From the Division of Critical Care (S.S.R., N.M.T., S.L.G., V.G., C.R.), Department of Pediatrics, University of Alabama at Birmingham; Pediatric Simulation Center (C.N., J.L.Z.), Children's of Alabama; and Department of Biostatistics (Y.X.), University of Alabama at Birmingham, Birmingham, AL.
Simul Healthc. 2021 Dec 1;16(6):e168-e175. doi: 10.1097/SIH.0000000000000538.
The impact of booster training on pediatric resuscitation skills is not well understood. Rapid cycle deliberate practice (RCDP) to supplement pediatric advanced life support (PALS) training is beginning to be used to improve resuscitation skills. We tested the impact of booster RCDP training performed at 9 months after initial RCDP training on pediatric resuscitation skills of pediatric residents.
This study evaluated the impact of a 9-month RCDP booster training on PALS skills compared with usual practice debriefing (plus/delta) after an initial RCDP training session for PALS-certified pediatric interns.
All pediatric interns at a single institution were invited to a 45-minute RCDP training session after their initial PALS certification. The PALS performance score and times for key events were recorded for participants immediately before and after the RCDP training as well as 6, 9, and 12 months after the RCDP training. Learners were randomized to an RCDP intervention and usual practice (plus/delta) group. The intervention group received booster RCDP training after their 9-month assessment.
Twenty eight of 30 residents participated in the initial training with 22 completing randomization at 9 months. There was no significant difference in 12-month PALS median performance scores after the booster training between the intervention and usual practice groups (83% vs. 94%, P = 0.31). There was significant improvement in PALS performance score from 51 ± 27% pre-initial RCDP assessment to 93 ± 5% post-initial RCDP training (P < 0.001). There were significant improvements in individual skills from pre- to post-initial RCDP testing, including time to verbalize pulseless, start compressions, and attach defibrillation pads (P < 0.001).
Rapid cycle deliberate practice booster training versus plus/delta training at 9-month post-initial RCDP training did not alter 12-month performance. However, RCDP is effective at improving PALS performance skills, and this effect is maintained at 6, 9, and 12 months. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.
强化培训对儿科复苏技能的影响尚不清楚。快速循环刻意练习（RCDP）补充儿科高级生命支持（PALS）培训开始被用于提高复苏技能。我们测试了在初始 RCDP 培训后 9 个月进行强化 RCDP 培训对儿科住院医师儿科复苏技能的影响。
本研究评估了与初始 RCDP 培训后常规实践（附加/减）相比，9 个月 RCDP 强化培训对 PALS 认证儿科住院医师的 PALS 技能的影响。
邀请一家机构的所有儿科住院医师参加 45 分钟的 RCDP 培训，在他们完成初始 PALS 认证后。在 RCDP 培训前后以及 RCDP 培训后 6、9 和 12 个月，记录参与者的 PALS 表现评分和关键事件的时间。学习者被随机分配到 RCDP 干预组和常规实践（附加/减）组。干预组在 9 个月评估后接受强化 RCDP 培训。
30 名住院医师中有 28 名参加了初始培训，其中 22 名在 9 个月时完成了随机分组。强化培训后 12 个月干预组和常规实践组的 PALS 中位数表现评分无显著差异（83%比 94%，P = 0.31）。从初始 RCDP 评估前的 51 ± 27%到初始 RCDP 培训后的 93 ± 5%，PALS 表现评分显著提高（P < 0.001）。从初始 RCDP 测试前到后，单个技能都有显著提高，包括口头宣布无脉搏、开始按压和连接除颤片的时间（P < 0.001）。
与初始 RCDP 培训后 9 个月的附加/减训练相比，快速循环刻意练习强化训练并未改变 12 个月的表现。然而，RCDP 能有效提高 PALS 表现技能，这种效果在 6、9 和 12 个月时保持。我们的研究支持在传统的 PALS 课程之外进行补充复苏培训的重要性。
