit. Provider confidence increased significantly after a single session. There was a trend for further increased confidence with an additional session and the increased confidence was maintained for at least 3-6 months given the sensitivity analysis. The number of cardiopulmonary arrests directly participated in

Validity of a questionnaire developed to measure the impact of a high‐fidelity simulation intervention: A feasibility study

“…These were rated on a five‐point scale using the following categories: not at all, somewhat, average, largely and very confident. The self‐confidence items were adapted, with permission, from the critical care Self‐Confidence Scale (Hicks et al, ) used in previous studies (Zavotsky et al, ). The development of the questionnaire was based on the American Heart Association (AHA) examination for Basic Life Support, after approval from the AHA.…”

Advanced Cardiac Life Support Simulation for Nurse Anesthetists and Student Nurse Anesthetists

“…Simulation training has the ability to translate what is learned didactically into the motor skills necessary to perform on a real, live patient. In addition, simulation can have a potent impact for scenarios that are not frequently encountered in the clinical setting (Davis, Storjohann, Spiegel, Beiber, & Barletta, 2013;Langdorf et al, 2014;Zavotsky et al, 2016). Cannon-Diehl, Rugari, and Jones (2012) completed a study that examined events cited as highly effective in simulation curricula, such as cardiopulmonary resuscitation, anesthesia machine mishaps, and malignant hyperthermia.…”