Marshall University Graduate School of Education and Professional Development, South Charleston, West Virginia 25303, USA.
Simul Healthc. 2009 Winter;4(4):200-6. doi: 10.1097/SIH.0b013e3181b1b877.
The use of high-fidelity simulation has been studied in many healthcare education areas. However, the use of this instructional technology in the American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) course has not been extensively reported, despite this program being one of the most widely taught standardized medical courses in the United States.
This study examined high-fidelity versus low-fidelity simulation in the context of an AHA ACLS course to determine subjects' educational outcomes as judged by expert raters reviewing videos of subjects performing a simulated cardiac arrest event immediately after the conclusion of the course. A purposeful sample of 34 subjects was enrolled in one of two ACLS classes. One class used high-fidelity simulation (n = 16), whereas the other used low-fidelity simulation (n = 18).
The high-fidelity simulation group had a higher overall mean rank score on expert rater video review (M = 59.55 versus M = 44.34). This difference reached a level of statistical significance (P = 0.010, z = -2.592). On item level analysis of the instrument, 9 of 14 items reached levels of significance (P < 0.05).
Expert raters judged students in a high-fidelity simulation-based AHA ACLS course as more competent than students in a low-fidelity course. On item level analysis, items focused on manual tasks or actions in the first 1 to 2 minutes of the cardiac arrest event were more likely to be nonsignificant. As the scenario grew longer and more complex, expert rater scores of the high-fidelity trained team leaders' confidence, knowledge, and treatment decisions were higher than the low-fidelity team leaders' score at a statistically significant level.
高保真模拟已在许多医疗保健教育领域进行了研究。然而，尽管该程序是美国最广泛教授的标准化医学课程之一，但在 American Heart Association（AHA）高级心血管生命支持（ACLS）课程中使用这种教学技术的情况并未得到广泛报道。
本研究在 AHA ACLS 课程中检查了高保真与低保真模拟，以根据专家评审员在课程结束后立即对模拟心脏骤停事件进行的视频评估来确定受试者的教育成果。一项目的样本由 34 名受试者组成，他们参加了两个 ACLS 课程之一。一个班使用高保真模拟（n = 16），另一个班使用低保真模拟（n = 18）。
高保真模拟组的专家评审员视频审查总体平均排名得分更高（M = 59.55 与 M = 44.34）。这一差异达到了统计学意义（P = 0.010，z = -2.592）。在工具的项目水平分析中，14 个项目中有 9 个达到了显著性水平（P < 0.05）。
专家评审员认为高保真模拟 AHA ACLS 课程中的学生比低保真课程中的学生更有能力。在项目水平分析中，在心脏骤停事件的前 1 到 2 分钟内专注于手动任务或操作的项目更有可能没有达到显著性水平。随着场景变得更长和更复杂，高保真培训的团队领导的信心、知识和治疗决策的专家评审员得分高于低保真团队领导的得分，达到了统计学意义的水平。
