The Effect of High-Fidelity Manikin-Based Human Patient Simulation on Educational Outcomes in Advanced Cardiovascular Life Support Courses

The use of high-fidelity manikin-based simulation has been studied in many healthcare education areas. However, the use of this education technology in the American Heart Association Advanced Cardiovascular Life Support (ACLS) course has not been well examined in the literature, despite this education program being one of the most widely taught standardized medical courses in the United States. This study examined high fidelity manikin-based simulation versus low-fidelity manikin-based simulation in the context of an actual ACLS course. Four outcomes were measured: learning outcomes as judged by an expert rater panel reviewing videos of subjects performing a simulated cardiac arrest event immediately after the conclusion of the course, and three self-reported measures examining confidence with the course material, motivation, and affect. A convenience sample of 34 subjects self assigned to one of two ACLS classes. One class utilized high-fidelity simulation (n=16) while the other used low-fidelity simulation (n=18). While the high-fidelity simulation group had a higher composite score for the video review (M= 220.88 vs. M=193.67), this did not reach a level of significance (p=.122). On item level analysis of the scoring, 7 of 14 items reached levels of significance (p < .05). Although all items reported higher mean scores for the highfidelity simulation group, items that focused on manual tasks or actions in the first one to two minutes of the cardiac arrest event were more likely to be non-significant. Items that focused on actions that occurred later in the event or were expert rater assessments of team leader confidence and knowledge were more likely to be found significant. There was no statistical significance found in any of the self-reported measures examining confidence (p = .850), motivation (p = .899), and affect (p = .215).