Realistic simulation and medical students' performance in the Advanced Cardiac Life Support course: a comparative study.

Clinical practice has benefited from new methodologies such as realistic simulation (RS). RS involves recreating lifelike scenarios to more accurately reflect real clinical practice, enhancing learners' skills and decision-making within controlled environments, and experiencing remarkable growth in medical education. However, RS requires substantial financial investments and infrastructure. Hence, it is essential to determine the effectiveness of RS in the development of skills among medical students, which will improve the allocation of resources while optimizing learning. This cross-sectional study was carried out in the simulation laboratory of a medical school, and the performance of students who underwent two different curriculum matrices (without RS and with RS, from 2021 to 2022) in the Advanced Cardiac Life Support (ACLS) course was compared. This test was chosen considering that the competencies involved in cardiac life support are essential, regardless of the medical specialty, and that ACLS is a set of life-saving protocols used worldwide. We observed that the impact of RS can be different for practical abilities when compared with the theoretical ones. There was no correlation between the general academic performance and students' grades reflecting the RS impact. We conclude that RS leads to less remediation and increased competence in practical skills. RS is an important learning strategy that allows repeating, reviewing, and discussing clinical practices without exposing the patient to risks.NEW & NOTEWORTHY Realistic simulation (RS) positively affected the performance of the students differently; it had more influence on practical abilities than theoretical knowledge. No correlation between the general academic performance and grades of the students without RS or with RS was found, providing evidence that RS is an important tool in Advanced Cardiac Life Support education.

Medical Behavior in Cardiorespiratory Arrest before and After Simulation Based on Advanced Cardiac Life Support (ACLS) Course

Abstract Background: The Advanced Cardiac Life Support (ACLS) course is designed to teach cardiovascular emergency, aiming to promote a harmonious and synchronized work of the entire hospital team, making the multidisciplinary job more effective in the execution of cardiopulmonary resuscitation (CPR). Objective: To compare the effectiveness of CPR performed between physicians trained on ACLS and non-trained physicians. Methods: A questionnaire was applied to physicians working at the emergency room of hospitals in Curitiba, state of Paraná, whose resolution required theoretical and practical knowledge about CPR. For analysis, descriptive statistics and Fisher's association analysis were used, and the medians of the groups were evaluated by Mann-Whitney/Kruskal-Wallis with significance of 5%. Results: Thirty-four physicians were volunteers, of whom 20 had taken the ACLS course (Group A) and 14 had not (Group B). The trained physicians obtained the highest median (4.00 vs. 3.00, p = 0.06) of correct answers. Group A scored at least 3 of the 5 questions in the questionnaire, showing better performance than Group B (OR = 6.75, 95% CI, 1.1 < OR < 41.0, p = 0.04). The year of the course did not significantly change the performance in the questionnaire. Conclusion: It is suggested that the ACLS course was effective in qualifying physicians to handle situations of cardiorespiratory arrest properly, which was reproduced by the better performance in the resolution of the questionnaire. It is believed that when the sample of volunteers is increased, the trends found materialize the other hypotheses proposed.

Partnering for Professional Development in the Galápagos Islands.

Nurses living in the Galápagos Islands face barriers to accessing continuing professional development (CPD), particularly in their native language and appropriate for their unique island culture due to their remote location, 1,000 km off the coast of Ecuador. This article reviews the evidence on providing professional development from high-resource countries to low-resource countries; describes a case example of the process of developing, implementing, and evaluating the first professional development program targeting nurses in the Galápagos; and presents recommendations to sustain a culturally relevant international professional nursing development partnership that can be a model for nurses in other remote locations with limited educational access. [J Contin Educ Nurs. 2019;50(9):417-422.].

Impact of training in Advanced Cardiac Life Support (ACLS) in the professional career and work environment.

