Introduction: To become board certified in internal medicine, candidates must demonstrate competence in advanced cardiac life support (ACLS). Historically, this has been achieved through completion of American Heart Association courses in ACLS. Research suggests that this traditional paradigm does not produce lasting competence in ACLS. In the era of duty-hour reform, residents have limited opportunities for deliberate practice in real-world scenarios. Our curriculum seeks to fill this void by offering a focused teamwork skills development curriculum woven into robust, interdisciplinary ACLS-based resuscitation scenarios. Methods: At the beginning of the session, instructors utilize the included visual aid to introduce the learners to the fundamental behaviors observed in high-functioning teams such as team leadership; mutual performance monitoring; backup behavior, adaptability; team orientation; shared mental models; closed-loop communication; and mutual trust. In the subsequent scenarios, faculty use Teamwork Observation Checklists, anchored on these behaviors, to provide meaningful feedback regarding team performance in the various domains. In addition, each Teamwork Observation Checklist includes one “Tangible Teamwork Tool.” These are specific techniques or phrases designed to provide concrete means of fostering the high-functioning team behaviors noted above. Our interdisciplinary training has been underway for 1 year. Results: Overall, we have observed consistent improvements in participants' self-rated confidence, though the literature cautions us against assuming this can be directly translated into increased competence. Evaluations have been uniformly positive with many participants commenting on the value of the interdisciplinary format. We have had anecdotal accounts of medical residents thanking us for the structured training after experiencing real-world codes in which they felt better prepared. Our nursing and pharmacy providers have commented on how much they appreciate ACLS training in which they can focus on their typical tasks instead of being asked to serve as the team leader in a traditional ACLS course. This adds a degree of realism we believe better prepares these groups for functioning together in real-world code scenarios. Discussion: In conclusion, we have created a 4-hour simulation-based ACLS refresher curriculum with synergistic teamwork training. It was designed in accordance with best practices in simulation education and is tailored to meet the needs of Internal Medicine residency training programs.
- Gain the knowledge, technical skills, and teamwork skills necessary to successfully lead an interdisciplinary resuscitation team.
- Select and employ the appropriate American Heart Association (AHA) algorithm to resuscitate a simulated patient.
- Understand the fundamental behaviors of high-functioning teams.
- Employ specific teamwork tools to operationalize those behaviors in a simulated resuscitation environment.
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