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    Simulation-based assessment of trainee's performance in post-cardiac arrest resuscitation.

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    Author
    Ali, Afrah A
    Chang, 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
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    Date
    2022-04-28
    Journal
    Resuscitation Plus
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.resplu.2022.100233
    Abstract
    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 variance
    CI, 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
    Show allShow less
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18797
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.resplu.2022.100233
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