Effectiveness of In-Situ Simulation Training in Adult Non-Trauma Resuscitation: A Comparison of ISS and OSS Team Performance Using the A-C-L-S Model

January 13, 2026 updated by: National Taiwan University Hospital

Effectiveness of In Situ and Off-site Simulation on A-C-L-S Teamwork Model Implementation for Adult Non-trauma Resuscitation: A Two-group Pre-post Study

This study employed a two-group non-randomized pre-post design to evaluate the effectiveness of interprofessional ISS training over one year at the National Taiwan University Hospital Yunlin Branch. The research implements the A-C-L-S teamwork model for adult non-trauma resuscitation teams, comparing the impacts of ISS versus Off-site Simulation (OSS) on team performance. Emergency department teams are assigned between two campuses: ISS at Douliu campus and OSS at Huwei campus. Each training session follows a standardized protocol: twenty-minute briefing, ten-minute high-fidelity simulation, and thirty-minute structured debriefing. The assessment utilizes the Team Emergency Assessment Measure (TEAM) scale for non-technical skills evaluation, alongside secondary outcomes including resuscitation process, CPR quality, and patient outcome indicators. External ACLS instructor-qualified experts conduct blinded evaluations of recorded scenarios to analyze team performance and training transfer. The study aims to deliver benefits across three dimensions: establishing evidence-based education models to enhance resuscitation team efficiency and patient outcomes; strengthening institutional teaching and research capacity through standardized assessment mechanisms; and developing systematic data collection processes with localized quality indicators for early error detection and improvement.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Taiwan
    • Yunlin
      • Douliu, Yunlin, Taiwan, 64047
        • Recruiting
        • National Taiwan University Hospital Yunlin Branch (Douliu)
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

The Adult Non-Traumatic Resuscitation Teams in the emergency departments of the Douliu and Huwei (branches consist of approximately 2 to 7 healthcare professionals per team). The healthcare professionals include attending physicians, resident physicians, specialized nurses, and registered nurses from the National Taiwan University Hospital system.

Exclusion Criteria:

  1. Medical students and emergency medical technicians (EMTs) observing resuscitation in the emergency room.
  2. Healthcare professionals who have not obtained a valid ACLS certification.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: In-situ Simulation (ISS) Group
Other: In-situ Simulation (ISS) Training
The ISS group will undergo high-fidelity simulation training conducted in a real clinical environment, such as the emergency department. This training will involve a structured scenario with a briefing (20 minutes), a simulation exercise (10 minutes), and a debriefing session (30 minutes). The goal is to enhance teamwork and improve non-technical skills (e.g., communication, coordination) during adult non-trauma cardiac arrest resuscitation. The training follows the A-C-L-S (Airway-Circulation-Leadership-Support) model for team role structuring.
Active Comparator: Off-site Simulation (OSS) Group
Other: Off-site Simulation (OSS) Training
The OSS group will participate in simulation training at a dedicated simulation center, using high-fidelity mannequins and equipment. Similar to the ISS group, the training involves a briefing (20 minutes), a simulation scenario (10 minutes), and a debriefing (30 minutes). However, this training is conducted in a controlled environment away from the real clinical setting. The training follows the same A-C-L-S model for team role structuring and focuses on improving teamwork and technical skills for resuscitation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Non-Technical Skills Evaluation Using the TEAM Scale
Time Frame: Through study completion, an average of 1 year
The Team Emergency Assessment Measure (TEAM) scale will be used to evaluate non-technical skills. The scale consists of 11 items across three categories (leadership, teamwork, and task management) and a global rating. Total scores range from 0 to 44, where higher scores represent better team performance and non-technical skills.
Through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Key Resuscitation Interventions
Time Frame: Through study completion, an average of 1 year.

This measure assesses the efficiency of the ACLS team. We will measure the time intervals (in seconds/minutes) for critical steps, including:

  1. Time to initial pulse and rhythm assessment.
  2. Time to first shock (for shockable rhythm).
  3. Time to first adrenaline (for non-shockable rhythm).
  4. Time to endotracheal intubation completion.
  5. Time to established EtCO2 monitoring.
  6. Time to first ultrasound exam.
Through study completion, an average of 1 year.
CPR Quality - Chest Compression Fraction (CCF)
Time Frame: Through study completion, an average of 1 year.
The Chest Compression Fraction (CCF) is defined as the proportion of total resuscitation time during which active chest compressions are performed. It is calculated by dividing the total chest compression time by the total duration of the resuscitation event. This indicator is used to evaluate the resuscitation team's ability to minimize interruptions during cardiopulmonary resuscitation (CPR). Data will be collected through systematic observation and analysis of resuscitation performance during both in-situ and off-site simulation training, as well as actual clinical events, to assess the effectiveness of the A-C-L-S teamwork model.
Through study completion, an average of 1 year.
Patient Outcomes - Rate of Return of Spontaneous Circulation (ROSC)
Time Frame: Through study completion, an average of 1 year.
The percentage of patients achieving Return of Spontaneous Circulation (ROSC) after cardiac arrest. ROSC is defined as the restoration of a palpable pulse and measurable blood pressure during the resuscitation process. This measure evaluates the clinical outcome of the A-C-L-S teamwork model. Data collection includes comprehensive analysis of patient outcomes and factors influencing resuscitation success, such as initial cardiac rhythm, cause of arrest, and pre-hospital interventions, to assess the overall effectiveness of the simulation training.
Through study completion, an average of 1 year.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

January 2, 2026

First Submitted That Met QC Criteria

January 13, 2026

First Posted (Actual)

January 22, 2026

Study Record Updates

Last Update Posted (Actual)

January 22, 2026

Last Update Submitted That Met QC Criteria

January 13, 2026

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 202510146RIND

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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