• Jenny E Han, Antoine R Trammell, James D Finklea, Timothy N Udoji, Daniel D Dressler, Eric G Honig, Prasad Abraham, Douglas S Ander, George A Cotsonis, Greg S Martin, and David A Schulman.
• J Grad Med Educ. 2014 Sep 1; 6 (3): 501-6.

BackgroundSimulation training is widely accepted as an effective teaching tool, especially for dealing with high-risk situations.ObjectiveWe assessed whether standardized, simulation-based advanced cardiac life support (ACLS) training improved performance in managing simulated and actual cardiac arrests.MethodsA total of 103 second- and third-year internal medicine residents were randomized to 2 groups. The first group underwent conventional ACLS training. The second group underwent two 2 1/2-hour sessions of standardized simulation ACLS teaching. The groups were assessed by evaluators blinded to their assignment during in-hospital monthly mock codes and actual inpatient code sheets at 3 large academic hospitals. Primary outcomes were time to initiation of cardiopulmonary resuscitation, time to administration of first epinephrine/vasopressin, time to delivery of first defibrillation, and adherence to American Heart Association guidelines.ResultsThere were no differences in primary outcomes among the study arms and hospital sites. During 21 mock codes, the most common error was misidentification of the initial rhythm (67% [6 of 9] and 58% [7 of 12] control and simulation arms, respectively, P  =  .70). There were no differences in primary outcome among groups in 147 actual inpatient codes.ConclusionsThis blinded, randomized study found no effect on primary outcomes. A notable finding was the percentage of internal medicine residents who misidentified cardiac arrest rhythms.

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