There is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines the results of a pilot ALS resuscitation course tailored for providers working in pre-hospital resource-limited settings. The focus on the pre-hospital ALS environment, team mix, techniques, skills and equipment are important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival.
A pre-hospital ALS course was piloted following research into the need for a course and development of a pre-hospital-specific curriculum, based on Australian Resuscitation Council (ARC) guidelines. There were 13 pilot courses run, involving 66 participants. Participants all worked in the pre-hospital environment and held qualifications ranging from a Certificate IV in Healthcare through to postgraduate paramedicine qualifications. The pre-hospital ALS course consisted of theory and practical elements, pre-reading and a pre- and post-course quiz. Feedback was sought from course participants and an expert panel was consulted on the findings.
Participants and the Expert Panel indicated that a pre-hospital ALS course should follow current recommendations of the ARC and be delivered to persons with sufficient underpinning knowledge of ALS resuscitation. The course should include pre-reading on ALS protocols and a pre-test followed by one day of face-to-face teaching using equipment reflective of the pre-hospital environment. Scenarios should be relevant to the pre-hospital setting and involve varying numbers of responders. Participants should be assessed on a continual basis during the course.
To improve participant confidence in the delivery of ALS and maximise the likelihood of patient survival, pre-hospital ALS resuscitation education for pre-hospital providers should follow ARC guidelines, include pre-course reading and practical simulation that reflects participants’ day-to-day employment.
Reid D, Jones R, Sim M. Pre-hospital advanced life support education - core components for pre-hospital professionals. Australasian Journal of Paramedicine 2018;15(1).
Lyon RM, Sinclair N. National standards in prehospital resuscitation training are required. Emerg Med J 2012;29:602.
Cardiac arrest - an introduction. Australian Resuscitation Council (NSW Branch). Undated. Available at: http://arcnsw.org.au/files/4913/5088/1980/Cardiac_Arrest_-_intro_summary_-_ARC_NSW_document.pdf
Perkins G, Fullerton JN, Davis-Gomez N, et al. The effect of pre-course e-learning prior to advanced life support training: a randomised controlled trial. Resuscitation 2010;81:877-81.
Williams NM. Advanced life support training and assessment: a literature review. Australas Emerg Nurs J 2011;14:240-5.
Reid D, Sim M, Beatty S, Grantham H, Gale M. Pre-hospital advanced life support resuscitation – a curriculum for pre-hospital education. Australasian Journal of Paramedicine 2020;17.
Bonnetain E, Boucheix J, Hamet M, Freysz M. Benefits of computer screen-based simulation in learning cardiac arrest procedures. Med Educ 2010;44:716-22.
Christenson J, Parrish K, Barabé S, et al. A comparison of multimedia and standard advanced cardiac life support learning. Acad Emerg Med 1998;5:702-8.
Gale M, Grantham H, Morley P, Parr M. Advanced life support level 2. Australian Resuscitation Council; 2016.
Gjerra K, Moller TP, Ostergaard D. Efficacy of simulation-based trauma team training of non-technical skills. A systematic review. Acta Anaesthesiol Scand 2014;58:775-87.
Bredmose PP, Habig K, Davies G, Grier G, Lockey DJ. Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Scand J Trauma Resusc Emerg Med 2010;18:13.
Lumsden H. Newborn life support course: training students. Br J Midwifery 2008;16:717-21.
Hoadley TA. Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation. Nurs Educ Perspect 2009;30:91-5.
Aqel AA, Ahmad MM. High-fidelity simulation effects on CPR knowledge, skills, acquisition, and retention in nursing students. Worldviews Evid Based Nurs 2014;11:394-400.
Davis LE, Storjohann TD, Spiegel JJ, Beiber KM, Barletta JF. High-fidelity simulation for advanced cardiac life support training. Am J Pharm Educ 2013;77:59.
Husebø SE, Rystedt H, Friberg F. Educating for teamwork - nursing students' coordination in simulated cardiac arrest situations. J Adv Nurs 2011;67:2239-55.
Dagnone JD, McGraw RC, Pulling CA, Patteson AK. Interprofessional resuscitation rounds: a teamwork approach to ACLS education. Med Teach 2008;30:e49-54.
Birkhoff SD, Donner C. Enhancing pediatric clinical competency with high-fidelity simulation. J Contin Educ Nurs 2010;41:418-23.
Garbee DD, Paige J, Barrier K, et al. Interprofessional teamwork among students in simulated codes: a quasi-experimental study. Nurs Educ Perspect 2013;34:339-44.
Australian Resuscitation Council. Resuscitation guidelines. 2019. Available at: https://resus.org.au/guidelines/
Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika 1951;16:297-334.
Taber K. The use of Cronbach’s alpha when developing and reporting research instruments in science education. Res Sci Educ 2018;48:1273-96.
Hanusz Z, Tarasinksa J, Zielinski W. Shapiro-Wilk test with known mean. Revstat 2016;14:91-100.
Noughabi H. Two powerful tests for normality. Annals of Data Science 2016;3:225-34.
Gale M. Advanced life support 1 survey results. 2020.
Fox S, Wares C, et al. Simulation-based interdisciplinary education improves intern attitudes and outlook toward colleagues in other disciplines. Br Med J Med Educ 2019;19(276).
Timmis S, Williams J. Playing the interdisciplinary game across education–medical education boundaries: sites of knowledge, collaborative identities and methodological innovations. International Journal of Research & Method in Education 2017;40:257-69.
Pandey A, Jackson J. Importance of interdisciplinary medical education: a frontline perspective. Southern Medical Journal 2018;111:209-10.
Maharajan MK, Rajiah K, Khoo SP, et al. Attitudes and readiness of students of healthcare professions towards interprofessional learning. PLoS One 2017;12:e0168863.
Guraya SY, Barr H. The effectiveness of interprofessional education in healthcare: a systematic review and meta-analysis. Kaohsiung J Med Sci 2018;34:160-5.
Von Wyl T, Zuercher M, Amsler F, Walter B, Ummenhofer W. Technical and non-technical skills can be reliably assessed during paramedic simulation training. Acta Anaesthesiol Scand 2009;53:121-7.
Salkind N. Encyclopedia of research design. California: Thousand Oaks; 2010.
Wolbring T, Treischl E. Selection bias in students' evaluation of teaching. Research in Higher Education 2016;57:51-71.
Burchett D, Ben-Porath YS. Methodological considerations for developing and evaluating response bias indicators. Psychol Assess 2019;31:1497-511.
Bootzin RR. Expectancy and individual differences in experimenter bias. J Gen Psychol 1971;84:303-12.
Michelson L, Mannarino A, Marchione K, Kazdin AE, Costello A. Expectancy bias in behavioral observations of therapeutic outcome: an experimental analysis of treatment and halo effects. Behav Res Ther 1985;23:407-14.