Pediatric Advanced Life Support Product & Course Orientation
The American Heart Association is pleased to introduce new course materials and curriculum updates to the PALS course. These course enhancements will make a big impact on the way you teach. This Product and Course Orientation focuses on the new PALS course design and resources for instructors.
The AHA developed course enhancements in direct response to suggestions offered by our valued instructors. Candid feedback from our instructors enables us to better understand what is most helpful to you and equips us to continually improve our training content. This document will guide you to incorporate these updates into your classes and provide your students with a quality learning experience.
Best Practices in Education
In 2018, the AHA released a scientific statement that examines best practices in education and applies them to resuscitation science.
Implementing guidance from this resource in our training programs will raise the quality of care and increase the rate of survival from cardiac arrest. You may find this document, and the new 2020 Guidelines for CPR & ECC, on our website at: eccguidelines.heart.org.
Course Delivery Options
There are 3 delivery options for PALS training. All 3 options focus on the same learning objectives. Passing any one of these results in an AHA PALS course completion card.
- Instructor-led training. Instructor-led training takes place in a classroom setting and includes both the cognitive and psychomotor components of skills practice and testing.
- HeartCode® blended learning. The HeartCode® blended-learning format uses online learning to deliver the instructional portion of the course. The skills practice and skills testing portion of the course can be done either as a hands-on session with an instructor or with a HeartCode-compatible manikin.
- Resuscitation Quality Improvement® (RQI®). Resuscitation Quality Improvement®, or RQI®, is a proprietary AHA program that uses low-dose, high-frequency training to deliver quarterly coursework and practice that supports the mastery of high-quality CPR skills.
Teaching Methods
The PALS Course uses a variety of teaching methods in an environment that should simulate a real healthcare setting.
Evidence supports the effectiveness of simulation-based education in improving participant knowledge, clinical skills, team performance, leadership, and communication.
Precourse Self-Assessment
An important feature of the course design is the precourse self-assessment. Market research indicates that instructors strongly favor making this assessment mandatory.
A passing score of 70% on the precourse self-assessment confirms baseline knowledge.
Precourse Work
A new feature of the PALS instructor-led course is the inclusion of an option for precourse work.
If you choose this option, before students enter the classroom, they will review the PALS content through online videos. This format ensures that students are better prepared to learn when they enter the classroom, and it allows more time for hands-on skills training. Instructors may also choose to deliver the traditional course, without precourse work.
Precourse work includes High-Quality BLS, Science of Pediatric Resuscitation, Assessment, Respiratory, Shock, Cardiac, High-Performance Teams, CPR Coach, Post–Cardiac Arrest Care, and Coping with Death.
Course Information
The AHA has also made significant changes to some of the learning stations.
We’ve introduced the new role of CPR Coach to both the High-Quality BLS Station and the Airway Management Station. This new role is designed to promote the delivery of high-quality CPR. The CPR Coach will focus only on the BLS skills being performed by the team, which allows the Team Leader to focus on other areas of critical care.
In addition, teams will use required feedback devices that provide immediate guidance and encouragement on both compressions and ventilation.
The AHA allows instructors to tailor the PALS Course to meet the needs of specific audiences. Local protocol discussions are built into some of the lessons. AHA Instructors should incorporate local protocols related to CPR into learning stations. For example, local protocols such as 3 cycles of 200 continuous compressions with passive oxygen insufflation and airway adjuncts can be used.
The AHA has included more case scenarios in multiple settings. These scenarios include a diverse audience and help promote the high-performance team concept for all the professionals you teach. The ability to build your own case scenarios further expands your flexibility to tailor the PALS Course.
Prebriefing and Debriefing
Effective briefing before a learning event, known as prebriefing, helps establish a safe environment for learning. During prebriefing, you can build a sense of psychological safety by letting students know that mistakes are expected and should serve as sources of learning. This also provides an opportunity to encourage students to take interpersonal risks. During the prebriefing session, the team will set an objective goal for the case scenario.
After each case scenario, you’ll conduct a debriefing session. This is an evidence-based method of helping students think about their actions and how they can apply this knowledge in the clinical setting.
During the debriefing, you’ll also lead a discussion about whether the students accomplished the goal they set for their team during the prebriefing.
Course Videos
The AHA allows instructors to tailor the PALS Course to meet the needs of specific audiences. For example, if most of your students are nurses, you can select the In-Facility Provider track in the video.
The new videos are offered in a digital format through the AHA’s eBook application. The videos may be streamed or downloaded to a device for offline use.
Instructor Manual
The AHA has updated the instructor manual to provide additional support for you. It’s important to spend time reviewing the information detailed in each section when you prepare to teach the course.
Part 1. All AHA instructor manuals have been reorganized, placing general information in Part 1 and course-specific information throughout the other Parts. Part 1 of the instructor manual includes information that is relevant to your role as an AHA Instructor—regardless of the discipline you teach. It is important to review this entire section when you prepare for teaching a course.
