J Educ Eval Health Prof.  2016;13:25. 10.3352/jeehp.2016.13.25.

Impact of a novel, resource appropriate resuscitation curriculum on Nicaraguan resident physician's management of cardiac arrest

Affiliations
  • 1Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA. btaira@ucla.edu
  • 2Department of Emergency Medicine, Stony Brook University, Stony Brook, New York, USA.
  • 3Department of Medicine Statistics Core, UCLA, Los Angeles, California, USA.
  • 4Department of Anesthesia, Universidad Nacional Autónoma de Nicaragua, León, Nicaragua.

Abstract

PURPOSE
Project Strengthening Emergency Medicine, Investing in Learners in Latin America (SEMILLA) created a novel, language and resource appropriate course for the resuscitation of cardiac arrest for Nicaraguan resident physicians. We hypothesized that participation in the Project SEMILLA resuscitation program would significantly improve the physician's management of simulated code scenarios.
METHODS
Thirteen Nicaraguan resident physicians were evaluated while managing simulated cardiac arrest scenarios before, immediately, and at 6 months after participating in the Project SEMILLA resuscitation program. This project was completed in 2014 in Leon, Nicaragua. The Cardiac Arrest Simulation Test (CASTest), a validated scoring system, was used to evaluate performance on a standardized simulated cardiac arrest scenario. Mixed effect logistic regression models were constructed to assess outcomes.
RESULTS
On the pre-course simulation exam, only 7.7% of subjects passed the test. Immediately post-course, the subjects achieved a 30.8% pass rate and at 6 months after the course, the pass rate was 46.2%. Compared with pre-test scores, the odds of passing the CASTest at 6 months after the course were 21.7 times higher (95% CI 4.2 to 112.8, P<0.001). Statistically significant improvement was also seen on the number of critical items completed (OR=3.75, 95% CI 2.71-5.19), total items completed (OR=4.55, 95% CI 3.4-6.11), and number of "excellent" scores on a Likert scale (OR=2.66, 95% CI 1.85-3.81).
CONCLUSIONS
Nicaraguan resident physicians demonstrate improved ability to manage simulated cardiac arrest scenarios after participation in the Project SEMILLA resuscitation course and retain these skills.

Keyword

Emergency medicine; Heart arrest; Logistic models; Nicaragua; Resuscitation

MeSH Terms

Curriculum*
Emergency Medicine
Heart Arrest*
Latin America
Logistic Models
Nicaragua
Resuscitation*

Reference

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