Prospective randomized controlled trial of computer simulation versus high-fidelity mannequin simulation in advanced cardiovascular life support (ACLS) training for anesthesiology novice clinicians.

Abstract

Background: Traditionally, cardiopulmonary resuscitation (CPR) and advanced cardiovascular life support (ACLS) training programs have relied heavily on paper-based instructional materials and multimedia theoretical presentations. This study conducts the inaugural comparative analysis of the effectiveness of high-fidelity mannequin simulators versus computer simulators in ACLS training for anesthesiology novice clinicians. Additionally, it aims to identify an optimal training cycle for ACLS.

Methods: This prospective randomized controlled study included 62 participants, 30 first-year residents and 32 interns from 2020-2021, who were randomly divided into three groups: the computer simulator group (Group C), the high-fidelity mannequin group (Group M), and the combined computer-mannequin group (Group SM). Baseline (T0) and immediate post-training (T1) assessments were performed, covering technical skills, non-technical skills, and self-confidence and satisfaction. Group performance, CPR initiation time, and defibrillation time were analyzed. Follow-up assessments were conducted at 1, 3, 6, and 12 months (T2-T5) to identify the optimal ACLS training interval.

Results: Groups C, M, and SM showed significant improvements in technical skills at T1 versus T0 (P < 0.05), with higher megacode scores and reduced times to initiate CPR and defibrillation at T1 (all P < 0.05); no significant differences were observed among the three groups (all P > 0.05). Non-technical skill scores in all groups improved significantly at T1 compared to T0 (P < 0.05), and Groups M and SM had generally higher overall non-technical skill scores than Group C (P < 0.05). For self-confidence and satisfaction, Groups M and SM scored higher than Group C in "this mode can stimulate my interest" (P < 0.05). Temporal trends of technical and non-technical skills varied among groups, but all indicated a consistent decline at T5, indicating reduced memory retention.

Conclusion: Both computer simulator training and high-fidelity mannequin-based scenario simulation effectively improve novice clinicians' ACLS technical and non-technical skills, though scenario simulation is more advantageous for enhancing non-technical skills. Thus, computers can complement scenario simulators in ACLS training. ACLS training effectiveness appears to decline over time, with notable reductions in knowledge retention and test scores observed at 12 months, which supports the necessity of annual retraining.

Trial registration: The study was retrospectively registered at the ClinicalTrials.gov(NCT05001659) on June 23, 2021.