Samuel DeMaria1, Eric R Silverman2, Kyle A B Lapidus1, Christian H Williams3, John Spivack4, Adam Levine1, Andrew Goldberg1. 1. a Department of Anesthesiology , Icahn School of Medicine at Mount Sinai , New York , NY , USA ; 2. b Department of Anesthesiology , Montefiore Medical Center , New York , NY , USA ; 3. c Department of Psychiatry , Icahn School of Medicine at Mount Sinai , New York , NY , USA. 4. d Department of Population Health Science and Policy , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
Abstract
INTRODUCTION: There is considerable controversy as to whether the simulator should die during high-fidelity simulation (HFS). We sought to describe the physiologic and biochemical stress response induced by simulated patient death as well as the impact on long-term retention of Advanced Cardiovascular Life Support (ACLS) knowledge and skills. METHODS:Twenty-six subjects received an American Heart Association (AHA) ACLS provider course. Following the course, subjects participated in HFS and were randomized to simulated death or survival. Heart rate and salivary cortisol (SC) and dihydroepiandrosterone (DHEA) were collected at this time. Subjects returned six months later for a follow-up simulation in which ACLS knowledge and skills were tested. RESULTS: For all participants, there was an increase in heart rate during simulation compared with baseline heart rate (+ 32 beats/minute), p < 0.0001. Similarly, SC and DHEA were higher compared with baseline levels (+ 0.115 μg/dL, p <0.01 and + 97 pg/mL, p < 0.001, respectively). However, the only statistically significant difference between groups was an increase in heart rate response at the end of the simulation compared with baseline in the death group (+ 29.2 beats/minute versus + 18.5 beats/minute), p < 0.05. There was no difference on long-term knowledge or skills. CONCLUSIONS: Learners experience stress during high-fidelity simulation; however, there does not appear to be a readily detectable difference or negative response to a simulated patient death compared with simulated survival.
RCT Entities:
INTRODUCTION: There is considerable controversy as to whether the simulator should die during high-fidelity simulation (HFS). We sought to describe the physiologic and biochemical stress response induced by simulated patientdeath as well as the impact on long-term retention of Advanced Cardiovascular Life Support (ACLS) knowledge and skills. METHODS: Twenty-six subjects received an American Heart Association (AHA) ACLS provider course. Following the course, subjects participated in HFS and were randomized to simulated death or survival. Heart rate and salivary cortisol (SC) and dihydroepiandrosterone (DHEA) were collected at this time. Subjects returned six months later for a follow-up simulation in which ACLS knowledge and skills were tested. RESULTS: For all participants, there was an increase in heart rate during simulation compared with baseline heart rate (+ 32 beats/minute), p < 0.0001. Similarly, SC and DHEA were higher compared with baseline levels (+ 0.115 μg/dL, p <0.01 and + 97 pg/mL, p < 0.001, respectively). However, the only statistically significant difference between groups was an increase in heart rate response at the end of the simulation compared with baseline in the death group (+ 29.2 beats/minute versus + 18.5 beats/minute), p < 0.05. There was no difference on long-term knowledge or skills. CONCLUSIONS: Learners experience stress during high-fidelity simulation; however, there does not appear to be a readily detectable difference or negative response to a simulated patientdeath compared with simulated survival.
Authors: David Fernández-Ayuso; Rosa Fernández-Ayuso; Cristino Del-Campo-Cazallas; José Luis Pérez-Olmo; Borja Matías-Pompa; Josué Fernández-Carnero; Cesar Calvo-Lobo Journal: JMIR Serious Games Date: 2018-08-15 Impact factor: 4.143