***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: & NA ; To increase cardiopulmonary arrest survival , the American Heart Association developed basic and advanced cardiac life support ( ACLS ) courses that expose participants to realistic learning situations . This experimental study compared results of two ACLS classes on measures of knowledge ( content exam ) and resuscitation skills ( performance exam ) .  Both the control and experimental groups consisted of physicians , nurses , emergency medical technicians , respiratory therapists , and advanced health care providers . The control group used low‐fidelity simulation ( LFS ) ; the experimental group was exposed to enhanced realism via high‐fidelity simulation ( HFS ) . The findings showed a positive correlation between enhanced practice and learning but no significant correlation between posttest and skills test scores for the LFS and HFS groups . The HFS group did score higher on both cognitive and behavioral tests , but the difference was not statistically significant . Participants from both groups indicated satisfaction with their forms of simulation experience and course design . In addition , participants ' self‐confidence to care for a victim of cardiopulmonary arrest was increased after completing their course ; profession and work experience had no effect on responses . The largest difference noted was in verbal responses to course satisfaction . The experimental group stated that learning using HFS was enjoyable and adamantly recommended that ACLS should only be taught using HFS . Further study is required to assess if practicing beyond the course enhances short‐ and long‐term retention of ACLS techniques Objective : To compare the usefulness for training of a porcine model ( larynx , trachea , and pig skin ) and a manikin model using a Portex cricothyrotomy kit ( PCK ) . Methods : In a prospect i ve r and omised crossover trial , participants in the airway workshop performed crico-thyrotomy using a PCK on the porcine and manikin models ( Tracheostomy Trainer and Case ) . The porcine model was made with larynxes and trachea from freshly  slaughtered pigs  and covered with a piece of thinned pigskin stapled to a wooden board . Participants were asked to assess the following : reality of skin turgor ; difficulty with skin penetration , l and mark recognition and procedure ; reality of the model ; and preference for each model using a visual analogue scale ( VAS ) of 0–10 cm . The VAS scores for each model were compared . Results : 49 participants were included in the study . Mean ( SD ) VAS scores for the reality of skin turgor , degree of difficulty with skin penetration and l and mark recognition were higher with the porcine model than with the manikin model ( 7.0 ( 2.1 ) vs 4.7 ( 2.0 ) , 6.4 ( 2.4 ) vs 3.6 ( 2.2 ) , 5.1 ( 2.2 ) vs 4.2 ( 2.5 ) , respectively ) . There was no difference between the models in the difficulty of the procedure ( 5.0 ( 2.4 ) vs 4.7 ( 3.2 ) ) . The porcine model had a higher VAS score for overall reality and preference of the model ( 7.1 ( 2.0 ) vs 4.8 ( 2.3 ) and 7.1 ( 2.0 ) vs 4.8 ( 2.2 ) , respectively ) . Conclusion : The porcine model is a more useful training tool than the manikin model for cricothyrotomy with PCK because of its reality and similarity to human anatomy Traditional teaching of laryngoscopy is difficult due to the trainer and trainee lacking a shared view . The Karl Storz BERCI DCI ® Video Laryngoscope provides a video image for the trainer and a direct view identical to that of a st and ard laryngoscope for the trainee . Forty‐nine novice subjects were r and omly assigned to a  control group ( n = 24 ) taught using a st and ard Macintosh laryngoscope  or a study group ( n = 25 )  taught using the Video Laryngoscope . Following training all subjects were assessed using  a st and ard laryngoscope . Under simulated difficult airway conditions the study group performed better in terms of number of attempts ( p = 0.02 ) , number of repositioning manoeuvres required ( p = 0.046 ) and teeth trauma ( p = 0.034 ) . The study group were more confident of the success of their tube placement ( p = 0.035 ) , found it easier than the control group ( p = 0.042 ) and had improved knowledge of airway anatomy ( p = 0.011 ) . We conclude that video laryngoscopy confers benefits in the teaching of tracheal intubation OBJECTIVE : Poor communication and teamwork may contribute to errors during neonatal resuscitation . Our objective was to evaluate whether interns who received a 2-hour teamwork training intervention with the Neonatal Resuscitation Program ( NRP )  demonstrated more teamwork and higher quality resuscitations than control subjects . METHODS : Participants were noncertified 2007 and 2008 incoming interns for pediatrics , combined pediatrics and