The Impact of a Simulation-Based Exercise on Knowledge Retention and Confidence Regarding Medication Use and Preparation for Medical Emergencies Marilyn N. Bulloch Pharm.D, BCPS Nathan A. Pinner Pharm.D, BCPS Stephen Eure RPh BackgroundPurpose Disclosures Conclusions Results Methods Participation of pharmacists in medical emergencies (ME) has been described since the 1970s. Approximately one-third of hospitals report pharmacist involvement in the resuscitation team. By participating in this multidisciplinary setting, pharmacy involvement has been shown to increase medical compliance with ACLS guidelines and decrease mortality. This data highlights the benefit pharmacists can have during ME. According to Machado et al, over ninety-six percent of pharmacists who respond to ME report they prepare medications for patient administration, calculate dosages and infusion rates, and provide drug information. Considering over half of all pharmacists who do not respond to ME report inadequate training as a barrier to participation in such events, training for these tasks should be a focus of pharmacy training programs for ME. Previous studies have reported the utility of simulation-based settings for training physicians, nurses, medical students, and medical residents for ME. While simulation-based learning has been employed to teach pharmacy students and residents physical assessment skills, oral and rectal medication compounding, and pharmacotherapy, its utility in teaching parenteral medication preparation is not well known. The impact of CPR and ACLS certification for pharmacists, pharmacy students, and pharmacy residents on knowledge and confidence in drug selection during ME has been also studied. However, little data exists to illustrate confidence and competence regarding medication preparation in this setting  To assess the impact of a hands-on workshop on knowledge retention and confidence in relation to the use, preparation, and labeling of medications most commonly encountered during ME STUDY DESIGN  Prospective, pre- and post- intervention study  January to June 2010 STUDY POPULATION  All fourth-year Pharm.D students and PGY1 pharmacy residents assigned to the internal medicine or family medicine rotation were required to participate  Pharmacists and other PharmD students at DCH Regional Medical Center were allowed to participate on a voluntary basis CONSENT  All participants were assigned a random study number to which all investigators were blinded  Pharmacy students and residents who were required to participate provided or withdrew consent for their data to be included in analysis through an “opt out” option located on the pre-workshop materials  Pharmacists and other pharmacy students not assigned to one of the study rotations provided written informed consent DATA COLLECTION  Pre-workshop demographic survey  Current position, highest level of training, parenteral preparation experience, ACLS certification, medical emergency participation experience  Pre- and post-workshop confidence survey  4 point Likert scale  Location and knowledge of medications used in medical emergencies, preparations of parenteral medications, assembly of prefilled syringes, dosage and infusion rate calculations, medication needs anticipation, labeling, communication with team members, drug information  Pre- and post-workshop knowledge test  20 multiple choice questions  Assessed the use, preparation, administration, labeling, and disposal of medications commonly utilized during a ME ACLS MEDICATION WORKSHOP  Preparation of the following medications  Epinephrine, atropine, vasopressin, amiodarone, lidocaine, adenosine, magnesium sulfate, norepinephrine, dopamine, phenylephrine, naloxone, calcium chloride, sodium bicarbonate,  Labeling of prepared infusions  Appropriate use of workshop medications in ME  General administration concepts and expiration times  Medication and supply disposal The authors have no conflicts of interest to disclose Students (14)Pharmacists (43) Experience (N)Residents(4)BS Pharm(16)PharmD(18) PharmD + Residency (5) IV experience N (%)10(71)2(50)15(94)17(94)4(80) ACLS trained04(100)2(13)02(40) ME participation3(21)2(50)8(50)12(67)3(60) ACLS: Acute Cardiac Life Support, ME: Medical Emergency Table 1: Baseline Characteristics Figure 1: Survey Responses Groups (N)Pre-TestPost-Test Mean Improvement Student (14)31.8 (11.5)56.4 (14.6)24.6 Resident (4)53.8 (7.5)77.5 (13.2)23.7 BS Pharm (16)68.1 (9.8)86.3 (10.7)18.2 PharmD (23)69.4 (15.8)88.0 (8.9)18.6 All Groups (57)58.7 (20.3)79.0 (17.2)20.3 Table 2: Test Scores Pre- and Post-Test data are mean (SD)  Workshop participation increased student and pharmacist confidence and knowledge regarding medical emergencies.  Pre-survey responses were “not confident” or “somewhat confident” 61.6% of the time versus 67.7% being “confident” or “highly confident” in the post-survey.  Participants reported “anticipating medications” and “communicating with ME team” as most “not confident” prior to the training.  The most commonly reported as “highly confident” after training were: “labeling of medications” and “assembling pre-filled syringes”.  We plan to study whether this training translates into more pharmacists participating in ME