Validation for a scoring system of the ALS cardiac arrest simulation test (CASTest)

Abstract

Aim: The cardiac arrest simulation test (CASTest) assesses resuscitation knowledge and skills during a simulated cardiac arrest. The aim of this study is to validate an alternative scoring system for measuring individual candidate performance during research involving the CASTest.

Methods: The performance of 537 participants was measured using the new scoring system. Evidence of internal structure was sought by comparing the score with global rating of performance and pass/fail decision; identification of participants with instructor potential, skill tests and MCQ scores. Relationships between CASTest score, profession and seniority were also examined.

Results: Global assessment of performance identified 413 passes (76.9%) and 124 fails (23.1%). CASTest score was significantly higher in those that passed than in those that failed (median 77 vs 62.5, P<0.0001). There were no differences between professions. Senior staff performed slightly better than junior staff (median 74 and 72 respectively, P=0.01). Excellent participants (identified as having instructor potential) scored significantly higher than the other participants (median 94 and 72 respectively, P<0.0001). A strong correlation was demonstrated between domains in the CASTest (rho 0.72-0.82, P<0.01). Other assessment outcomes for the ALS course correlated poorly with CASTest scores (rho 0.27-0.37, P<0.01).

Conclusion: This new simple scoring system can be used to better characterise performance on the ALS course CASTest than the current binary pass-fail outcome.