Physicians in Training and Critical Care Nurses Performance in Medical Code Events: Effect of Simulation-Based Training

METHODS:

Subjects:

All internal medicine (IM), emergency medicine (EM), anesthesia (A), surgery (S) residents and all hospital ICU nurses (approximately 400 subjects) will be undergoing evaluation and training in CPR techniques according to their department training policy.

Study Assessment Tool:

An objective assessment tool has been developed and tested in medical code scenarios during training sessions recently done in the simulation lab. The tool has five domains: Airway, Breathing, Circulation, Communications/Leadership, and Defibrillation. Each domain consists of 3-8 tasks and skills (attachment A).

Design:

• Phase I: In groups of five to six subjects, residents and nurses will undergo baseline assessment in CPR techniques in the simulation lab. Subject will be presented with a clinical scenario that includes cardiopulmonary arrest. Subjects will be scored by observers based on the previously described assessment tool and will be video recorded.
• Phase II: All study subjects who completed phase I assessment will undergo standardized debriefing and demonstration of proper CPR techniques after reviewing their individual baseline videotape followed by repeated demonstration in CPR techniques during a clinical scenario with cardiopulmonary arrest in the simulation lab. Knowledge retention will be assessed periodically.
• Phase III: Rates of survival to hospital discharge and survival at 24 hours in hospitalized patients after cardiopulmonary arrest collected by the CPR committee and QA department longitudinally for one year after completion of project training (phase II) will be reviewed and compared to the same period one year earlier (CPR outcome data are being collected since 2005 at St. Luke's-Roosevelt Hospitals).

Study Overview

• Status: Completed
• Conditions: Ventricular Fibrillation
• Intervention / Treatment: Behavioral: Simulation-Based Training

• Study Type: Interventional
• Enrollment (Actual): 157
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • NYC, New York, United States, 10019
      • St. Luke's Roosevelt Roosevelt

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Physicians in training and nurses

Exclusion Criteria:

• Physicians in training and nurses refusing to have their data included in final analysis

Study Plan

How is the study designed?

Design Details

• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
OTHER: Physicians; Physician in training: All internal medicine (IM), emergency medicine (EM), anesthesia (A), surgery (S) residents and all hospital ICU nurses.	Behavioral: Simulation-Based Training; An objective assessment tool has been developed and tested in medical code scenarios during training sessions recently done in the simulation lab. The tool has five domains: Airway, Breathing, Circulation, Communications/Leadership, and Defibrillation. Each domain consists of 3-8 tasks and skills.
OTHER: Nurses; Nurses in Training	Behavioral: Simulation-Based Training; An objective assessment tool has been developed and tested in medical code scenarios during training sessions recently done in the simulation lab. The tool has five domains: Airway, Breathing, Circulation, Communications/Leadership, and Defibrillation. Each domain consists of 3-8 tasks and skills.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance scale	Change in performance scale at 1 year as compared to baseline	Baseline and 1 year
Rates of survival	Rates of survival to hospital discharge after cardiopulmonary arrest one year after completion of the simulation based training in CPR	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survey questionnaire	Change in survey questionnaire score at 1 year as compared to baseline. The questionnaire consists of 4 parts, including: adequacy of training, sense of preparedness, supervision and feedback, and general information. With the exception of the section on general information, responses are scored on a 5 point Likert scale.	Baseline and 1 year
Perceptions of preparedness	Change in perceptions of preparedness at 1 year as compared to baseline. The method of assessment for this outcome measure is the Likert Scale	Baseline and 1 year

Collaborators and Investigators

• Sponsor: St. Luke's-Roosevelt Hospital Center

Study record dates

Study Major Dates

• Study Start: June 1, 2012
• Primary Completion (ACTUAL): December 1, 2014
• Study Completion (ACTUAL): December 1, 2014

Study Registration Dates

• First Submitted: May 10, 2011
• First Submitted That Met QC Criteria: March 11, 2016
• First Posted (ESTIMATE): March 14, 2016

Study Record Updates

• Last Update Posted (ESTIMATE): March 14, 2016
• Last Update Submitted That Met QC Criteria: March 11, 2016
• Last Verified: March 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Heart Diseases; Cardiovascular Diseases; Arrhythmias, Cardiac; Ventricular Fibrillation
• Other Study ID Numbers: 10-080; MCT STUDY (OTHER_GRANT: NEW YORK STATE ECRIP 2009)