We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years). Longer training was associated with older age, male gender, having undergone residency training, private office, greater earnings and longer time since graduation and a lower chance to participate in providing care for a cardiac arrest. Regarding personal change, no modification was detected according to time since taking the course. The only change in the work environment was the purchase of an automated external defibrillator (AED) by those who had taken the course more than 5 years ago. In multivariable analysis, however, the implementation of an AED was not independently associated with this group, which showed a lower chance to take a new ACLS course. ACLS courses should emphasize also how physicians could reinforce the survival chain through environmental changes.

Impact of training in Advanced Cardiac Life Support (ACLS) in the professional career and work environment / Impacto da capacitação no Suporte Avançado à Vida em Cardiologia (SAVC) na carreira profissional e no ambiente de trabalho

Abstract We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years). Longer training was associated with older age, male gender, having undergone residency training, private office, greater earnings and longer time since graduation and a lower chance to participate in providing care for a cardiac arrest. Regarding personal change, no modification was detected according to time since taking the course. The only change in the work environment was the purchase of an automated external defibrillator (AED) by those who had taken the course more than 5 years ago. In multivariable analysis, however, the implementation of an AED was not independently associated with this group, which showed a lower chance to take a new ACLS course. ACLS courses should emphasize also how physicians could reinforce the survival chain through environmental changes.

Resumo Buscou-se avaliar o impacto do curso de Suporte Avançado a Vida em Cardiologia (SAVC) na carreira e no ambiente profissional de médicos formados em um centro de treinameto certificado pela American Heart Association (AHA). De 4631 estudantes (desde 1999 até 2009), 2776 foram encontrados, 657 cartas retornaram, sendo 388 excluidas da análise devido à não localização do endereço. A população final estudada foi composta por 269 participantes alocados em 3 grupos (< 3 anos, 3-5 anos e > 5 anos). Tempo maior de treinamento foi associado a sexo masculino, ter feito residência médica, de idade maior, melhores salários e mais tempo de formação, também menor chance de participar de um atendimento de parada cardíaca. No quesito mudança pessoal, nenhuma modificação foi detectada independentemente do tempo de curso. A única mudança no local de trabalho foi a implantação do desfibrilador externo automático (DEA) por aqueles que terminaram o curso há mais de 5 anos. Na análise multivariada, entretanto, a implementação de DEA não foi associada independentemente nesse grupo, que mostrou menor chance de repetir o curso. Os cursos SAVC deveriam enfatizar a forma como os médicos poderiam reforçar as mudanças no trabalho, melhorando a cadeia de sobrevida.

Characteristics of training and motivation of physicians working in emergency medicine.

INTRODUCTION:: Emergency medicine is an area in which correct decisions often need to be made fast, thus requiring a well-prepared medical team. There is little information regarding the profile of physicians working at emergency departments in Brazil. OBJECTIVE:: To describe general characteristics of training and motivation of physicians working in the emergency departments of medium and large hospitals in Salvador, Brazil. METHOD:: A cross-sectional study with standardized interviews applied to physicians who work in emergency units in 25 medium and large hospitals in Salvador. At least 75% of the professionals at each hospital were interviewed. One hospital refused to participate in the study. RESULTS:: A total of 659 physicians were interviewed, with a median age of 34 years (interquartile interval: 29-44 years), 329 (49.9%) were female and 96 (14.6%) were medical residents working at off hours. The percentage of physicians who had been trained with Basic Life Support, Advanced Cardiovascular Life Support and Advanced Trauma Life Support courses was 5.2, 18.4 and 11.0%, respectively, with a greater frequency of Advanced Cardiovascular Life Support training among younger individuals (23.6% versus 13.9%; p<0.001). Thirteen percent said they were completely satisfied with the activity, while 81.3% expressed a desire to stop working in emergency units in the next 15 years, mentioning stress levels as the main reason. CONCLUSION:: The physicians interviewed had taken few emergency immersion courses. A low motivational level was registered in physicians who work in the emergency departments of medium and large hospitals in Salvador.

