Electronic Supplementary Materials
Table E1: Classification and levels ofevidence of articles reviewed
[1] RCTs, and cross-over trials (if randomised) / [2] Cohort studies, "outcomes", Audit / questionnaire results, Ecological studies / [3] Case controls, limited population studies / [4] Case series, research from a database, non-randomised or observational studies / [5] Expert opinion - no explicit critical appraisal, or based on "first principles" / Letters / Editorial / comentary / ReviewA. Training Issues
i) The Scale of the Problem
Resuscitation and acute care skills [1-31] / 0 / 27 / 0 / 0 / 0 / 4 / 0 / 0
Practical skills at time of graduation [32-47] / 0 / 14 / 0 / 0 / 0 / 1 / 1 / 0
Acute care teaching [48-59] / 0 / 5 / 0 / 0 / 6 / 1 / 0 / 0
BLS and ALS teaching [60-75] / 1 / 9 / 0 / 3 / 2 / 1 / 0 / 0
Emergency medicine teaching [76-83] / 0 / 7 / 0 / 0 / 1 / 0 / 0 / 0
Other clinical skills teaching [84-95] / 0 / 10 / 0 / 0 / 2 / 0 / 0 / 0
Totals (n=95) / 1 / 72 / 0 / 3 / 11 / 7 / 1 / 0
ii) Educational Interventions
Assessment [96-109] / 0 / 13 / 0 / 0 / 0 / 0 / 0 / 1
Courses, placements curricula [110-186] / 7 / 48 / 0 / 6 / 3 / 1 / 3 / 9
Medical simulation [187-230] / 3 / 32 / 0 / 2 / 0 / 0 / 2 / 5
Totals (n=135) / 10 / 93 / 0 / 8 / 3 / 1 / 5 / 15
B. Clinical Issues
i) The Scale of the Problem
Healthcare systems error [231-254] / 1 / 6 / 0 / 10 / 0 / 0 / 3 / 4
Adverse outcomes in the critically ill [255-272] / 1 / 5 / 0 / 8 / 0 / 1 / 0 / 3
Adverse outcomes post-cardiac arrest [273-294] / 1 / 16 / 0 / 3 / 0 / 0 / 0 / 2
Diagnostic errors [295-302] / 0 / 0 / 0 / 8 / 0 / 0 / 0 / 0
Failure to identify 'high-risk' patients [303-334] / 0 / 14 / 0 / 13 / 0 / 2 / 1 / 2
Totals (n=104) / 3 / 41 / 0 / 42 / 0 / 3 / 4 / 11
ii) Clinical Interventions
‘Early warning' scores [335-342] / 0 / 5 / 0 / 2 / 0 / 0 / 0 / 1
Rapid Response teams [343-374] / 1 / 12 / 0 / 3 / 2 / 9 / 2 / 3
Totals (n=40) / 1 / 17 / 0 / 5 / 2 / 9 / 2 / 4
Grand Total (n=374) / 15 / 223 / 0 / 58 / 16 / 20 / 12 / 30
Table E2: Taught Courses in Acute Care
Provider / Name of Course / Website / further informationAdvanced Life Support Group / Several courses, including those dealing with acute medical emergencies, paediatric resuscitation and trauma resuscitation /
AmericanCollege of Surgeons / Advanced Trauma Life Support (ATLS) course /
American Heart Association (AHA) / Advanced Cardiac Life Support (ACLS) Provider Course, plus Basic Life Support (BLS) / Cardiopulmonary Resuscitation (CPR) provider and renewal courses /
Australian Resuscitation Council / Advanced Life Support (ALS), paediatric ALS and neonatal resuscitation courses /
Barts and The London Medical Simulation Centre / Many courses for all levels of training, including Anaesthesia Crisis Resource Management (ARCM) and simulated trauma and resuscitation training /
Basic Trauma Life Support Course International / Basic Trauma Life Support provider and instructor courses /
British Paramedic Association / Prehospital Trauma Life Support (PHTLS) course /
Centre for Medical Simulation, Cambridge US. / Anaesthesia Crisis Resource Management (ACRM) courses, Advanced Cardiac Life Support Plus+ (ACLS with a Crisis Resource Management qualification) plus courses offered for specific groups such as emergency department personnel and medical students /
European Resuscitation Council (ERC) and Resuscitation Council (UK) / Basic Life Support (BLS) / Automated External Defibrillator (AED) provider and instructor courses, Intermediate Life Support (ILS), Advanced Life Support (ALS) and Emergency Paediatric Life Support (EPLS) provider courses /
European Society for Intensive Care Medicine (ESICM) / Patient Centred Acute Care Training (PACT) - multidisciplinary distance learning programme for Intensive Care Medicine, Fundamentals of Critical Care Support (FCCS) course, Fundamentals of Disaster Management (FDM) course /
Federation of the RoyalCollege of Physicians and Surgeons of Glasgow / Ill Medical Patients Acute Care Treatment (IMPACT) / (requires log-in)
Greater Manchester Strategic Health Authority / Greater Manchester Acute Illness Management (GM AIM) / Information received via personal communication (Alex Larkin)
Intensive Care Society (UK) / Local critical care workshops /
Liverpool Department of Anaesthesia / ALERT-type one-day course for final year undergraduate medical and nursing students. / Information received via personal communication
National Association of Emergency Medical Technicians / Prehospital Trauma Life Support (PHTLS), Advanced Medical Life Support (AMLS), and Paediatric Prehospital Care (PPC) courses, aimed at all levels of professional who regularly encounter acutely ill patients in the pre-hospital setting /
New Zealand Resuscitation Council / Various courses at different ‘levels’ which prescribe the knowledge and skills that should be learnt on these courses. Courses at levels 4-7 are healthcare providers /
PortsmouthUniversity / Acute Life-threatening Events Recognition and Treament (ALERT) Course /
Resuscitation Council of Southern Africa / Several centres providing Basic Life Support (BLS) for Healthcare Providers, Advanced Cardiac Life Support (ACLS) course, ACLS for experienced providers course, Paediatric Advanced Life Support (PALS), Advanced Neonatal Life Support (ANLS) courses /
RoyalCollege of Surgeons of England / Care of the Critically Ill Patient (CCrISP) provider and instructor courses, Pre-Hospital Trauma Life Support Course (PHTLS) /
SimulationCenter for Crisis Management Training in HealthCare, StanfordUniversityMedicalSchool / Improving Management of Patients in Emergency Situations (IMPES) -Crisis Resource Management (CRM) courses in Intensive Care and in Emergency Medicine, Anaesthesia Crisis Resource Management Courses (ACRM) /
Society of Critical Care Medicine (SCCM) / Fundamentals of Critical Care Support (FCCS) course, Fundamentals of Disaster Management (FDM) course /
The list of courses and institutions offering them is far from exhaustive, but is representative of the types of courses in acute care that can be available to undergraduate students.
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