title: Randomized trial of a novel ACLS teaching tool: does it improve student performance?
abstract: BACKGROUND
  Mounting evidence suggests that high-fidelity mannequin-based (HFMBS) and computer-based simulation are useful adjunctive educational tools for advanced cardiac life support (ACLS) instruction. We sought to determine whether access to a supplemental, online computer-based ACLS simulator would improve students' performance on a standardized Mega Code using high-fidelity mannequin based simulation (HFMBS).
  
  
  METHODS
  Sixty-five third-year medical students were randomized. Intervention group subjects (n = 29) each received a two-week access code to the online ACLS simulator, whereas the control group subjects (n = 36) did not. Primary outcome measures included students' time to initiate chest compressions, defibrillate ventricular fibrillation, and pace symptomatic bradycardia. Secondary outcome measures included students' subjective self-assessment of ACLS knowledge and confidence.
  
  
  RESULTS
  Students with access to the online simulator on average defibrillated ventricular fibrillation in 112 seconds, whereas those without defibrillated in 149.9 seconds, an average of 38 seconds faster [p<.05]. Similarly, those with access to the simulator paced symptomatic bradycardia on average in 95.14 seconds whereas those without access paced on average 154.9 seconds a difference of 59.81 seconds [p<.05]. On a subjective 5-point scale, there was no difference in self-assessment of ACLS knowledge between the control (mean 3.3) versus intervention (mean 3.1) [p-value =.21]. Despite having outperformed the control group subjects in the standardized Mega Code test scenario, the intervention group felt less confident on a 5-point scale (mean 2.5) than the control group. (mean 3.2) [p<.05].
  
  
  CONCLUSIONS
  The reduction in time to defibrillate ventricular fibrillation and to pace symptomatic bradycardia among the intervention group subjects suggests that the online computer-based ACLS simulator is an effective adjunctive ACLS instructional tool.
authors.affiliation: SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Nacca
authors.affiliation: SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York.
authors.forename: Jordan
authors.initials: J
authors.lastname: Holliday
authors.affiliation: SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York.
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Ko
mesh_terms: D022561:Advanced Cardiac Life Support / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D020407:Internet; D008348:Manikins; D017145:Models, Educational; D009518:New York; D012647:Self-Assessment