Characteristics of training and motivation of physicians working in emergency medicine

Summary Introduction: Emergency medicine is an area in which correct decisions often need to be made fast, thus requiring a well-prepared medical team. There is little information regarding the profile of physicians working at emergency departments in Brazil. Objective: To describe general characteristics of training and motivation of physicians working in the emergency departments of medium and large hospitals in Salvador, Brazil. Method: A cross-sectional study with standardized interviews applied to physicians who work in emergency units in 25 medium and large hospitals in Salvador. At least 75% of the professionals at each hospital were interviewed. One hospital refused to participate in the study. Results: A total of 659 physicians were interviewed, with a median age of 34 years (interquartile interval: 29-44 years), 329 (49.9%) were female and 96 (14.6%) were medical residents working at off hours. The percentage of physicians who had been trained with Basic Life Support, Advanced Cardiovascular Life Support and Advanced Trauma Life Support courses was 5.2, 18.4 and 11.0%, respectively, with a greater frequency of Advanced Cardiovascular Life Support training among younger individuals (23.6% versus 13.9%; p<0.001). Thirteen percent said they were completely satisfied with the activity, while 81.3% expressed a desire to stop working in emergency units in the next 15 years, mentioning stress levels as the main reason. Conclusion: The physicians interviewed had taken few emergency immersion courses. A low motivational level was registered in physicians who work in the emergency departments of medium and large hospitals in Salvador.

Impact of levels of simulation fidelity on training of interns in ACLS.

AIM: Identifying the modality and fidelity of simulation that offers the greatest benefit to the learner is critical to Advanced Cardiac Life Support (ACLS) training. Our hypothesis is that participants who receive ACLS training on high-fidelity mannequins will perform better than those trained on low-fidelity mannequins. METHODS: The study was performed in the context of an ACLS Initial Provider course for new postgraduate year 1 residents and involved 3 training arms: (1) low-fidelity, (2) mid-fidelity, and (3) high-fidelity. Educational outcomes were evaluated by written scores, student evaluations of the course, and expert rater reviews of megacode performance. RESULTS: A convenience sample of 54 subjects was randomized to 1 of the 3 training arms. All 3 groups significantly improved based on written posttest scores (P < 0.0001); however, pretest to posttest improvement among the 3 training arms was not significantly different: low-fidelity = 42.3 (95% CI, 35.7-48.9); mid-fidelity = 41.3 (95% CI, 34.7-47.9); high-fidelity = 40.8 (95% CI, 34.3-47.5; P = 0.95). All participants felt the simulator environment was realistic regardless of level of fidelity. Participants in the high-fidelity group were less likely to feel comfortable in the simulator environment (P = 0.0045). Clinical performance as assessed by expert raters' megacode scores was better for high-fidelity (66.3) than mid-fidelity (60.1) (P = 0.04). CONCLUSION: Overall, there was no difference among the 3 groups in test scores or perceived instructor or course quality; however, subjects trained on high-fidelity mannequins performed better than those trained on mid-fidelity with respect to megacode performance.

Prince Edward Island: building capacity--the implementation of a critical care/emergency program.

Like other Canadian provinces, Prince Edward Island has a shortage of experienced nurses, especially in critical and emergency care. To increase the numbers of competent nurses, a PEI-based nursing course in these areas was identified as key to building capacity. This Research to Action pilot program successfully involved nurses in PEI-based emergency and critical care courses developed by the Nova Scotia Registered Nurses Professional Development Centre and funded by Human Resources and Skills Development Canada. The programs were offered on a full-time basis, lasted 14 weeks and included classroom and simulation laboratory time, along with a strong clinical component.Sixteen RNs graduated from the courses and became Advanced Cardiovascular Life Support (ACLS) certified. An additional 12 RNs were trained as preceptors. Feedback from participants indicates greater job satisfaction and increased confidence in providing patient assessments and care. Based on the program's success, the RTA partners proposed the establishment of an ongoing, PEI-based critical care and emergency nursing program utilizing 80/20 staffing models and mentorship. Their proposal was approved, with courses set to resume in January, 2012.

Using tele-education to train civilian physicians in an area of active conflict: certifying Iraqi physicians in Pediatric Advanced Life Support from the United States.

