Implementation of a Real-Time Defibrillator to Correct Cardiac Rhythm Disturbances in Safety Scenarios When Teaching Physiology

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Background: When a patient undergoes cardiac arrest, the longer a patient goes without defibrillation and successful recognition of ventricular fibrillation (V-Fib) or ventricular tachycardia (V-Tach) rhythm, chances of survival decline at 74 percent for those who received their first defibrillation no later than three minutes after a witnessed collapse(Valenzuela et al., 2000), therefore, early defibrillation for V-Fib is underpinned by the fact that the rate of successful resuscitation falls by 7%–10% per min from the circulatory collapse(Szabó et al., 2020), and has being documented in 70% of cases that there was V-Tach and V-Fib in which early defibrillation is the most effective for cardiac arrest(de Luna et al., 1989). Therefore, the objective of our study was to implement defibrillation skills in a virtual simulated setting to determine the acceptability of the implementation of a Real-Time Defibrillator(RTD) for shockable cardiac rhythms in safety scenarios at the nation´s largest school of medicine in Guatemala to test the hypothesis that a virtual interactive learning tool would have higher learning acceptability when correcting cardiac rhythm disturbances in a safe environment for medical students while building confidence to operate a defibrillator. Methods: This study included 114 medical students. After a 45-minutes of theoretical lecture on physiology and pathophysiology of cardiac arrest fundamentals, normal cardiac rhythm, non-shockable and shockable rhythms were taught and tested with a free web-based RTD available at https://joshferge.com/Defibrillator-Simulator/Tutorial?testnum=1&sess=-1&user=undefined to assess students’ ability to use the defibrillator to correct rhythm disturbances. The defibrillator has 3 components: An interactive tour of the defibrillator's features and accessories, a case-based tutorial that guides you through the management of case scenarios requiring defibrillation, synchronized cardioversion, or transcutaneous pacing, and lastly a series of cases designed to test your ability to use the defibrillator to correct rhythm disturbances within a suggested timeframe. The acceptability was assessed using a five-point Likert scale to evaluate: “general perception”, compliance with “real-rime defibrillator objectives”, “realism”, “educational value”, “quality of practice”, and free text comments. Median (IQR) were obtained for the scale excellent=5, very good=4 and adequate=3. Free text comments were grouped according to recurrent themes, age and sex were obtained. Data analysis was performed using STATA 12. Results: Of the 114 participants, 65 (57.02%) and 49(42.98%) were women and men respectively, the mean (SD) age was 21.7(2.12). The survey data(median:IQR) for the virtual RTD general perception was, 5 (5-5); objectives reached, 5 (5-5); realism, 5 (4-5); educational value, 5 (5-5); and quality of practice, 5 (4-5); there were no mediocre or poor ratings. Recurrent comments were: “an excellent practice and virtual didactic material”, “The RTD is closer to reality, and with that we could practice more often to learn for scenarios in real life”, “Everyone should use it when learning to perform cardiac defibrillation”. Conclusions: Cardiovascular rhythm disturbances correction with a virtual RTD integrated into cardiovascular physiology, showed high learning acceptability to learn device management and assess skills in safety scenarios for medical students to evaluate diagnostic skills in a more realistic way, to better prepare for early recognition of a patient succumbing to a myocardial event. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

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