title: Impact of a novel, resource appropriate resuscitation curriculum on Nicaraguan resident physician's management of cardiac arrest.
abstract: OBJECTIVE
  Project Strengthening Emergency Medicine, Investing in Learners in Latin America (SEMILLA) created a novel, language and resource appropriate course for the resuscitation of cardiac arrest for Nicaraguan resident physicians. We hypothesized that participation in the Project SEMILLA resuscitation program would significantly improve the physician's management of simulated code scenarios.
  
  
  METHODS
  Thirteen Nicaraguan resident physicians were evaluated while managing simulated cardiac arrest scenarios before, immediately, and at 6 months after participating in the Project SEMILLA resuscitation program. This project was completed in 2014 in Leon, Nicaragua. The Cardiac Arrest Simulation Test (CASTest), a validated scoring system, was used to evaluate performance on a standardized simulated cardiac arrest scenario. Mixed effect logistic regression models were constructed to assess outcomes.
  
  
  RESULTS
  On the pre-course simulation exam, only 7.7% of subjects passed the test. Immediately post-course, the subjects achieved a 30.8% pass rate and at 6 months after the course, the pass rate was 46.2%. Compared with pre-test scores, the odds of passing the CASTest at 6 months after the course were 21.7 times higher (95% CI 4.2 to 112.8, P<0.001). Statistically significant improvement was also seen on the number of critical items completed (OR=3.75, 95% CI 2.71-5.19), total items completed (OR=4.55, 95% CI 3.4-6.11), and number of "excellent" scores on a Likert scale (OR=2.66, 95% CI 1.85-3.81).
  
  
  CONCLUSIONS
  Nicaraguan resident physicians demonstrate improved ability to manage simulated cardiac arrest scenarios after participation in the Project SEMILLA resuscitation course and retain these skills.
authors.affiliation: Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA.
authors.forename: Breena R
authors.identifier: 0000-0002-2510-651X
authors.initials: BR
authors.lastname: Taira
authors.affiliation: Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA.
authors.forename: Aristides
authors.identifier: 0000-0002-5549-7857
authors.initials: A
authors.lastname: Orue
authors.affiliation: Department of Emergency Medicine, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Edward
authors.identifier: 0000-0002-4022-4581
authors.initials: E
authors.lastname: Stapleton
authors.affiliation: Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA.
authors.forename: Luis
authors.identifier: 0000-0001-7406-5534
authors.initials: L
authors.lastname: Lovato
authors.affiliation: Department of Medicine Statistics Core, UCLA, Los Angeles, California, USA.
authors.forename: Sitaram
authors.identifier: 0000-0002-8842-5702
authors.initials: S
authors.lastname: Vangala
authors.affiliation: Department of Anesthesia, Universidad Nacional Autónoma de Nicaragua, León, Nicaragua.
authors.forename: Lucia Solorzano
authors.identifier: 0000-0002-5756-5331
authors.initials: LS
authors.lastname: Tinoco
authors.affiliation: Department of Anesthesia, Universidad Nacional Autónoma de Nicaragua, León, Nicaragua.
authors.forename: Orlando
authors.identifier: 0000-0003-1188-0800
authors.initials: O
authors.lastname: Morales
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009527:Nicaragua; D010820:Physicians; D012151:Resuscitation / Q000193:education*
keywords: Emergency medicine; Heart arrest; Logistic models; Nicaragua; Resuscitation