Simulation for teaching cardiorespiratory resuscitation by teams: setting and performance assessment

Santos, Emílio Carlos Alves dos; Fontes, Cor Jesus Fernandes; D’Artibale, Eloana Ferreira; Miravete, Jocilene de Carvalho; Ferreira, Gimerson Erick; Ribeiro, Mara Regina Rosa

doi:10.1590/1518-8345.3932.3406

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 29 • 2021 • https://doi.org/10.1590/1518-8345.3932.3406 copy

Simulation for teaching cardiorespiratory resuscitation by teams: setting and performance assessment^* * Paper extracted from master’s thesis “Realistic simulation as a teaching-learning methodology in training of the cardiorespiratory rehabilitation protocol of a university hospital”, presented to Universidade Federal de Mato Grosso, Hospital Universitário Júlio Muller, Cuiabá, MT, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to evaluate the acquisition of cognitive knowledge in cardiorespiratory resuscitation through training mediated by health simulation and to verify satisfaction with the teaching methodology design.

Method:

a study of quasi-experimental intervention, of the before and after type, with only one group. Population composed of medical students in the internship phase, nurses and resident physicians, nursing technicians and nurses of the institution’s effective staff. Convenience sampling consisting of 91 participants. Data collected through the Sociodemographic and Educational Questionnaire, Knowledge Test and Simulation Design Scale. Data was organized in tables and analyzed based on absolute frequencies, measures of central tendency and dispersion, Cronbach’s alpha reliability test, Wilcoxon’s test.

Results:

the increase in cognitive learning was 81.9%, being that for nursing technicians it was 117.8 %. Wilcoxon’s test showed a significant increase (p<0.0001) in knowledge. The Simulation Design Scale, displayed 4.55 of global mean. Cronbach’s alpha pointed good internal consistency (0.898).

Conclusion:

the health simulation was effective as a learning-teaching method in cardiorespiratory resuscitation, being effective in increasing knowledge in cardiorespiratory arrest, with a great level of design satisfaction.

Descriptors:
High Fidelity Simulation Training; Professional Education; Cardiopulmonary Resuscitation; Simulation Training; Continuing Education; Cardiopulmonary Arrest

	Functional category	<70% of correct answers	> = 70% of correct answers	Mean (%)	SD^* * SD = Standard deviation;	MIN^† † MIN = Minimum;	MAX^‡ ‡ MAX = Maximum;	% of improve-ment^§ § Percentage of participants who improved their performance after the training. There may have been great null difference, that is, the nurses continued to answer the same question after the training;	p^\|\| \|\| Wilconxon's test;
General (n=91)
	Pre	81(89.0)	10(11.0)	11.8 (43.7)	4.95	1	22	81.9	<0.0001
	Post	41(45.0)	50(55.0)	18.0 (66.7)	4.37	7	24	81.9	<0.0001
Nursing technician (n=40)
	Pre	40 (100.0)	0	8.4 (31.2)	4.04	1	18	117.8	<0.0001
	Post	31(77.5)	9(22.5)	14.9 (55.1)	4.22	7	22	117.8	<0.0001
Medical intern (n=21)
	Pre	14(67.0)	7(33.0)	14.7 (54.5)	4.36	8	21	55.9	0.0001
	Post	2(9.5)	19(90.5)	21.0 (77.6)	2.54	12	24	55.9	0.0001
Nurse (n=19)
	Pre	17(89.5)	2(10.5)	14.2 (52.2)	3.51	7	19	50.1	0.0002
	Post	6(31.6)	13(68.4)	19.9 (74.1)	2.62	15	24	50.1	0.0002
Resident (Nur^¶ ¶ Nur = Nurse; , Phy^ Phy = Physician ) (n=11)
	Pre	10(90.9)	1(9.1)	14.4 (53.5)	4.16	7	22	56	0,005
	Post	2(18.2)	9(81.8)	20.5 (75.4)	2.48	15	23	56	0,005

