Ready for the First Cardiac Arrest: A Teaching Intervention Using a Video-Based Simulation to Increase Confidence and Preparedness to Perform Cardiac Arrest Roles in Newly Qualified Doctors.

Background Many newly-qualified doctors take time to grasp the knowledge and skills needed for managing a cardiac arrest. One intervention which can reduce the time taken to feel confident is video-based simulation training that covers essential information, including role allocations and local Trust-specific procedures, which would only otherwise be learned ad hoc. A video simulation course offers a quick, efficient teaching format which can be easily incorporated into induction week. It serves to help doctors feel more confident and prepared for managing cardiac arrests from the very start of their careers. This study aimed to use video-based simulation training at Watford General Hospital (UK) to, first, assess newly qualified doctors' knowledge of cardiac arrest roles by measuring changes in role identification accuracy, and, second, to improve newly qualified doctors' confidence and preparedness for a cardiac arrest at the start of their careers, measured using self-reported confidence scores. Methodology In total, 70 doctors participated in this teaching intervention. Of these, 46 (65.7%) completed an anonymous pre-session questionnaire, and 37 (52.9%) completed a post-session questionnaire. The questionnaires assessed the participants' knowledge, preparedness, and confidence to participate in roles at cardiac arrest. The teaching intervention consisted of a video-based simulation and a debrief facilitated by senior resident doctors. It was supported by a presentation focusing on job roles and Trust-based procedures. Knowledge of cardiac arrest roles was measured as the number of distinct roles participants could correctly identify. Confidence and preparedness to participate in these roles were self-reported on a 10-point Likert scale. Responses were analysed using the Mann-Whitney U test for Likert scales and using descriptive statistics for role identification. Results Overall, 35 (97.2%) respondents in the post-session questionnaire felt the session increased their confidence in managing a cardiac arrest. Identification increased for all roles, except for compressions and defibrillation. Their identification of key roles such as timekeeper, scribe/documenting, and runner/bringing equipment improved by 42.6%, 23.1%, and 30.8%, respectively. These roles had been among the least identified in the pre-session questionnaire. Post-session, doctors felt they were better prepared to attend a cardiac arrest (n1 = 46, n2 = 36, U = 323.5, p < 0.00001), and that they could contribute more effectively (n1 = 45, n2 = 37, U = 296.5, p < 0.00001). Conclusions The pilot session demonstrated that video-based simulation with a debrief was an effective method to improve newly qualified doctors' knowledge and confidence in participating in the roles within a cardiac arrest team. Participants described the pilot as a valuable intervention in supporting them in their first cardiac arrests. Further research is needed to evaluate if these results will translate into improved performance in cardiac arrest outcomes.