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Poster presented at the International Meeting on Simulation in Healthcare, (2007, Jan.), San Diego, CA

Student Perceptions of Self-efficacy in ACLS are not Influenced by Simulator Fidelity

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


Introduction: Several studies have shown the use of high-fidelity manikin-based simulators in emergency and critical care scenarios produce better student skills performance than the use of lower fidelity manikins. A purpose of this study was to determine how students in American Heart Association Advanced Cardiovascular Life Support (ACLS) classes rated their self-efficacy in ACLS skills at the completion of either a high-fidelity simulation-based ACLS course or a low-fidelity simulation-based ACLS course.

Methods: 34 senior nursing students from four different nursing programs participated in ACLS. Two ACLS classes were conducted with 16 participants taking ACLS using a high-fidelity patient simulator and 18 participants taking ACLS with all the elements of the course being the same except the simulator was turned off and operated in a low fidelity mode. Immediately before and after completing the course, all participants completed a survey instrument based on the ACLS Megacode skills checklist to rate their perceived self-efficacy in performing ACLS skills in a real-world situation.

Results: Precourse mean score on self-efficacy in cardiac arrest management for the low-fidelity manikin group was 28.75 (SD = 8.01). The mean score for the high-fidelity manikin-based simulation group was 25.53 (SD = 10.94). There was no statistical difference in subjects’ ACLS confidence prior to the study courses, t(35) = 1.03, p = .309. Postcourse mean score for the low-fidelity manikin group was 60.67 (SD = 6.32). The mean score for the high-fidelity manikin-based simulation group was 61.06 (SD = 5.74). There was no statistical difference between the groups regarding subjects’ ACLS confidence at the conclusion of the course, t(32) = -0.190, p = .850.

Discussion: While both groups demonstrated considerable increases in their perceptions of self-efficacy related to their ability to perform ACLS skills in the real-world after completing ACLS, the use of high-fidelity simulation did not lead to greater feelings of self-efficacy. This may be related, as other authors have suggested, on the ability of participants to meet course objectives. Simply meeting course objectives gave all participants high feelings of self-efficacy. However, it is yet to be determined how accurate those perceptions are.