The Dose Makes the Poison: Cultivating Knowledge of Toxins and Treatments on a Botanical Voyage

Background: Our institution switched to Stryker LifePak 15 defibrillators in 2023.It was imperative that junior learners be trained to operate the new defibrillators prior to using it on patients.Objectives: To determine if skills including rhythm identification, mode selection (defibrillation, cardioversion, and transcutaneous pacing), and electricity delivery learned on a simulated defibrillator translate to correct use on a real defibrillator.Methods: This was an observational prospective study that included a convenience sample of EM interns, 4th-year medical students, EM Physician Assistants (PA), and 3rd-year PA students.Data collection ran from June 28 -July 23, 2024.Inclusion criteria included being a University of Kentucky EM intern, medical student, PA, or PA student voluntarily present during a didactic day.Exclusion criteria included those who did not desire to complete the survey.The study was completed in three phases.Phase 1 included a one-hour training on arrhythmias and defibrillator functions as well as hands-on practice with a simulated defibrillator.Phase 2 occurred 24 hours after and included three randomized simulation cases that assessed the learners' ability to recognize the correct rhythm and manually operate the simulated defibrillator.Phase 3 occurred 2-3 weeks after Phase 1 and also included three randomized cases where learners had to operate a live defibrillator.Results: The 32 participants included 13 EM interns, 9 medical students, 4 PAs, and 6 PA students.Phase 2 demonstrated near 100% completion across all tasks and rhythms.Accuracy was higher for defibrillation and cardioversion as compared to pacing.Defibrillation was the fastest task (mean 29.2 seconds; range: 19.2-78.7 seconds), and transcutaneous pacing was the slowest task (mean 48.9 second; range: 23.7-154.4seconds).In Phase 3, the task times were significantly longer across every task.Conclusion: Although task completion and accuracy remained mostly high on the live defibrillator at 2-3 weeks, each task took longer.This study demonstrated that learned skills on a simulated defibrillator can successfully translate to task completion and accuracy on a real defibrillator.However, because of possible skill erosion over time, re-training may be necessary at regular intervals.