Abstract / Summary
Abstract Background Internal Medicine residents routinely lead rapid medical response teams (RMRTs) at training hospitals, often reporting discomfort in this role. To address this issue, we developed a longitudinal, multidisciplinary, simulation-based curriculum aimed at enhancing RMRT functioning while boosting the confidence and knowledge of medical residents. Methods We developed several cases with debriefing and educational sessions based on Advanced Cardiac Life Support (ACLS) emergencies and retrospective RMRT data from our hospital, considering institutional policies and logistical limitations. The curriculum consisted of six workshops conducted over two years in fully equipped simulation suites using high-fidelity manikins or standardized patients. Participants included varying numbers of residents, nurses, and pharmacists. For this study, we observed three workshops and collected data from 12 cases involving 191 non-unique learners. We used surveys to assess changes in resident confidence and knowledge and evaluated initial group performance by timing critical actions to compare with national benchmarks. Results We observed a significant increase in resident confidence as RMRT leaders ( p = 0.01), though confidence surveys were unpaired (58 pre- vs. 24 post-curriculum respondents), and post-curriculum respondents had substantially greater real-world RMRT exposure, limiting causal attribution to the curriculum alone. Knowledge gains were selective and domain-specific: statistically significant improvements were observed in pharmacology, post-arrest care, and tracheostomy management, while cardiac rhythm recognition, cardiac rhythm management, noninvasive ventilation, and basic life support (BLS) did not demonstrate significant improvement; one BLS item showed a statistically significant decline. In simulated VF/pVT cases, our RMRTs met national benchmarks for all observed resuscitation process measures; performance data are descriptive and reflect simulated conditions without a pre-curriculum baseline or control group. Conclusions Our findings suggest that a formal simulation-based curriculum can be associated with improved resident confidence as RMRT leaders, though observed gains likely reflect both curricular exposure and the accumulation of real-world clinical experience over time. Knowledge improvements were domain-specific, with significant gains in pharmacology, post-arrest care, and tracheostomy management, but not in cardiac rhythm recognition, noninvasive ventilation, or BLS. The curriculum also demonstrated value as a diagnostic and descriptive tool for evaluating simulated RMRT performance against national benchmarks. Further investigation is needed to determine which resuscitation domains benefit most from simulation-based education and whether multimodal approaches improve knowledge acquisition in domains that did not show significant gains.