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Use of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review

Schwid, Howard A. MD; Rooke, G. Alec MD, PhD; Ross, Brian K. MD, PhD; Sivarajan, Murali MD

Apparatus And Techniques

Objective To determine whether an advanced cardiac life support (ACLS) computer simulation program improves retention of ACLS guidelines more effectively than textbook review.

Design Randomized, controlled trial.

Setting Academic medical center.

Participants Forty-five anesthesia residents and faculty tested 10 to 11 months after ACLS provider course training.

Intervention Participants were randomized and asked to prepare for a mock resuscitation (Mega Code) with either textbooks or a computerized ACLS simulation program.

Main Outcome Measure Performance on a standardized Mega Code examination that required application of supraventricular tachycardia, ventricular fibrillation, and second-degree Type II atrioventricular block algorithms. Mega Code sessions were administered by an instructor who was blinded as to the subject group. The sessions were videotaped and scored by two evaluators who also were blinded as to the subject group.

Results Participants who used the ACLS simulation program scored significantly higher (mean 34.9 +/- 5.0 [SD] of 47 possible points) than participants who reviewed using a textbook (29.2 +/- 4.9); p < .001. Pass-fail rates for the algorithms were also higher for the group that reviewed with the simulator (mean 2.5 +/- 0.5 of 3 possible passes) than the group that used the textbook (1.6 +/- 1.0); p = .001.

Conclusions Use of a computerized ACLS simulation program improves retention of ACLS guidelines better than textbook review. (Crit Care Med 1999; 27:821-824)

From the Department of Anesthesiology (Drs. Schwid, Rooke, Ross, Sivarajan), University of Washington, and Veterans Administration Puget Sound Health Care System (Drs. Schwid, Rooke, Sivarajan), Seattle, WA.

Work completed at the University of Washington Human Patient Simulation Center. Supported, in part, by the University of Washington Department of Anesthesiology.

Address requests for reprints to: Howard A. Schwid, MD, Anesthesia Service (112A), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seatlle, WA 98108.

© 1999 Lippincott Williams & Wilkins, Inc.