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Letters |20 November 2012

Improving the Efficiency of Advanced Life Support Training

Diane B. Wayne, MD; Aashish K. Didwania, MD; William C. McGaghie, PhD

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Author, Article, and Disclosure Information
  • From Northwestern University Feinberg School of Medicine, Chicago, IL 60611.

    Potential Conflicts of Interest: None disclosed.

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TO THE EDITOR:
We read the article by Perkins and colleagues (1) with interest. They studied advanced life support (ALS) education provided to 3732 health care professionals at 31 centers in the United Kingdom and Australia. We commend the authors for conducting such a large trial but are not surprised by the finding that learners assigned to the e-learning group performed worse on the cardiac arrest simulation test. Deliberate practice with feedback from a skilled instructor is a critical component of mastery. This has been shown by K. Anders Ericsson in many areas, including development of expertise in medicine and related domains (2). Therefore, we believe that removing deliberate practice from ALS education and replacing it with e-learning led to the decrease in performance on the simulation test. Current training in ALS has already been shown to be deficient because skills deteriorate rapidly after training (3). In contrast, simulation-based training that features deliberate practice has been shown to boost ALS skills, with improvement lasting up to 14 months (4). These skills have also been shown to transfer to the clinical setting, resulting in improved quality of care (5).
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Wayne DB, Didwania AK, McGaghie WC. Improving the Efficiency of Advanced Life Support Training. Ann Intern Med. ;157:753. doi: 10.7326/0003-4819-157-10-201211200-00017

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Published: Ann Intern Med. 2012;157(10):753.

DOI: 10.7326/0003-4819-157-10-201211200-00017

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