Evaluation of resuscitation skills in new residents before and after pediatric advanced life support course

Objective. Acquisition of resuscitation skills taught in advanced resuscita tion courses has not been evaluated. We sought to determine the interobserv er reliability of a resuscitation performance skills checklist to assess re sident performance of bag mask ventilation, intubation, defibrillation, and intraosseous vascular access, and to measure skill acquisition by entering residents after a pediatric advanced life support (PALS) course. Design. The resuscitation skills of all 39 pediatric R1's in 2 university-b ased training programs were assessed immediately before and after completio n of a PALS course just before starting residency. Independent observers sc ored and timed resident performance of bag mask ventilation, endotracheal i ntubation, intraosseous access, and defibrillation. Scores before and after the PALS course were compared. Four independent observers scored 4 residen ts' videotaped skills performance. Observers' scores for each resident were compared. Results. Successful performance improved for bag mask ventilation from 62% to 97% after the PALS course; for successful endotracheal intubation, from 64% to 90%; for successful intraosseous needle placement, from 54% to 92%; and for successful defibrillation, from 77% to 97%. Interobserver reliabili ty was high for continuous and noncontinuous variables. Conclusions. New residents demonstrated significant acquisition of pediatri c resuscitation skills immediately after completion of the PALS course. The skills performance checklist has excellent interobserver reliability and i s a useful tool for evaluation of other training venues.