Variables	General		TE^* * NT = Nursing Technician;		INT^† † INT = Medical Intern;		ENF^‡ ‡ NUR = Nurse;		RES^§ § RES = Medical Residence and Nurse;
Variables	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post
CRA recognition^\|\| \|\| CRA = Cardiorespiratory arrest;	53.8	60.4	43.8	45	61.9	83.3	60.5	63.2	63.6	68.2
CRR sequence^¶ ¶ CRR = Cardiorespiratory resuscitation; in BLS^ BLS = Basic life support;	47.3	84.1	36.3	73.8	45.2	88.1	60.5	94.7	68.2	95.5
Chest compression technique	48.4	72.9	32.5	61.7	60.3	82.5	56.1	77.2	69.7	87.9
Airway management in CRA^\|\| \|\| CRA = Cardiorespiratory arrest; (BLS^ BLS = Basic life support; and ALSC^†† †† ALSC = Advanced life support in cardiology )	34.1	55.3	29.2	48.3	39.7	63.5	40.4	61.4	30.3	54.5
CRA care sequence^\|\| \|\| CRA = Cardiorespiratory arrest; in ALSC^†† †† ALSC = Advanced life support in cardiology	55.3	76.2	40.8	59.2	61.9	93.7	63.2	86	81.8	87.9
Handling the manual external defibrillator	44.4	51.6	38	45	46.7	60	50.5	54.7	52.7	54.5
Defibrillation indication based on cardiac rhythms	32.6	67.4	12.5	44.2	65.1	95.2	38.6	77.2	33.3	81.8
How CRA drugs are administered^\|\| \|\| CRA = Cardiorespiratory arrest; (drug administration in CRA^\|\| \|\| CRA = Cardiorespiratory arrest; )	41.1	80.2	29	65.5	53.3	92.4	53.7	92.6	40	89.1
Post-CRA care^\|\| \|\| CRA = Cardiorespiratory arrest;	38.5	37.4	25	32.5	33.3	33.3	52.6	42.1	72.7	54.5

	Items	MN^* * MN = Mean;	SD^† † SD = Standard deviation;	p^‡ ‡ p = p value
Factor 1 - Objectives and information
	1. At the start of the simulation, enough information was furnished to provide guidance and encouragement	4.34	0.83	0.901
	2. I clearly understood the purpose and objectives of the simulation	4.6	0.53	0.896
	3. The simulation provides enough information, clearly, for me to solve the problem situation	4.43	0.72	0.895
	4. Sufficient information was provided during the simulation	4.45	0.64	0.894
	5. The clues were adequate and directed to promote my understanding	4.51	0.69	0.896
	Factor 1 overall	4.47	0.69
Factor 2 - Support
	6. Support was provided in a timely manner	4.55	0.67	0.897
	7. My need for help was recognized	4.59	0.52	0.895
	8. I felt supported by the professor during the simulation	4.58	0.63	0.895
	9. I was supported in the learning process	4.69	0.51	0.894
	Factor 2 overall	4.6	0.59	4
Factor 3 - Troubleshooting
	10. Autonomous troubleshooting was made easier	4.47	0.58	0.901
	11. I was encouraged to explore all the possibilities of the simulation	4.51	0.6	0.899
	12. The simulation was designed for my specific level of knowledge and skills	4.46	0.73	0.898
	13. The simulation allowed me the opportunity to prioritize nursing assessments and care	4.55	0.6	0.902
	14. The simulation provided me with an opportunity to set goals for the care of my patient	4.69	0.49	0.899
	Factor 3 overall	4.54	0.61
Factor 4 - Feedback/Reflection
	15. The feedback provided was constructive	4.77	0.42	0.898
	16. The feedback was provided in a timely manner	4.64	0.55	0.899
	17. The simulation allowed me to analyze my own behavior and actions	4.79	0.41	0.902
	18. After the simulation, there was an opportunity to obtain information/feedback from the professor in order to build up knowledge to another level	4.45	0.7	0.901
	Factor 4 overall	4.66	0.55
Factor 5 - Realism
	19. The setting resembled a real-life situation	4.4	0.7	0.899
	20. Real-life factors, situations and variables were incorporated into the simulation setting	4.49	0.64	0.899
	Factor 5 overall	4.45	0.67
Overall Scale
	Overall of all items	4.55	0.63	0.898

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[1] Corresponding author: Emílio Carlos Alves dos Santos E-mail: enfermeiro.emilio@gmail.com