The Effect of a Simulation-Based Training on the Performance of ACLS and Trauma Team of 5-Year Medical Students

Abstract

Objective 56 5-year medical students without Advanced Cardiovascular Life Support (ACLS) and trauma management learning experience were took as the research object, to compare the efficacy of a simulation- based course versus a video plus case-based learning course in medical students on ACLS and trauma management. Methods This is a self-controlled randomized crossover study design with blinded assessors carried out in a university simulation center and using a high -fidelity patient simulator. Two hour simulation course or video plus case-based learning (CBL) course were taken after the theory course. The students undertook a theory test before and after the training. ACLS and trauma management skills assessment and teamwork behavior evaluation were made before and after the simulation course or video plus case-based learning course in pre- and post-assessment scenarios. Results We demonstrated significant improvements in scores after the simulation training for the theoretical examinations, the practical skills and the team cooperation ability. There was significant difference of improvements between simulation group and CBL group except for overall teamwork behavior in trauma teamwork. Conclusion Simulation-based learning or video plus case-based learning also seemed to be an effective teaching strategy. A simulation-based learning for emergency team training in medical students can improve practical ability and teamwork more.

Appendix 25.1

Team behavioral rater
1. A leader was clearly established
2. The leader’s plan for treatment was communicated to the team
3. Priorities and orders of actions were communicated to the team
4. The team leader showed an appropriate balance between authority and openness to suggestion
5. The team leader was able to maintain an overview of the situation
6. Plans were adapted when the situation changed
7. Each team member had a clear role
8. Instructions and verbal communication was explicit and directed
9. Team members repeated back or paraphrased instructions and clarifications
10. When directions were unclear, team members asked for repetition and clarification
11. Team members shared situation assessment information
12. Team members asked each other for assistance before or during periods of task overload
13. Team members offered assistance when other team members became task overloaded
14. Team members verbalized important clinical interventions (e.g., I am giving adrenaline)
15. Task implementation was well coordinated
16. Team members referred to written aids appropriately
17. The team sourced external assistance when appropriate
18. Team members called attention to potentially hazardous actions or omissions
19. Individual team members reacted appropriately when other team members pointed out their potential errors or mistakes
20. When statements directed at avoiding or containing potential hazards, did not elicit a response, team members persisted in seeking a response, or took action
21. Disagreements or conflicts impaired team performance
22. The team became fixated on an isolated indicator or occurrence to the exclusion of other important aspects of care
23. Team members made inappropriate assumptions about the capabilities or actions of other team members
24. Overall behavioral performance