IJCS | Volume 33, Nº2, March / April 2020

152 Catolino & Knofholz Medical behavior before and after advanced cardiac life support (ACLS) course Int J Cardiovasc Sci. 2020; 33(2):151-157 Original Article Doctors’ updating is crucial for adequatemanagement of cardiorespiratory arrest. Training and continued education on cardiopulmonary resuscitation (CPR), 3,4 since success in cardiac arrest management requires technical and scientific efficiency, as well as adequate team training. 5 Cardiorespiratory arrest care should be considered mandatory and priority knowledge for all health professionals, regardless of their specialty. It requires adequate infrastructure with frequent updates to basic life support conduct for an effective, harmonious and synchronized work of the multidisciplinary team. 6,7 This work aims to identify the effectiveness of ACLS course in enabling physicians to handle cardiovascular emergency situations. It was based on the assumption that ACLS essentially seeks to standardize the actions in a cardiorespiratory arrest situation, so the patients may receive the best treatment.¹ The importance of this study is remarkable because if the alleged increase in effectiveness after ACLS training is confirmed, more hospitals or educational institutions would appreciate the application of the course and invest in the training of their professionals and students. This investment would be reflected in the patients with cardiorespiratory arrest, who would most likely be assisted by successful resuscitation teams. Methods Data collection The ACLS efficacy analysis was performed by distributing a questionnaire to physicians working at the emergency room of hospitals in the city of Curitiba, state of Paraná. The questionnaire was to be answered on a volunteering basis and included 5 multiple choice questions. It contained an approach involving theoretical and practical knowledge about cardiopulmonary resuscitation (Supplementary 1). In addition to the questions, additional data were collected such as the physician’s year of training, age, institution of graduation, medical specialty, employing hospital and participation in the ACLS course, as well as the year in which such training took place. Volunteering physicians answered the survey in front of a researcher in the emergency room. This was to avoid any potential consultation or communication among the volunteers, which could add bias to the results. In total, 34 physicians participated in the study. There was no specific criterion for determining the sample size. The number of volunteers was exclusively due to the number of physicians willing to participate in the study that met the inclusion criteria during the data collection period. Once the data were collected, the main focus of the discussionwas the comparison between the performance of volunteers who had attended the ACLS course versus the performance of those who did not, seeking to analyze the effectiveness of the course. Also, the retention of knowledge in the short and long term was examined by contrasting the results of the volunteers participating in the course to the year in which such training occurred. Statistical analysis The epidemiological data collected in the questionnaire was evaluated by descriptive statistics, and normality check was performed using the Kolmogorov-Smirnov test. The variables were represented by medians and values of the first and third quartiles. For the association analysis, independence tests were performed between the groups using Fisher’s test with odds ratio calculation, and 95% confidence interval using the SISAprogrampackage. The analysis between the groups and the median number of correct questions were performed using the Mann- Whitney/Kruskal-Wallis tests with odds ratio calculation, in the GraphPad Prismprogram. P values lower than 0.05 were considered significant. Results The questionnaire was distributed to 34 volunteer physicians working at the emergency room of hospitals in Curitiba. Of this total, 20 had attended an ACLS course, while 14 had not. In order to facilitate exposure, the group of physicians who attended the ACLS course (n = 20) was named “Group A” and the group of physicians who had never attended an ACLS course (n = 14) was called “Group B”. Since the data followed a non-normal distribution pattern, nonparametric statistical tests were performed. Regarding the number of correct answers in the questionnaire, it could be observed that the groups (physicians who have attended an ACLS course versus physicians who have never attended such course) tend to be different, with p value of 0.06 (Figure 1). Group A obtained a median score greater than Group B (4.00 vs. 3.00). However, this difference was not statistically validated (p = 0.06). In addition, it was observed that Group A scored at least 3 of the 5 questions in the questionnaire, while Group B showed inferior