title: A Comparison of Teaching Modalities and Fidelity of Simulation Levels in Teaching Resuscitation Scenarios.
abstract: BACKGROUND
  The purpose of our study was to examine the ability of novices to learn selected aspects of Advanced Cardiac Life Support (ACLS) in training conditions that did not incorporate simulation compared to those that contained low- and high-fidelity simulation activities. We sought to determine at what level additional educational opportunities and simulation fidelity become superfluous with respect to learning outcomes.
  
  
  METHODS
  Totally 39 medical students and physician assistant students were randomly assigned to 4 training conditions: control (lecture only), video-based didactic instruction, low-, and high-fidelity simulation activities. Participants were assessed using a baseline written pretest of ACLS knowledge. Following this, all participants received a lecture outlining ACLS science and algorithm interpretation. Participants were then trained in specific aspects of ACLS according to their assigned instructional condition. After training, each participant was assessed via a Megacode performance examination and a written posttest.
  
  
  RESULTS
  All groups performed significantly better on the written posttest compared with the pretest (p < 0.001); however, no groups outperformed any other groups. On the Megacode performance test, the video-based, low-, and high-fidelity groups performed significantly better than the control group (p = 0.028, p < 0.001, p = 0.019). Equivalence testing revealed that the high-fidelity simulation condition was statistically equivalent to the video-based and low-fidelity simulation conditions.
  
  
  CONCLUSIONS
  Video-based and simulation-based training is associated with better learning outcomes when compared with traditional didactic lectures only. Video-based, low-fidelity, and high-fidelity simulation training yield equivalent outcomes, which may indicate that high-fidelity simulation is superfluous for the novice trainee.
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Adams
authors.affiliation: School of Medicine, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Wasson
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: John R
authors.initials: JR
authors.lastname: Admire
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Pedro
authors.initials: P
authors.lastname: Pablo Gomez
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Raman A
authors.initials: RA
authors.lastname: Babayeuski
authors.affiliation: Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, Texas.
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Sako
authors.affiliation: Department of Surgery, University of Texas Health Science Center at San Antonio, Texas. Electronic address: willisr@uthscsa.edu.
authors.forename: Ross E
authors.initials: RE
authors.lastname: Willis
mesh_terms: D000328:Adult; D022561:Advanced Cardiac Life Support / Q000193:education*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D011897:Random Allocation; D012151:Resuscitation / Q000193:education*; D000066908:Simulation Training
keywords: ACLS; Interpersonal and Communication Skills; Medical Knowledge; Patient Care; simulation-based education; simulator fidelity