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New ALERT - PALS-on-Demand in Skill Training

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Jang HY (CHOP), Nadkarni V, Nishisaki A, Niles D

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New ALERT - PALS-on-Demand in Skill Training

  1. 1. ALERT Presentation: Skill training with Peds-RQI cart for two-person BLS with an instructor versus without an instructor Hye-Young Jang, Vinay Nadkarni, Akira Nishisaki, Dana Niles The Center for Simulation, Advanced Education and Innovation at The Children’s Hospital of Philadelphia INSPIRE @ IMSH 2016 – San Diego, CA / USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. • “High-quality CPR” is essential and emphasized in Guidelines • CPR skill acquisition is incomplete, and skill retention decays within 3 to 6 months after training (Ref: Smith et al. Resuscitation 2008) • Real time feedback and Just-in-Time refresher training can improve skill performance on patients (Ref: Niles et al. Resuscitation 2009, Wolfe et al. Pediatr Emerg Care 2015) International Network for Simulation-based Pediatric Innovation, Research and Education Background
  3. 3. • The RQI cart is developed for frequent training and assessment of BLS skills. • The AHA RQI program – Provides convenient and regular training – Uses real-time feedback and summative assessment (e.g. Competence, Excellence) – Tracks individual participant performance • Two-person BLS skill training and assessment using the P-RQI cart WITHOUT AN INSTRUCTOR has not been tested. International Network for Simulation-based Pediatric Innovation, Research and Education Background
  4. 4. Objective: To evaluate the efficacy of Peds-RQI cart two-person CPR training with vs without instructors/facilitators Hypotheses: 1) BLS skill performance scores for providers trained every 2 months using the Peds-RQI cart WITHOUT an instructor will not be inferior to those trained WITH an instructor (Non-inferiority design) 2) The proportion of healthcare providers meeting BLS skill performance score criteria for EXCELLENCE will be smaller for those trained WITHOUT an instructor than WITH an instructor (Inferiority design) International Network for Simulation-based Pediatric Innovation, Research and Education Objective and Hypotheses
  5. 5. International Network for Simulation-based Pediatric Innovation, Research and Education PICO / Research Question Current BLS-certified providers at CHOP Two-person BLS refreshers with P-RQI cart with an instructor Two-person BLS refreshers with P-RQI cart without an instructor Skill competency and excellence for two-person BLS at 9 months P I C O
  6. 6. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design Time 0  Baseline assessment for two-person BLS skill performance  Block randomization  Orientation to the Peds-RQI cart for two-person BLS training  Initial training on two-person BLS with P-RQI cart with feedback 1 week later 3 months later  Skill test for two-person BLS with P-RQI cart  Booster training with P-RQI cart with feedback 3 months later  Skill test for two-person BLS with P-RQI cart  2nd Booster training with P-RQI cart with feedback 3 months later  Final evaluation of skill competence/excellence in two-person BLS
  7. 7. • ALERT Presentation – January 2016 • IRB Submission – Spring 2016 • Recruitment / Data Collection – Fall 2016 • Data Analysis – Late fall 2016 • Abstract Presentation – Late 2016/Early 2017 (IMSH?) • Manuscript Preparation – Early 2017 International Network for Simulation-based Pediatric Innovation, Research and Education Timeline
  8. 8. 1. Should I randomize first before beginning of training or do I need to block randomize participants after baseline skill assessment? 2. How can we get standardization of instructions during study to avoid bias? 3. How many episodes of refreshers before test do I need to show the difference of the skill competency/excellence between two study groups? International Network for Simulation-based Pediatric Innovation, Research and Education 3 questions to improve study
  9. 9. At INSPIRE @ IMSH 2016: Refine study protocol In 2 months: Complete IRB submission Pilot and refine assessment tools International Network for Simulation-based Pediatric Innovation, Research and Education Goals to accomplish
  10. 10. Hye-Young Jang, MD, PhD The Center for Simulation, Advanced Education and Innovation at CHOP JANGH@email.chop.edu Akira Nishisaki, MD, MSCE The Center for Simulation, Advanced Education and Innovation at CHOP Nishisaki@email.chop.edu Vinay Nadkarni, MD The Center for Simulation, Advanced Education and Innovation at CHOP Nadkarni@email.chop.edu International Network for Simulation-based Pediatric Innovation, Research and Education Contact Information

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