Perkins, Gavin D., Kimani, Peter K., Bullock, Ian, Clutton-Brock, T., Davies, R. P, Gale, M., Lam, J., Lockey, A. and Stallard, Nigel (2012) Improving the efficiency of advanced life support training : a randomized, controlled trial. Annals of Internal Medicine, Volume 157 (Number 1). pp. 19-28. doi:10.7326/0003-4819-157-1-201207030-00005 ISSN 0003-4819.

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Abstract

Background: Each year, more than 1.5 million health care professionals receive advanced life support (ALS) training.

Objective: To determine whether a blended approach to ALS training that includes electronic learning (e-learning) produces outcomes similar to those of conventional, instructor-led ALS training.

Design: Open-label, noninferiority, randomized trial. Randomization, stratified by site, was generated by Sealed Envelope (Sealed Envelope, London, United Kingdom). (International Standardized Randomized Controlled Trial Number Register: ISCRTN86380392)

Setting: 31 ALS centers in the United Kingdom and Australia.

Participants: 3732 health care professionals recruited between December 2008 and October 2010.

Intervention: A 1-day course supplemented with e-learning versus a conventional 2-day course.

Measurements: The primary outcome was performance in a cardiac arrest simulation test at the end of the course. Secondary outcomes comprised knowledge- and skill-based assessments, repeated assessment after remediation training, and resource use.

Results: 440 of the 1843 participants randomly assigned to the blended course and 444 of the 1889 participants randomly assigned to conventional training did not attend the courses. Performance in the cardiac arrest simulation test after course attendance was lower in the electronic advanced life support (e-ALS) group compared with the conventional advanced life support (c-ALS) group; 1033 persons (74.5%) in the e-ALS group and 1146 persons (80.2%) in the c-ALS group passed (mean difference, −5.7% [95% CI, −8.8% to −2.7%]). Knowledge- and skill-based assessments were similar between groups, as was the final pass rate after remedial teaching, which was 94.2% in the e-ALS group and 96.7% in the c-ALS group (mean difference, −2.6% [CI, −4.1% to 1.2%]). Faculty, catering, and facility costs were $438 per participant for electronic ALS training and $935 for conventional ALS training.

Limitations: Many professionals (24%) did not attend the courses. The effect on patient outcomes was not evaluated.

Conclusion: Compared with conventional ALS training, an approach that included e-learning led to a slightly lower pass rate for cardiac arrest simulation tests, similar scores on a knowledge test, and reduced costs.

Item Type:	Journal Article
Alternative Title:
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	Annals of Internal Medicine
Publisher:	Silverchair Information Systems
ISSN:	0003-4819
Official Date:	2012
Dates:	Date Event 2012 Published
Volume:	Volume 157
Number:	Number 1
Page Range:	pp. 19-28
DOI:	10.7326/0003-4819-157-1-201207030-00005
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Description:	Electronic Advanced Life Support Collaborators

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