Years of violence have resulted in a lack of trained health care providers in Iraq. To address this need, International Medical Corps has implemented a national emergency care program for the country. As part of this program, we implemented via tele-education the country's first civilian course in Pediatric Advanced Life Support.

Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?

Advanced cardiac life support (ACLS) is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003) and Model 2 (N = 2085; 2003-2007). Model 2 increased practical skill activities to 75 percent of the total versus 60 percent in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85 percent in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given). Compared to Model 1, Model 2 presented odds ratios (OR) indicating better performance in the theoretical (OR = 1.34; 95 percentCI = 1.10-1.64), practical (OR = 1.19; 95 percentCI = 0.90-1.57), and combined (OR = 1.38; 95 percentCI = 1.13-1.68) outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?

Advanced cardiac life support (ACLS) is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003) and Model 2 (N = 2085; 2003-2007). Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given). Compared to Model 1, Model 2 presented odds ratios (OR) indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64), practical (OR = 1.19; 95%CI = 0.90-1.57), and combined (OR = 1.38; 95%CI = 1.13-1.68) outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

Estratégias tecnológicas de ensino associadas ao treinamento em Suporte Básico de Vida / Estrategias tecnológicas de enseñanza asociadas al entrenamiento en Soporte Básico de Vida / Technological strategies associated with training in Basic Life Support

Neste estudo objetivou-se analisar a eficácia e as vantagens do uso dos recursos tecnológicos para o ensino em Suporte Básico de Vida (SBV) por meio de revisão narrativa. Foram analisados 29 artigos publicados e indexados nas bases de dados MedLine, PubMed e LILACS que utilizaram vídeo, CD-ROM, DVD, websites e programas computacionais para o ensino em SBV. Observou-se que a utilização desses recursos pode favorecer a aquisição de conhecimento em níveis similares ou superiores aos métodos tardicionais de ensino. Dentre as vantagens observadas citam-se a redução dos custos de treinamento, a facilidade de acesso e padronização das informações.

En este estudio se tuvo como objetivo analizar la eficacia y las ventajas del uso de los recursos tecnológicos para la enseñanza del Soporte Básico de Vida (SBV) por medio de revisión narrativa. Se analizaron 29 artículos publicados e indexados en las bases de datos MedLine, PubMed y LILACS que utilizaron video, CD-ROM, DVD, websites y programas de informática para la enseñanza en SBV. Se observó que la utilización de esos recursos puede favorecer en la adquisición de conocimientos en niveles similares o superiores a los métodos tradicionales de enseñanza. Entre las ventajas observadas se citan la reducción de los costos de entrenamiento, la facilidad de acceso y patronización de las informaciones.

This study aimed to analyze the effectiveness and advantages of the use of technological resources for teaching Basic Life Support (SBV) through a narrative review. We analyzed 29 articles published and indexed in these sources: Medline, PubMed and LILACS that used video, CD-ROM, DVD, websites and computer programs for teaching SBV. It was observed that the use of these resources may favor the acquisition of knowledge at levels similar or superior to methods of traditional teaching. Among the observed advantages cited were the reduction in training costs, ease of access and standardization of information.

Educação Permanente em SBV e SAVC: impacto no conhecimento dos profissionais de enfermagem / Permanent Education in BLS and ACLS: impact on the knowledge of nursing professionals / Educación permanente en SBV y SAV: impacto en el conocimiento de los profesionales de enfermería

