An innovative approach to teaching resuscitation skills

Abstract

We report the impact of a monthly educational exercise for residents that emphasized practical skills and equipment usage rather than knowledge of advanced cardiac life support (ACLS) protocols. Residents were divided into groups of approximately four that rotated through three stations. Each station included several objectives, most of which related to specific types of equipment. The exercise was held six times from July 2003 to June of 2004. Sixty-seven residents participated and completed a questionnaire prior to and following the exercise. The questionnaire elicited comfort level with basic tasks including using an automated external defibrillator (AED), attaching leads and paddles to read a cardiac rhythm, delivering unsynchronized shocks with monophasic and biphasic defibrillators and implementing the pacing function on a defibrillator. There were significant differences in the pre- and post-answers to each question. The largest difference was found in the question asking how comfortable participants were delivering unsynchronized shocks with a defibrillator. Importantly, responses for the question ‘How comfortable are you being a code leader?’ showed significant improvement. Simple skills such as attaching tubing to the oxygen tank, turning on the defibrillator and entering appropriate charge, or positioning paddles and monitor leads properly often caused significant difficulty. Cardiopulmonary arrests tend to generate anxiety among house staff, despite certification in ACLS and adequate knowledge of protocols. Exercises, such as the one presented here, will reduce anxiety by specifically addressing this skill. We conclude that residents benefit from additional teaching and practice in actual performance of basic skills used during cardiac arrests. Furthermore, our data demonstrate that comfort levels among house officers increase when they are given the opportunity to practice these skills.

Additional information

Notes on contributors

Ann Settgast

ANN SETTGAST, MD, was also Chief Resident in Internal Medicine at the Minneapolis VAMC at the time the study was conducted. She recently completed her Diploma in Tropical Medicine and Hygiene at the Liverpool School of Tropical Medicine and is now working with Medecins Sans Frontieres.

John T Nguyen

JOHN T. NGUYEN, MD, was Chief Resident in Internal Medicine at the Minneapolis VAMC at the time of this study. He is currently enrolled in the Masters of Public Health program as part of a Fellowship in Cardiovascular Medicine at the University of Minnesota.

Aaron Devries

AARON DEVRIES, MD, is board certified in Internal Medicine and Pediatrics and as a Chief Resident at the Veterans Administration Medical Center (VAMC) at the time of this study. Currently, he is obtaining his Masters of Public Health as part of a Fellowship in Infectious Disease and International Medicine at the University of Minnesota.

Erin Krebs

ERIN KREBS, MD, was also a Chief Resident in Internal Medicine at the time the study was conducted. She is now a Robert Wood Johnson Clinical Scholar at the University of North Carolina at Chapel Hill.

Peter Duane

PETER DUANE, MD, is a Pulmonary and Critical Care Physician practicing at the Minneapolis VAMC. He currently serves as the Program Director for the University of Minnesota Internal Medicine Residency Program and has over 20 years of experience in medical education.