Integrating Basic Electrocardiogram Interpretation into Advanced Cardiovascular Life Support Stations Through Simulation-Based Learning Among Preclinical Medical Students: Comparing Student and Teacher Perceptions

Background: Simulation-based learning (SBL) was introduced at Phramongkutklao College of Medicine to improve electrocardiogram skills within an advanced cardiovascular life support (ACLS) context for pre-clinical students. Objectives: This study compared the perceptions of third-year students and teachers regarding the SBL course. Methods: A cross-sectional study included 96 students and 10 instructors. The course featured five stations to assess ECG interpretation, ACLS management, and pharmacological knowledge. The questionnaire included sections on demographics, a 5-point Likert scale to assess satisfaction with preparation, effectiveness, scenarios, equipment, and perception, as well as open-ended questions to explore pros and cons. Internal reliability, construct validity (exploratory factor analysis: EFA), and content validity (item objective congruence: IOC) were assessed. Responses were analyzed using Mann-Whitney U-tests, and open-ended questions underwent content analysis. Stata 17.0 was used for analysis, and p 0.05 was considered significant. Results: Eighty-nine students and 10 instructors responded to the questionnaire. Cronbach’s alpha for the satisfaction and perception sections were 0.91 and 0.97, respectively. IOC ranged from 0.67 to 1.00, and EFA confirmed unidimensionality (Eigenvalue1: Eigenvalue2 = 9.31:0.55, λ = 0.55-0.91). The participants responded positively to the preparation resources and course effectiveness. Median (IQR) scenario-difficulty scores were 5.00 (4.00-5.00) for the students and 3.50 (3.00-4.00) for the instructors (p 0.001), and perception scores were 4.93 (4.43-5.00) for the students and 4.32 (4.00-4.57) for the instructors (p=0.021). Content analysis showed that the students valued comprehensiveness and realism but wanted more pre-training. The instructors noted high resource use and information sharing by the morning group tested first, which influenced the afternoon groups and resulted in bias. Conclusion: The SBL course met learning objectives with high satisfaction and was perceived as effective. The participants agreed that it enhanced knowledge but suggested adding a peer-led mock exam to boost confidence and increasing parallel cases to reduce bias.