Fundamento: O conhecimento teórico e as habilidades práticas das equipes de Suporte Básico de Vida (SBV) e Suporte Avançado de Vida (SAV) estão entre os determinantes mais importantes das taxas de sucesso em reanimação cardiopulmonar. Objetivo: Avaliar o impacto de um programa permanente de treinamento em SBV e SAV no conhecimento dos profissionais de enfermagem. Método: Estudo de corte transversal. A população foi composta por profissionais de enfermagem de um hospital de nível terciário. Foram realizadas avaliações antes e após o treinamento. Abordaram-se pontos críticos das diretrizes do International Liaison Committee on Resuscitation (ILCOR). Resultados: Foram avaliados 213 profissionais (76 enfermeiros, 35,7 por cento; 38 auxiliares, 17,8 por cento; e 99 técnicos, 46,7 por cento). As médias na avaliação pré-curso foram estatisticamente diferentes (p<0,001) entre auxiliares (3,25), técnicos (3,96) e enfermeiros (4,69). Os profissionais solteiros e sem filhos apresentaram desempenho significativamente superior ao dos casados e com filhos (p=0,02 e 0,004 respectivamente). O nível de conhecimento pré-treinamento foi inversamente proporcional ao tempo transcorrido desde a conclusão da graduação ou curso técnico. As maiores deficiências foram relacionadas à abordagem inicial das vias aéreas, aos cuidados pós-ressuscitação e à técnica de massagem cardíaca externa. A média geral pós-curso foi 7,26. Os auxiliares alcançaram um desempenho de 131,2 por cento, os técnicos de 78,9 por cento e os enfermeiros de 85 por cento, sem diferença estatisticamente significante (p=0,43). Conclusão: O programa de treinamento permanente em SBV e SAV resultou em importante incremento no nível de conhecimento dos profissionais de enfermagem.

Background: The theoretical knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Life Support (ALS) are among the most important determining factors of the cardiopulmonary reanimation success rates. Objective: Assess the impact of a permanent training program in BLS and ALS on the knowledge of nursing professionals. Method: Cross-sectional study. Population was made of nursing professionals of a tertiary level hospital. Assessments were carried out before and after training. The critical points of the International Liaison Committee on Resuscitation (ILCOR) analysis were addressed. Results: 213 professionals were assessed (76 nurses, 35.7 percent; 38 assistants, 17.8 percent; and 99 technicians, 46.7 percent). Pre-course assessment average grades were statistically different (p<0.001) among assistants (3.25), technicians (3.96) and nurses (4.69). Single professional without kids showed performance significantly superior to married professional with kids (p=0.02 and 0.004 respectively). Pre-training level of knowledge was inversely proportional to the time elapsed since the completion of undergraduate course or technical course. Main deficiencies were related to the initial approach of airways, to post-resuscitation cares and to the external cardiac massage technique. The post-course general average grade was 7.26. Assistants achieved a performance of 131.2 percent, technicians, of 78.9 percent and the nurses, of 85 percent, with no significant statistic difference (p=0.43). Conclusion: The permanent training program in BLS and ALS resulted in important increment in the level of knowledge of nursing professionals.

Fundamento: El conocimiento teórico y las habilidades prácticas de los equipos de Soporte Básico de Vida (SBV) y Soporte Avanzado de Vida (SAV) están entre los determinantes más importantes de los índices de éxito en reanimación cardiopulmonar. Objetivo: Evaluar el impacto de un programa permanente de entrenamiento en SBV y SAV en el conocimiento de los profesionales de enfermería. Método: Estudio de corte transversal. La población estaba compuesta por profesionales de enfermería de un hospital de nivel terciario. Se realizaron evaluaciones antes y después del entrenamiento. Se abordaron puntos críticos de las directrices del International Liaison Committee on Resuscitation (ILCOR). Resultados: Se evaluaron 213 profesionales (76 enfermeros, 35,7 por ciento, 38 auxiliares, 17,8 por ciento y 99 técnicos, 46,7 por ciento). Los promedios en la evaluación previa al curso fueron estadísticamente diferentes (p<0,001) entre auxiliares (3,25), técnicos (3,96) y enfermeros (4,69). Los profesionales solteros y sin hijos presentaron desempeño significativamente superior al de los casados y con hijos (p=0,02 y 0,004 respectivamente). El nivel de conocimiento previo al entrenamiento fue inversamente proporcional al tiempo transcurrido desde la conclusión de la graduación o curso técnico. Las mayores deficiencias estaban relacionadas al abordaje inicial de las vías aéreas, a los cuidados post resucitación y a la técnica de masaje cardíaco externo. El promedio general después del curso fue 7,26. Los auxiliares alcanzaron un desempeño del 131,2 por ciento, los técnicos del 78,9 por ciento y los enfermeros del 85 por ciento, sin diferencia estadísticamente significativa (p=0,43). Conclusión: El programa de entrenamiento permanente en SBV y SAV resultó en un importante incremento en el nivel de conocimiento de los profesionales de enfermería.

