Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial

Sabine Nabecker; Sören Huwendiek; Christian Seidl; Anisa Hana; Lorenz Theiler; Robert Greif

doi:10.3389/fcvm.2022.840114

Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial

Front Cardiovasc Med. 2022 Jul 15:9:840114. doi: 10.3389/fcvm.2022.840114. eCollection 2022.

Authors

Sabine Nabecker^{1

2

3

4}, Sören Huwendiek⁵, Christian Seidl⁶, Anisa Hana⁷, Lorenz Theiler⁸, Robert Greif^{1

3

9}

Affiliations

¹ Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
² Department of Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, ON, Canada.
³ ERC Research NET, Niel, Belgium.
⁴ Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland.
⁵ Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland.
⁶ EMS Rescue Service of the Canton Basel-Stadt, Basel, Switzerland.
⁷ Department of Intensive Care Medicine, Laurentius Hospital, Roermond, Netherlands.
⁸ Department of Anesthesia, Kantonsspital Aarau, Aarau, Switzerland.
⁹ School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.

Abstract

Aim: Human factors are essential for high-quality resuscitation team collaboration and are, therefore, taught in international advanced life support courses, but their assessment differs widely. In Europe, the summative life support course assessment tests mainly adhere to guidelines but few human factors. This randomized controlled simulation trial investigated instructors' and course participants' perceptions of human factors assessment after two different summative assessments.

Methods: All 5th/6th-year medical students who attended 19 advanced life support courses according to the 2015 European Resuscitation Council guidelines during one study year were invited to participate. Each course was randomized to either: (1) Simulated team assessment (one instructor simulates a team, and the assessed person leads this "team" through a cardiac-arrest scenario test); (2) Real team assessment (4 students form a team, one of them is assessed as the team leader; team members are not assessed and act only on team leader's commands). After the summative assessments, instructors, and students rated the tests' ability to assess human factors using a visual analog scale (VAS, 0 = no agreement, 10 = total agreement).

Results: A total of 227 students participated in the 1-day Immediate Life Support courses, 196 students in the 2-day Advanced Life Support courses, additionally 54 instructors were included. Instructors judged all human factors significantly better in real team assessments; students rated leadership and situational awareness comparable between both assessments. Assessment pass rates were comparable between groups.

Conclusion: Summative assessment in real teams was perceived significantly better to assess human factors. These results might influence current summative assessment practices in advanced life support courses.

Keywords: CPR; European Resuscitation Council (ERC); education; human factors; life support.

Grants and funding

This project was funded by an institutional research grant awarded to SN by the Department of Anesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. Open access funding was provided by the University of Bern.