Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study.
BACKGROUND
Simulation technology is widely used in medical education. Linking educational outcomes achieved in a controlled environment to patient care improvement is a constant challenge.


METHODS
This was a retrospective case-control study of cardiac arrest team responses from January to June 2004 at a university-affiliated internal medicine residency program. Medical records of advanced cardiac life support (ACLS) events were reviewed to assess adherence to ACLS response quality indicators based on American Heart Association (AHA) guidelines. All residents received traditional ACLS education. Second-year residents (simulator-trained group) also attended an educational program featuring the deliberate practice of ACLS scenarios using a human patient simulator. Third-year residents (traditionally trained group) were not trained on the simulator. During the study period, both simulator-trained and traditionally trained residents responded to ACLS events. We evaluated the effects of simulation training on the quality of the ACLS care provided.


RESULTS
Simulator-trained residents showed significantly higher adherence to AHA standards (mean correct responses, 68%; SD, 20%) vs traditionally trained residents (mean correct responses, 44%; SD, 20%; p = 0.001). The odds ratio for an adherent ACLS response was 7.1 (95% confidence interval, 1.8 to 28.6) for simulator-trained residents compared to traditionally trained residents after controlling for patient age, ventilator, and telemetry status.


CONCLUSIONS
A simulation-based educational program significantly improved the quality of care provided by residents during actual ACLS events. There is a growing body of evidence indicating that simulation can be a useful adjunct to traditional methods of procedural training.
Wayne
Diane B
DB
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. dwayne@northwestern.edu
Didwania
Aashish
A
Feinglass
Joe
J
Fudala
Monica J
MJ
Barsuk
Jeffrey H
JH
McGaghie
William C
WC
D022561:Advanced Cardiac Life Support; D000368:Aged; D016022:Case-Control Studies; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods*; D006323:Heart Arrest / Q000628:therapy*; D006784:Hospitals, Teaching; D006801:Humans; D010348:Patient Care Team; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies