Impact of a Distanced Team Leader for Medical Student ACLS Simulation Training

Abstract

Healthcare simulation institutions switched to distance simulation, defined as, “implementing a simulation or training at a physical distance from the participant”, out of necessity during the COVID-19 pandemic, and institutions also reported a likelihood to continue this into the future. This study aims to determine the viability of a “distanced team leader” as a learning tool for medical simulation, specifically as it relates to Advanced Cardiac Life Support (ACLS) courses. 122 2nd year medical students from Warren Alpert Medical School (AMS), partaking in an ACLS course, were randomized into two groups, “in-person” (n=61) and “distance” (n=61). During the course, both groups underwent team-based simulation training using the same team-based resuscitation scenarios designed by the American Heart Association (AHA). The "distance" group had a distanced team leader, who acted as the team leader behind a webcam and two-way audio-visual broadcast to their team, while the other team members were present in a room with training equipment and the instructor. The "in-person" group had an in-person team leader only. Three primary pieces of data were collected and were used to determine viability and overall sentiment: the NASA Task Load Index (TLX), a post-course survey with questions related to group member and team leader experience and comfort, and finally written ACLS exam final scores. The TLX, which collected specific feedback from participants after their time as team leader, demonstrated no significant statistically significant difference in mean levels of frustration or perceived performance between the in-person and distance groups respectively. In-person participants rated questions related to non-team leader experience higher on post-course survey responses when compared with distance participants, but questions related to team leader comfort, experience and performance demonstrated no statistically significant difference between the two groups. Finally, ACLS written exam scores were not statistically significantly different, whether a participant was in a distance or in-person group, or whether they performed the written exam before or after simulation experiences. A distanced team leader for ACLS simulation coursework appears to be a viable alternative to in-person team leaders, but some key differences were apparent between the two groups. Future iterations of the study could include additional qualitative methods such as structured interviews and focus groups to further elucidate differences related to group-member experience, and overall sentiment as a distanced team leader.