internal medicine , family medicine , emergency medicine , and obstetrics and gynecology ( n = 98 ) . Pediatrics and combined pediatrics/internal medicine interns were eligible for 6-month follow-up ( n = 34 ) . A r and omized trial was conducted in which half of the participants in the  team training  arm practice d NRP skills by using high-fidelity simulators ; the remaining practice d with low-fidelity simulators , as did control subjects . Blinded , trained observers viewed video recordings of high-fidelity – simulated resuscitations for teamwork and resuscitation quality . RESULTS : High-fidelity training ( HFT ) group had higher teamwork frequency than did control subjects ( 12.8 vs 9.0 behaviors per minute ; P < .001 ) . Intervention groups maintained more workload management ( control subjects : 89.3 % ; low-fidelity training [ LFT ] group : 98.0 % [ P < .001 ] ; HFT group : 98.8 % ; HFT group versus control subjects [ P < .001 ] ) and completed resuscitations faster ( control subjects : 10.6 minutes ; LFT group : 8.6 minutes [ P = .040 ] ; HFT group : 7.4 minutes ; HFT group versus control subjects [ P < .001 ] ) . Overall , intervention teams completed the resuscitation an average of 2.6 minutes faster than did control subjects , a time reduction of 24 % ( 95 % confidence interval : 12%–37 % ) . Intervention groups demonstrated more frequent teamwork during 6-month follow-up resuscitations ( 11.8 vs 10.0 behaviors per minute ; P = .030 ) . CONCLUSIONS : Trained participants exhibited more frequent teamwork behaviors ( especially the HFT group ) and better workload management and completed the resuscitation more quickly than did control subjects . The impact on team behaviors persisted for at least 6 months . Incorporating team training into the NRP curriculum is a feasible and effective way to teach interns teamwork skills . It also improves simulated resuscitation quality by shortening the duration Current Advanced Cardiac Life Support ( ACLS ) course instruction involves a 2-day course with traditional lectures and limited team interaction . We wish to explore the advantages of a scenario-based performance-oriented team instruction ( SPOTI ) method to implement core ACLS skills for non-English-speaking international paramedic students . The objective of this study was to determine if scenario-based , performance-oriented team instruction ( SPOTI ) improves educational outcomes for the ACLS instruction of Korean paramedic students . Thirty Korean paramedic students were r and omly selected into two groups . One group of 15 students was taught the traditional ACLS course . The other 15 students were instructed using a SPOTI method . Each group was tested using  ACLS megacode examinations  endorsed by the American Heart Association . All 30 students passed the ACLS megacode examination . In the traditional ACLS study group an average of 85 % of the core skills were met . In the SPOTI study group an average of 93 % of the core skills were met . In particular , the SPOTI study group excelled at physical examination skills such as airway opening , assessment of breathing , signs of circulation , and compression rates . In addition , the SPOTI group performed with higher marks on rhythm recognition compared to the traditional group . The traditional group performed with higher marks at providing proper drug dosages compared to the SPOTI students . However , the students enrolled in the SPOTI method result ed in higher megacode core compliance scores compared to students trained in traditional ACLS course instruction . These differences did not achieve statistical significance due to the small sample size BACKGROUND Recent literature describes " cognitive dispositions to respond " ( CDRs ) that may lead physicians to err in their clinical reasoning . OBJECTIVES To assess learner perception of high-fidelity mannequin-based simulation and debriefing to improve underst and ing of CDRs . METHODS Emergency medicine ( EM ) residents were exposed to two simulations design ed to bring out the CDR concept known as " vertical line failure . " Residents were then block-r and omized to a technical/knowledge debriefing covering the medical subject matter or a CDR debriefing covering vertical line failure . They then completed a written survey and were interviewed by an ethnographer . Four investigators blinded to group assignment review ed the interview transcripts and coded the comments . The comments were qualitatively analyzed and those upon which three out of four raters agreed were quantified . A r and om sample of 84 comments was assessed for interrater reliability using a kappa statistic . RESULTS Sixty-two residents from two EM residencies participated . Survey results were compared by technical ( group A , n = 32 ) or cognitive ( group B , n = 30 ) debriefing . There were 255 group A and 176 group B comments quantified . The kappa statistic for coding the interview comments was 0.42 . The CDR debriefing group made more , and qualitatively richer , comments regarding CDR concepts . The technical debriefing group made more comments on the medical subjects of cases . Both groups showed an appreciation for the risk of diagnostic error . CONCLUSIONS Survey data indicate that  technical debriefing  was better received than cognitive debriefing . The authors theorize that an underst and ing of CDRs can be facilitated through simulation training based on the analysis of interview comments OBJECTIVE To compare the ' 4-stage ' teaching technique ( demonstration , deconstruction , formulation , performance ) with the traditional ' 2-stage ' teaching technique ( deconstruction , performance ) in  laryngeal mask airway ( LMA ) insertion .  METHODS Using a prospect i ve r and omised study design , participants were taught LMA insertion on a manikin by either the ' 2-stage ' or ' 4-stage ' teaching method .  Subjects were eligible if they had never inserted a LMA .  Skill acquisition was assessed immediately following training , and skill retention assessed a number of weeks later . The primary outcome was  LMA insertion on a manikin , with successful ventilation within 30 s. Other outcomes included overall time to LMA insertion , and number of errors . Assessors were blinded to the teaching method used for each subject . RESULTS A total of 120 participants were r and omised between the two teaching groups ( 60 subjects in each group ) . Mean time to LMA insertion at acquisition was 39.7 s for 2-stage and 34.7 s for 4-stage ( p>0.05 ) , and proportion completing within 30 s was 41.67 % for 2-stage and 48.33 % for the 4-stage teaching group ( p>0.05 ) . With skill retention assessment , mean time to LMA insertion was 44.3 s for 2-stage and 42.5 s for the 4-stage teaching group ( p>0.05 ) . Proportion completing task within 30 s was 34.0 % for 2-stage and 41.67 % for 4-stage group ( p>0.05 ) . Overall , there was no significant difference found in skill acquisition or in skill retention between the 2 or 4-stage teaching method . CONCLUSION The 2-stage teaching technique is not statistically different to the 4-stage teaching method in efficacy of LMA insertion skill acquisition or retention OBJECTIVES The objective of the study was to compare the learning and retention rates of resident physicians trained in posterior epistaxis management with nasal gauze packing on a simulation model following two training methods . METHODS This was a prospect i ve , repeated- measures study . An objective , criterion-referenced performance st and ard , consisting of the number of major steps completed in the proper sequence , and the number of minor steps completed within a specified time , was used by an evaluator to assess performances . Subjects underwent two pretraining assessment s 1 week prior to and the day of training and then were r and omized to one of two training methods : the traditional " observation " method or a " pause- and -perfect " method . After training , both groups repeated the procedure until meeting the performance st and ard . Subjects were retested 1 and 3 months after training . RESULTS Twenty-eight subjects participated . Baseline performance measures were similar between groups and did not change prior to training . During performance testing , experimental subjects completed a greater percentage of major steps ( 84 % ) and minor steps ( 86 % ) in less time ( 25 minutes ) than the controls ( 65 and 68 % , in 35 minutes ) during the first attempt . All subjects met the st and ard within three attempts . There were no differences in major and minor steps completed between the two groups at either 1 week or 3 months after training , but performance times were shorter in the experimental group . After 3 months , 13 % of control and none of experimental subjects met the performance st and ard . CONCLUSIONS The pause- and -perfect training method produced more rapid progress toward a performance st and ard during the initial attempt and better performance times after 3 months than the traditional , observational training method . Without further practice , this skill deteriorated after 3 months with both methods of training Introduction : Major resuscitation councils endorse the use of 
    Output:
    
Qualitative comparisons of different simulation curricula are limited , although feedback , mastery learning , and higher fidelity were associated with improved learning outcomes .
CONCLUSIONS Technology-enhanced simulation for EM learners is associated with moderate or large favorable effects in comparison with no intervention and generally small and nonsignificant benefits in comparison with other instruction .