Embed recurrent, context-aligned ALS rehearsal with feedback supported by protected training time, accessible infrastructure, and ongoing performance monitoring¶

Strategy · All strategies
Evidence · 3 claims (3 for) · 1 study (1 review), q2 · 0 of 1 report an effect size · 3 claims rest on one study

Description¶

The review recommends treating ALS competence maintenance as an ongoing workplace capability rather than episodic recertification. Critical care programmes should embed recurrent rehearsal with feedback, prioritise high-consequence actions, and reinforce role clarity, leadership, and closed-loop communication, supported by organisational conditions. The review states: "Critical care programmes should embed recurrent rehearsal with feedback, prioritise high consequence actions and reinforce role clarity, leadership and closed loop communication."

Design Implications¶

Context¶

Requirements¶

• Organisational support including protected time, governance, standardised roles, audit with feedback, and accessible training infrastructure

Constraints¶

• Psychological readiness may be included within broader programmes but should not be presented as a proven standalone mechanism

Target Learners¶

• physicians and nurses in hospital-based critical care settings

Target Learning Goals¶

• maintenance of ALS competence including knowledge, psychomotor skills, and non-technical team behaviours

Affordances¶

• Three Domain Als Competence Maintenance Framework

Claims¶

• A team-focused, video-reviewed ED CPR bundle combining mechanical compression device training, in situ simulation, and multidisciplinary video review was followed by higher ROSC [+W]
• Educational factors were the most frequently reported domain influencing ALS competence maintenance, followed by institutional and individual determinants [+W]
• Spaced simulation reinforcement showed selective benefits: some psychomotor measures improved while written knowledge and time to shock did not [+W]

Related Strategies¶

• Design CPR education as an ongoing, reinforcement-based process combining spaced intervals, feedback, and cognitive components
• Design CPD programs with hands-on skill development, ongoing reinforcement, and integration into workplace protocols
• Integrate simulation as a curriculum-embedded component with trained instructors and technological infrastructure

Examples¶

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Key Sources¶

• de Sousa Sónia Ferreira, Marques Maria do Céu Mendes Pinto, da Silva Amaral Guida Maria Marques. (2026). Factors Influencing the Maintenance of Advanced Life Support Competencies Among Critical Care Professionals: A Scoping Review. Nursing in Critical Care. https://doi.org/10.1111/nicc.70545