The impact of simulation-based training on the knowledge and skills of postgraduate medical students in the management of cardiac arrest

Background: Use of simulation as a teaching learning method is said to improve the learners' skills and clinical decision making in a risk-free environment. The effectiveness of simulation in imparting protocol-based training of a critical situation like cardiac arrest to postgraduate students, needs to be evaluated. We aimed to train students in a simulation-based training session for Advanced Cardiac Life Support (ACLS) in the management of in-hospital cardiac arrest, and assess the effect on the pre-training efficacy. Methodology: Thirty post-graduate students were subjected to a pre-test in knowledge and skills regarding ACLS, followed by a didactic lecture and a training session on a high-fidelity mannequin for the same. The assessment was conducted one week later. A self-perception questionnaire from the students was obtained at the end of the whole program. Mean score of knowledge, skill, time to initiating CPR and time to defibrillation in pre-test and post-test were compared using the paired-t test. P < 0.05 was considered statistically significant. Results: There was statistically significant improvement in the post-test knowledge score (13.5 & PLUSMN; 2.87; P < 0.0001) and skills score (6.066 & PLUSMN; 1.25; P < 0.0001). Objective improvement was noticed in time to start cardiopulmonary resuscitation (pre-test 60 & PLUSMN; 19.76 sec vs. post-test 26.56 & PLUSMN; 16.07 sec; P = 0.0001). Time to defibrillation was markedly reduced (pre-test 118.6 & PLUSMN; 28.28 sec vs. post-test 93 & PLUSMN; 33.38 sec; P = 0.0022). Majority of the students strongly agreed that the training session resulted in improved confidence (76.7%), which enhanced clinical decision making in emergency situations (83.3%). Conclusion: The simulation-based training session significantly increases the knowledge and psychomotor skills of the post-graduate students with enhanced confidence to manage a victim of cardiac arrest as self-judged by the participants.