Permanent Education in BLS and ACLS: impact on the knowledge of nursing professionals.

BACKGROUND: The theoretical knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Life Support (ALS) are among the most important determining factors of the cardiopulmonary reanimation success rates. OBJECTIVE: Assess the impact of a permanent training program in BLS and ALS on the knowledge of nursing professionals. METHOD: Cross-sectional study. Population was made of nursing professionals of a tertiary level hospital. Assessments were carried out before and after training. The critical points of the International Liaison Committee on Resuscitation (ILCOR) analysis were addressed. RESULTS: 213 professionals were assessed (76 nurses, 35.7%; 38 assistants, 17.8%; and 99 technicians, 46.7%). Pre-course assessment average grades were statistically different (p<0.001) among assistants (3.25), technicians (3.96) and nurses (4.69). Single professional without kids showed performance significantly superior to married professional with kids (p=0.02 and 0.004 respectively). Pre-training level of knowledge was inversely proportional to the time elapsed since the completion of undergraduate course or technical course. Main deficiencies were related to the initial approach of airways, to post-resuscitation cares and to the external cardiac massage technique. The post-course general average grade was 7.26. Assistants achieved a performance of 131.2%, technicians, of 78.9% and the nurses, of 85%, with no significant statistic difference (p=0.43). CONCLUSION: The permanent training program in BLS and ALS resulted in important increment in the level of knowledge of nursing professionals.

Influence of financial subsidy and venue on advanced cardiac life support courses, in the learning of cardiovascular emergency.

BACKGROUND: The success in learning of emergency depends on many factors that can be summarized as: student, instructors and course. OBJECTIVE: To evaluate the influence of financial subsidy and venue of course in learning cardiovascular emergency. METHODS: Data were analyzed regarding the courses of Advanced Cardiac Life Support (ACLS) in the period from December 2005 to December 2006. In agreement with the financial subsidy, they were divided in: group 1 - integral subsidy; group 2 - subsidy of 50%; and group 3 - without subsidy. As for the venue of the course, they were divided in: locality A - study in city with> 1 million inhabitants; and locality B - study in city with <1 million inhabitants. The practical and theoretical approval and the theoretical average were compared. RESULTS: 819 students participated in ACLS: 199 (24%) in group 1, 122 (15%) in 2 and 498 (61%) in 3. The practical and theoretical approval and the average in the theoretical exam were greater in group 3 than in other groups (p <0.05). Four hundred and eighty two (482) took the course in venue A (59%) and 337 (41%) in venue B. The practical approval was similar for both groups (p = 0.33), however the theoretical approval was greater in venue A (73% vs. 65% - p = 0.021 - OR = 1.44 and IC: 1.05 - 1.97). The theoretical average was greater in venue A (87.1 +/- 10.4 and 86 +/- 11, respectively p <0.05). CONCLUSION: The financial subsidy and venue of the course had influence in the theoretical and practical approval.

