Elaborado con IA a partir del resumen de los autores
Estudio empírico que evalúa el impacto de la Práctica Deliberada de Ciclo Rápido (RCDP) en la formación de Soporte Vital Cardíaco Avanzado (ACLS) en residentes de Medicina Interna. La investigación, realizada con 36 residentes en un hospital público de 269 camas, comparó el entrenamiento basado en simulación estándar con un modelo RCDP que enfatiza práctica repetitiva con retroalimentación inmediata. El conocimiento se evaluó mediante una modificación de la escala de McEvoy y la autoeficacia mediante la Escala de Autoeficacia en Habilidades Básicas de Resucitación. Los resultados muestran que el conocimiento de ACLS mejoró significativamente en nueve meses: solo 5,6% de residentes aprobaron inicialmente versus 46,7% al seguimiento. Sin embargo, la autoeficacia disminuyó significativamente, con ningún residente reportando sentirse muy confiado en seguimiento. Los autores concluyen que la educación basada en simulación mejora el conocimiento, pero aumenta el reconocimiento de la complejidad del cuidado en resucitación.
Puntos clave
La práctica deliberada de ciclo rápido en simulación aumentó significativamente el conocimiento de protocolos ACLS, elevando la tasa de aprobación del 5,6% al 46,7% en nueve meses.
La autoeficacia de los residentes disminuyó significativamente a pesar de la mejora objetiva en el conocimiento, sin que ninguno reportara sentirse muy confiado al seguimiento.
El declive en autoeficacia puede reflejar mayor conciencia de la complejidad y limitaciones en el cuidado de resucitación cardíaca tras la formación prolongada.
Para quién: Útil para directores de programas de residencia, educadores en simulación clínica y profesionales de Medicina Interna interesados en optimizar la formación en ACLS y comprender la relación entre mejora del conocimiento y autoeficacia.
Resumen de los autores
Background Adherence to Advanced Cardiac Life Support (ACLS) protocols during cardiac arrest is inconsistent. Simulation-based training (SBT) has been shown to enhance resuscitation knowledge and technical skills. Rapid Cycle Deliberate Practice (RCDP) is an educational strategy emphasizing repetitive performance with immediate feedback and within-scenario debriefing. At our institution, Internal Medicine Interns undergo ACLS training and SBT throughout the year. This study assessed whether a RCDP model for ACLS training improves ACLS passing score and self-efficacy. Methods This study was conducted at a 269-bed public hospital with a 38-Intern Internal Medicine residency program. Training sessions (facilitated by a simulation fellowship-trained emergency/critical care physician) occurred in the institution’s simulation laboratory using a Laerdal Monitor System for rhythm recognition and management scenarios. ACLS SBT was organized into four training blocks. During the first block, Interns underwent standardized ACLS training using non-Rapid Cycle Deliberate Practice. Interns completed assessments evaluating ACLS knowledge and self-efficacy immediately following ACLS training at the start of residency and 9 months later. ACLS knowledge was assessed using a modified McEvoy scoring tool. A minimum score of 80% was required to achieve a passing score. Self-efficacy was measured using a modification of the Basic Resuscitation Skills Self-Efficacy Scale (BRS-SES). Results Intern knowledge of ACLS protocols demonstrated a statistically-significant increase over the 9-month study period (p <0.0001). At baseline, only 2 of 36 Interns (5.6%) achieved a passing score, whereas, following the intervention, 14 of 30 Interns (46.7%) attained scores higher than 80%. Despite objective improvements in knowledge as evidenced by higher passing rates, self-perception of knowledge decreased in the following domains: confidence in knowledge and guidelines, differentiating between defibrillation and synchronized cardioversion, and appropriate level of energy (Joules) necessary for cardioversion and defibrillation. Overall Intern self-efficacy demonstrated a statistically-significant decline (p <0.0059). Notably, although some learners rated themselves as “very confident” at the inception of their training, no Interns endorsed feeling “very confident” in any of the self-efficacy domains at their follow-up evaluation. Conclusion Simulation-based ACLS training was associated with significant improvement in ACLS protocol knowledge over a 9-month period. However, self-efficacy significantly declined over time; no Interns reported feeling “very confident” on follow-up assessment despite some initially endorsing high confidence. While longitudinal simulation-based education employing a RDCP model may improve ACLS knowledge, it may also increase recognition of the complexity of resuscitation care and the limitations of their abilities.
McCann, A., Mbapah, L. T., Matthew, C., Coard, J., Richman, M., & Smith, B. (2026). Rapid Cycle Deliberative Practice Simulation Improves Internal Medicine Intern ACLS Knowledge But Not Self-efficacy. https://doi.org/10.35542/osf.io/tuypf_v1
