Simulation-based assessment of trainee's performance in post-cardiac arrest resuscitation.
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Author
Ali, Afrah AChang, Wan-Tsu W
Tabatabai, Ali
Pergakis, Melissa B
Gutierrez, Camilo A
Neustein, Benjamin
Gilbert, Gregory E
Podell, Jamie E
Parikh, Gunjan
Badjatia, Neeraj
Motta, Melissa
Lerner, David P
Morris, Nicholas A
Date
2022-04-28Journal
Resuscitation PlusPublisher
ElsevierType
Article
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OBJECTIVES: To assess trainees' performance in managing a patient with post-cardiac arrest complicated by status epilepticus. METHODS: In this prospective, observational, single-center simulation-based study, trainees ranging from sub interns to critical care fellows evaluated and managed a post cardiac arrest patient, complicated by status epilepticus. Critical action items were developed by a modified Delphi approach based on American Heart Association guidelines and the Neurocritical Care Society's Emergency Neurological Life Support protocols. The primary outcome measure was the critical action item sum score. We sought validity evidence to support our findings by including attending neurocritical care physicians and comparing performance across four levels of training. RESULTS: Forty-nine participants completed the simulation. The mean sum of critical actions completed by trainees was 10/21 (49%). Eleven (22%) trainees verbalized a differential diagnosis for the arrest. Thirty-two (65%) reviewed the electrocardiogram, recognized it as abnormal, and consulted cardiology. Forty trainees (81%) independently decided to start temperature management, but only 20 (41%) insisted on it when asked to reconsider. There was an effect of level of training on critical action checklist sum scores (novice mean score [standard deviation (SD)] = 4.8(1.8) vs. intermediate mean score (SD) = 10.4(2.1) vs. advanced mean score (D) = 11.6(3.0) vs. expert mean score (SD) = 14.7(2.2)). CONCLUSIONS: High-fidelity manikin-based simulation holds promise as an assessment tool in the performance of post-cardiac arrest care.Rights/Terms
© 2022 The Authors.Keyword
ANOVA, Analysis of varianceCI, Confidence Intervals
CT, Computed tomography
Critical Care
ECG, Electrocardiography
EEG, Electroencephalogram
ENLS, Emergency Neurological Life Support
Hypothermia
ICC, Intra-class correlation
IQR, Interquartile ranges
Induced
OHCA, Out of Hospital Cardiac Arrest
Out of Hospital Cardiac Arrest
PGY, Post graduate year
SD, Standard Deviation
Simulation
Status Epilepticus
cEEG, Continuous EEG
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http://hdl.handle.net/10713/18797ae974a485f413a2113503eed53cd6c53
10.1016/j.resplu.2022.100233
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