(1093) Effectiveness of Simulation-Based Education in Acute Arrhythmia Management for APPs

Introduction: Advanced practice providers (APPs) are an increasingly integral part of the multidisciplinary team providing care for the cardiovascular disease population. It is therefore of utmost importance that they are provided training commensurate to the needs of their patients. We instituted a simulation-based education program in arrhythmia management for our step-down unit APPs.

Methods: Our primary intervention was a one-hour practical simulation training program focused on the management of supraventricular tachycardia, bradycardia, complete heart block, ventricular tachycardia, ventricular fibrillation and pulseless electrical activity. These arrhythmias were previously identified as areas of educational need. 10 Bellevue Hospital Center CDSU APPs were selected to participate in this training. Identical pre-and-post intervention questionnaires (aimed at assessing self-perceived competency in the management of these arrythmias) and knowledge assessments designed by CICU cardiologists were administered. Prism 10 (Graphpad, Boston MA, 2023) was utilized to conduct a Wilcoxon matched-pairs signed-rank test on the pre- and post-training data.

Results: Our training resulted in a positive and significant impact on short-term APP self-perception of competency in managing acute arrhythmias. In particular, the simulation-based education session led to increased confidence in utilizing the cardiac monitor/defibrillator (W = 28, p = 0.01) and selecting appropriate medications for acute arrhythmias (VF/pVT: W = 28, p = 0.01; bradycardia/CHB: W = 21, p = 0.03; SVT: W = 21 p = 0.03). There was a non-statistically significant increase in learner performance on the knowledge assessment, as average scores increased from 83% to 95% (W = -15, p = 0.06).

Conclusions: Simulation-based training has a positive impact on the self-perceived competency of CDSU APPs in managing acute arrythmias. While the improved average performance on a standardized knowledge assessment (83% to 95%) was not statistically significant, there appears to be a trend toward improvement following the training. Further studies of a larger scale are required to assess long-term knowledge retention and the effect of simulation-based education on outcomes and quality of care in the cardiac step-down unit.