Influência do subsídio financeiro e do local da realização do curso de suporte avançado de vida em cardiologia, no aprendizado da emergência cardiovascular / Influence of financial subsidy and venue on advanced cardiac life support courses, in the learning of cardiovascular emergency

FUNDAMENTO: O sucesso no aprendizado da emergência depende de muitos fatores que podem ser resumidos como: aluno, instrutores e curso. OBJETIVO: Avaliar a influência do subsídio financeiro e do local da realização do curso no aprendizado da emergência cardiovascular. MÉTODOS: Analisaram-se dados referentes aos cursos de Suporte Avançado de Vida em Cardiologia (ACLS) no período de dezembro de 2005 a dezembro de 2006. De acordo com o subsídio financeiro, foram divididos em: grupo 1 - subsídio integral; grupo 2 - subsídio de 50 por cento; e grupo 3 - sem subsídio. Quanto ao local do curso, foram divididos em: local A - curso em cidade com > 1 milhão de habitantes; e local B - curso em cidade com < 1 milhão de habitantes. Compararam-se a aprovação prática e teórica e a média teórica. RESULTADOS: Participaram do ACLS 819 alunos: 199 (24 por cento) no grupo 1, 122 (15 por cento) no 2 e 498 (61 por cento) no 3. A aprovação prática e teórica e a média na prova teórica foram maiores no grupo 3 que nos demais grupos (p<0,05). Quatrocentos e oitenta e dois fizeram o curso no local A (59 por cento) e 337 (41 por cento) no local B. A aprovação prática foi semelhante para ambos os grupos (p = 0,33), entretanto a aprovação teórica foi maior no local A (73 por cento vs. 65 por cento - p = 0,021 - OR = 1,44 e IC: 1,05 - 1,97). A média teórica foi maior no local A (87,1 ± 10,4 e 86 ± 11, respectivamente p<0,05). CONCLUSÃO: O subsídio financeiro e o local da realização do curso influenciaram na aprovação teórica e prática.

BACKGROUND: The success in learning of emergency depends on many factors that can be summarized as: student, instructors and course. OBJECTIVE: To evaluate the influence of financial subsidy and venue of course in learning cardiovascular emergency. METHODS: Data were analyzed regarding the courses of Advanced Cardiac Life Support (ACLS) in the period from December 2005 to December 2006. In agreement with the financial subsidy, they were divided in: group 1 - integral subsidy; group 2 - subsidy of 50 percent; and group 3 - without subsidy. As for the venue of the course, they were divided in: locality A - study in city with> 1 million inhabitants; and locality B - study in city with <1 million inhabitants. The practical and theoretical approval and the theoretical average were compared. RESULTS: 819 students participated in ACLS: 199 (24 percent) in group 1, 122 (15 percent) in 2 and 498 (61 percent) in 3. The practical and theoretical approval and the average in the theoretical exam were greater in group 3 than in other groups (p <0.05). Four hundred and eighty two (482) took the course in venue A (59 percent) and 337 (41 percent) in venue B. The practical approval was similar for both groups (p = 0.33), however the theoretical approval was greater in venue A (73 percent vs. 65 percent - p = 0.021 - OR = 1.44 and IC: 1.05 - 1.97). The theoretical average was greater in venue A (87.1 ± 10.4 and 86 ± 11, respectively p <0.05). CONCLUSION: The financial subsidy and venue of the course had influence in the theoretical and practical approval.

Capacitação em suporte básico de vida em um hospital universitário / Basic life support training in a university hospital

Introdução: A ressuscitação cardiopulmonar (RCP) precoce depende da disponibilidade e da funcionalidade do equipamento de reanimação, que deve estar pronto para uso imediato, além do treinamento da equipe, o que pode ser feito através dos cursos em Suporte Básico de Vida (SBV) e Suporte Avançado de Vida (SAV). Objetivo: Capacitar profissionais e acadêmicos da área de saúde em SBV. Metodologia: Curso teórico-prático com simulação em manequins. Realização de pré e pós-teste, comparando-se os resultados. Resultados: Foram treinadas 348 pessoas do Hospital Escola (HE) da UFPel. O número de acertos no pré-teste variou entre 55 e 65% (média de 63%) e no pós-teste variou entre 75 e 93% (média de 84%), portanto um acréscimo de 21% nos acertos. Conclusão: O treinamento qualificou os profissionais e acadêmicos que atuam no HE no atendimento em vítimas de parada cardiorrespiratória (AU)

