title: Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India.
abstract: OBJECTIVE
  Data on the efficacy of the simulation and multimedia teaching modalities is limited, particularly in developing nations. This study evaluates the effectiveness of simulator and multimedia educational tools in India.
  
  
  METHODS
  Advanced Cardiac Life Support (ACLS) certified paramedic students in India were randomized to either Simulation, Multimedia, or Reading for a 3-h ACLS refresher course. Simulation students received a lecture and 10 simulator cases. The Multimedia group viewed the American Heart Association (AHA) ACLS video and played a computer game. The Reading group independently read with an instructor present. Students were tested prior to (pre-test), immediately after (post-test), and 3 weeks after (short-term retention test), their intervention. During each testing stage subjects completed a cognitive, multiple-choice test and two cardiac arrest scenarios. Changes in exam performance were analyzed for significance. A survey was conducted asking students' perceptions of their assigned modality.
  
  
  RESULTS
  One hundred and seventeen students were randomized to Simulation (n=39), Multimedia (n=38), and Reading (n=40). Simulation demonstrated greater improvement managing cardiac arrest scenarios compared to both Multimedia and Reading on the post-test (9% versus 5% and 2%, respectively, p<0.05) and Reading on the short-term retention test (6% versus -1%, p<0.05). Multimedia showed significant improvement on cognitive, short-term retention testing compared to Simulation and Reading (5% versus 0% and 0%, respectively, p<0.05). On the survey, 95% of Simulation and 84% of Multimedia indicated they enjoyed their modality.
  
  
  CONCLUSIONS
  Simulation and multimedia educational tools were effective and may provide significant additive benefit compared to reading alone. Indian students enjoyed learning via these modalities.
authors.affiliation: Georgetown University Hospital & Washington Hospital Center, Department of Emergency Medicine, USA. Elizabeth.delasobera@gmail.com
authors.forename: B Elizabeth
authors.initials: BE
authors.lastname: Delasobera
authors.forename: Tress L
authors.initials: TL
authors.lastname: Goodwin
authors.forename: Matthew
authors.initials: M
authors.lastname: Strehlow
authors.forename: Gregory
authors.initials: G
authors.lastname: Gilbert
authors.forename: Peter
authors.initials: P
authors.lastname: D'Souza
authors.forename: Amit
authors.initials: A
authors.lastname: Alok
authors.forename: Pallavi
authors.initials: P
authors.lastname: Raje
authors.forename: S V
authors.initials: SV
authors.lastname: Mahadevan
mesh_terms: D000328:Adult; D022561:Advanced Cardiac Life Support / Q000193:education*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D019212:Multimedia; D011446:Prospective Studies; D055815:Young Adult