About Us
Simulation in Action
Contact Us
e-mail me


Poster presented at Emergency Cardiovascular Update 2008 (2008, June), Las Vegas, NV


Student Self-reported Confidence in Advanced Cardiovascular Life Support Skills is Overrated Compared to Expert-rater Evaluation of Student Performance


David L. Rodgers, EdD, NREMT-P1; Rudy D. Pauley, EdD1; Barbara R. McKee, RN, MS, CEN2;

Louis E. Robinson, MS, NREMT-P, CCEMT-P2; & David J. Matics, MS, EMT-P, CCEMT-P2

1 Marshall University Graduate School of Education and Professional Development, South Charleston, WV
2 CAMC Health Education and Research Institute, Charleston, WV


Objectives: Completion of American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) courses indicates students have met the objectives for the course at the time of completion of the course. Having met these objectives, students may feel they are now competent to perform ACLS-level skills in a cardiac arrest event. It has been hypothesized that students may base their confidence level on their ability to attain course objectives. Simply meeting course objectives may give students a false sense of confidence in their ability to actually perform ACLS-level skills.


Methods: 34 senior nursing students from four nursing programs participated in ACLS. After ACLS completion, participants rated their own confidence in being able to perform ACLS skills in a cardiac arrest event using a 10-item questionnaire based on the ACLS Megacode scoring sheet. All participants then served as team leader for a simulated cardiac arrest event that was video recorded. A panel of expert ACLS instructors who did not participate as instructors in the ACLS course reviewed each video and independently scored each team leader’s performance using the same 10-item assessment instrument.


Results: The scores for the overall scales showed there was a significant difference in the students’ self-reported confidence scores and their ability to perform ACLS actions as scored by the expert raters. Using a one-sample t-test, p = .000 (self-reported mean was 60.85, SD 5.96, n = 34; expert rater mean was 50.39, SD 13.83, n = 102). On examination at the item level, all 10 items showed significance (p = .000) with the self-reported levels of confidence being significantly higher than expert-rater scores of performance.

Conclusions: Students in this ACLS course tended to rate their confidence in their ability to perform ACLS skills significantly higher than what their actual demonstarted skill level was according to a team of expert raters. Student perceptions of confidence should not be a substitute for actual skill demonstration.