Introduction: The precocious cardiopulmonary resuscitation (CPR) depends on avaliability and functionality of the reanimation equipment, which must be ready for immediate use, and on the training of the team, which can be made through the Basic Life Support (BLS) and Advanced Life Support (ALS) courses. Objective: enable the health professionals and medical students in BLS. Methodology: Theoretical-practical course with simulations in mannequins. Pre and post-test were done and the results before and after the course were compared. Results: 348 people from Medical School Hospital (MSH) were trained. The correct answers percentage in the pre-test was from 55 to 65% (avarage was 63%) and in the post-test was from 75 to 93% (avarage was 84%), there was a 21% increase in the percentage of correct answers. Conclusion: The training qualified health professionals and medical studentes, who work in MSH, in charge of CPR (AU)

Advanced Cardiac Life Support Courses: live actors do not improve training results compared with conventional manikins.

PRIMARY OBJECTIVE: To determine whether using live actors to increase the reality of the scenario improves knowledge retention in Advanced Cardiac Life Support (ACLS) Courses. MAIN SECONDARY OBJECTIVES: To determine the effects of age, time since graduation from nursing or medicine, sex, medical specialty, and workplace in knowledge retention. METHODS: From December 2004 to October 2005, 19 selected ACLS courses were divided at random in two groups: group A (ACLS courses with conventional manikins plus live actors) and group B (ACLS courses with conventional manikins). The live actors vocalized appropriately to create more realistic scenarios. The participants' relevant theoretical knowledge was assessed before the course (pre-test), immediately after the course (post-test), and 6 months after the course (final-test). RESULTS: Four hundred and thirty-five participants were recruited and allocated at random allocated to either group A or B. Overall, the data of 225 participants (51.7%; 111 in group A and 114 in group B) who completed the entire sequence of pre-, post-, and final-tests were analysed. On univariate analysis, the use of live actors, workplace, gender, and healthcare provider profession did not affect pre-, post-, and final-test results (p>0.1). The results in all three tests correlated negatively with time since medical or nursing graduation (95% C.I. -0.53 to -0.17, -0.43 to -0.2, and -0.42 to -0.11, respectively, p<0.05) and age (and 95% C.I. -0.56 to -0.21, -0.42 to -0.2, and -0.38 to -0.07, respectively, p<0.05). CONCLUSION: The use of live actors did not affect knowledge retention in this group. Older age and a longer period since graduation were associated with the worst scores and the lowest levels of knowledge retention.

Advanced cardiac life support training improves long-term survival from in-hospital cardiac arrest.

CONTEXT: Advanced cardiac life support (ACLS) training was introduced to bring order and a systematic approach to the treatment of cardiac arrest by professional responders. In spite of the wide dissemination of ACLS training, it has been difficult to demonstrate improved outcome following such training. OBJECTIVE: To determine the value of formal ACLS training in improving survival from in-hospital cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS: A multi-center, prospective cohort study examined patient outcomes after resuscitation efforts by in-hospital rescue teams with and without ACLS-trained personnel. A total of 156 patients, experiencing 172 in-hospital cardiopulmonary arrest events over a 38-month period (January 1998 to March 2001) were studied. MAIN OUTCOME MEASURES: Primary endpoints included return of spontaneous circulation (ROSC), survival to hospital discharge, 30-day survival, and 1-year survival. RESULTS: The immediate success of resuscitation efforts for all patients was 39.7% (62/156). There was a significant increase in ROSC with ACLS-trained personnel (49/113; 43.4%) versus no ALCS-trained personnel (16/59; 27.1%; p=0.04). Likewise, patients treated by ACLS-trained personnel had increased survival to hospital discharge (26/82; 31.7% versus 7/34; 20.6%; p=0.23), significantly better 30-day survival (22/82; 26.8% versus 2/34; 5.9%; p<0.02), and significantly improved 1-year survival (18/82; 21.9% versus 0/34; 0%; p<0.002). CONCLUSION: The presence of at least one ACLS-trained team member at in-hospital resuscitation efforts increases both short and long-term survival following cardiac arrest.