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Abstract

Internal Medicine residents are responsible for leading the
code response team at most teaching hospitals, yet many
graduating interns (PGY1s) may feel unprepared to run
codes. Currently, the only formal training for house staff
is the two-day American Heart Association’s Advanced
Cardiac Life Support (ACLS) course, generally required at
the beginning of internship, with recertification necessary
every two years. This course does not address leadership
skills or a resident’s self-reported sense of comfort with
leading a code team within a teaching hospital. Prior
investigations have highlighted the deterioration in
knowledge of important ACLS protocols, with knowledge
levels at or near ACLS training levels within 6 months.1,2
Schwid and Sivarajan showed that the use of computerized
ACLS simulator on CD-ROM improves retention of the
guidelines better than textbook review alone.3 Others have
shown that refresher courses can enhance performance in
a mock resuscitation setting, with improvements
maintained, in part, over several months.4 The use of more
life-like simulation training has recently come into favor,
through a variety of commercially available medical
simulators. We designed an ACLS training program with
such a medical simulator for interns preparing for their
PGY2 year, namely those residents about to assume
responsibility for leadership of the code team. Prior to the
simulation training sessions, we collected baseline data
regarding interns’ experiences in code situations and
comfort with the anticipated transition to leading the code
team, as they advance to the PGY2 year of training.

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