Part 2 of the instructor manual provides everything you will need to prepare for teaching with the course delivery option you will be using. Part 2 also provides additional detail about the educational design and course flexibility mentioned earlier. To prepare for teaching a blended-learning course, we recommend that you take the online portion of HeartCode PALS. You will find out what students are required to learn in the cognitive training, and you will understand what that knowledge prepares them to do. Part 2 of the instructor manual also covers the precourse self-assessment. Students can take the precourse self-assessment as many times as needed to achieve a passing score of 70% or higher. If they already have a HeartCode completion certificate, they don’t need a self-assessment before entering the course.
Part 3 of the instructor manual contains information on teaching both the traditional instructor-led course and the blended-learning course, including interacting with students, course outlines, and course agendas. One of the most important points in the teaching section involves how to conduct the learning stations. Each learning station provides an environment for high-performance teams to practice and improve their communication skills, coordination, timing, and choreography.
You should conduct case-based scenarios with real equipment in real time. For example, during an arrest scenario, students should perform a full 2 minutes of CPR for the duration of the case. If possible, run the scenarios as if they were emergencies occurring in real settings, such as the back of an ambulance or on an emergency department bed.
The Team Leader decides whether it’s necessary to use advanced airway equipment with waveform capnography evaluation. Instructors should observe students performing all actions and skills indicated in the case scenarios.
Hold a prebriefing before each case. The goals of a prebriefing are to establish a positive learning environment and provide information about the session to all students.
Conduct a debriefing after each case. The goal is for students to use critical thinking skills. Rather than just focusing on what went right and what went wrong, debriefings allow students to reflect on the “why” behind their actions.
Part 4 of the instructor manual has information on testing. This section will help you understand the skills testing checklists and the exam. Skills testing checklists include both in-hospital scenarios and out-of-hospital scenarios to adapt to the students’ needs. Some content, including the lesson plans and the critical skills descriptors, has been updated to better support you when you are administering skills testing. Skills testing checklists are available as eForms that you can fill out and save electronically. eForms are located on CPRverify. For PALS, skills testing includes infant CPR, child CPR and AED, airway management, and Rhythm Disturbances/Electrical Therapy.
In Part 5 of the instructor manual, you’ll find all the information you need to conduct the learning station and Megacode scenarios, including debriefing tools, testing checklists, learning station checklists, ECG rhythms, a 2020 Science Summary Table, and sample agendas.
Part 6 of the instructor manual contains lesson plans for an instructor-led course and the classroom portion of HeartCode. Lesson plans include specific objectives, instructor tips, and icons to visually guide you throughout the lesson. Course videos are available in digital streaming format.
Exams
The AHA has an open-resource policy for exams. Open resource does not include open discussion with other students or the instructor. Acceptable resources for the exam may include:
- Provider manual (printed or eBook)
- Any notes the student took during the course
- Posters
- 2020 Handbook of Emergency Cardiovascular Care for Healthcare Providers
- 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
The AHA is introducing a new way of facilitating course exams. The AHA now offers Online Exams for the 2020 Guidelines BLS, PALS, and PALS instructor-led training courses. Online Exams improve exam security and are just one way the AHA ensures that cardholders around the world have met the same course completion requirements for classroom training. Another benefit of Online Exams is electronic scoring upon completion by the student, taking the burden of exam grading off the Instructor.
While Online Exams are the preferred method for administering exams, the AHA also continues to offer printed/paper exams, especially where Internet connectivity is limited. If you have any questions, contact your Training Center.
Online Exams are completed by students at the end of class. During a break in class or right before students take the exam, Instructors should email each student his or her unique Online Exam URL (see instructions below). NOTE: Instructors should not send the Online Exam URLs to students before class or too early during class. Doing so could jeopardize the security of the exam by allowing any students who did not attend or complete the course to access the exam.
Remediation
Effective remediation is an important part of the teaching and learning process. Knowing when and how to provide remediation appropriately can help instructors guide most students to successfully complete the course. Encouraging students to use the skills testing checklists, the critical skills descriptors, and the provider manual will also increase the likelihood of successful skills testing.
If a student requires formal remediation, speak with them privately immediately after testing, then follow the following steps for successful remediation:
- Review the critical action steps that the student did not perform adequately
- Using open-ended questions, assess the student’s understanding of the material—provide correction if necessary
- Identify whether other factors might have affected the student’s performance
- Use the same or a similar scenario for retesting the student
- Form a high-performance team composed of other students who need remediation or instructors to manage the case scenario
Provider Manual
The AHA revised the PALS Provider Manual to include a new section on the use of a CPR Coach and expanded the information on high-performance teams. The manual has also been updated with the latest AHA Guidelines science.
