Adult Non-trauma Cardiac Arrest Resuscitation, Effectiveness of In-situ Simulation (ISS) Training, Effectiveness of Off-site Simulation (OSS) Training, Improvement of Teamwork in Emergency Care Settings
Conditions
Keywords
In-situ Simulation, Teamwork, Resuscitation, Interprofessional Training, TEAM Scale
Brief summary
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.
Interventions
OTHERIn-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.
OTHEROff-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.
Sponsors
National Taiwan University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Non-Technical Skills Evaluation Using the TEAM Scale | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Key Resuscitation Interventions | 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. |
| CPR Quality - Chest Compression Fraction (CCF) | 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. |
| Patient Outcomes - Rate of Return of Spontaneous Circulation (ROSC) | 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. |
Countries
Taiwan
Contacts
CONTACTLiang-wei Wang
Outcome results
None listed