Evaluation of the effectiveness of advanced technology clinical simulation manikins in improving the capability of Australian paramedics to deliver high quality Cardiopulmonary Resuscitation: a pre-post intervention study (Preprint)

BACKGROUND Emergency medical services attend out-of-hospital cardiac arrest (OHCA) all across Australia. Resuscitation by emergency medical services is attempted in nearly half of all cases. However, resuscitation skills can degrade over time without adequate exposure, which negatively impacts patient survival. In locations where paramedic exposure to OHCA is low, other avenues for ensuring resuscitation skills are maintained should be put in place. Simulation-based training via resuscitation manikins offers a potential solution for maintaining paramedic clinical practice skills. OBJECTIVE To examine the effectiveness of advanced technology clinical simulation manikins and accompanying simulation resources (targeted clinical scenarios and debriefing tools) in improving the demonstrable capability of paramedics to deliver high quality patient care, as measured by External Cardiac Compression performance (ECC). METHODS A pre-post intervention study without a control group. Data were collected at the start of the manikin training forum (Baseline); immediately following the training forum (Time 2); and 6 to 11 months after the training forum (Time 3). The study was conducted in paramedics from 95 NSW Ambulance locations (75 regional locations, 20 metropolitan locations). Eligible participants were paramedics who were employed by NSW Ambulance (n=95; 100% consent rate). As part of the intervention, paramedics attended a training session on use of advanced technology simulation manikins. Manikins were then deployed to locations for further use. The main outcome measures was an overall compression score was automatically recorded and calculated by the simulator manikin in two-minute cycles. This score was derived from compressions with correct hand position, adequate depth, fully released, and adequate rate. RESULTS ECC compression scores were on average 95% or above at all time points, suggesting high performance. No significant differences over time (p>0.05) were identified for overall ECC performance score. CONCLUSIONS Training and deployment of simulator manikins did not significantly change paramedic’s ECC performance. The high baseline performance (ceiling effect) of paramedics in this sample may have prevented the potential increase in skills and performance. CLINICALTRIAL