317 - Step-up to Pediatric Codes: A Prospective Observational Study to Assess Impact of Periodic PALS Arrhythmia Algorithm Teaching Amongst Pediatric Residents

Poster Number: 317
Publication Number: 317.205

Ramya Sivasubramanian, State University of New York Downstate Medical Center College of Medicine, BROOKLYN, NY, United States; Sule Doymaz, State University of New York Downstate Medical Center College of Medicine, brooklyn, NY, United States

Background: A major challenge that pediatric residents face with algorithms in American Heart Association’s Pediatric Advanced Life Support (PALS) is knowledge retention due to limited exposure to actual pediatric codes and lack of recurrent PALS training beyond the mandated certification every two years. Reiterating PALS algorithms frequently is crucial for pediatric residents to perform effectively in codes. While impact of frequent mock codes on resident performance is studied widely,  there remains a scarcity in literature that studies the impact of periodic PALS lectures on pediatric residents during their residency training.

Objective: We aim to study effectiveness of periodic lectures focused on PALS arrhythmia algorithms on resident knowledge and confidence.

Design/Methods:

We introduced our intervention: forty-five-minute lectures that were given to eighty-eight residents every four to six weeks for a duration of eight months. We tested residents’ knowledge in the first month (baseline) and prospectively observed over eight months through tests conducted  pre- and post- every lecture.  Each test contained sets of 10 MCQs based on the lecture content. Residents’ knowledge was tested and scored on four categories (C1- C4): C1-Code Team Basics, C2- Arrhythmia Medication & Shock Dosing, C3-Arrhythmia Recognition, C4-Application in Case Scenarios. Overall knowledge trend was observed and residents’ confidence levels were also assessed through surveys. Statistical significance was set at p< 0.05. Null hypothesis tested the impact of the intervention assessed by comparing knowledge in the eighth month to baseline.

Results: Residents’ knowledge showed significant improvement in C2: Arrhythmia Medication & Shock Dosing, from 44% at baseline to 95% at eighth month (p value< 0.001). Overall knowledge also showed significant improvement from 47% at baseline to 88% at eighth month (p-value < 0.001) in post-lecture tests. Notably, self-reported confidence level among residents on their PALS knowledge also improved from pre- to post-lecture in 3 out of 3 surveys we conducted; Month-3: 5.7 to 7.6, Month-6: 6.2 to 6.8, Month-8: 5.3 to 6.7 [scale:1-10].

Conclusion(s): Periodic PALS arrhythmia algorithms teaching is noted to be highly effective in improving knowledge and confidence level amongst pediatric residents during residency training.