Purpose of the study: Rapid Cycle Deliberate Practice (RCDP) is a within event debriefing method that has been shown to improve adherence to resuscitation guidelines in pediatric cardiac arrest among residents. Anaphylaxis resembles cardiac arrest in the presence of a guideline with predefined steps in an international treatment algorithm.
The aim of this study was to examine if ambulance technicians would show improved performance in adherence to the anaphylaxis treatment algorithm when trained using RCDP in anaphylaxis scenarios compared to a standard after event debriefing method when tested in an Objective Structured Clinical Examination (OSCE).
Materials and methods: The study was a prospective observational study. It was conducted as a part of the national ambulance technician training program at Copenhagen Academy for Medical Education and Simulation (CAMES). Training in the anaphylaxis treatment algorithm using simulation and after event debriefing is part of the standard curriculum and served as the control group. The intervention group was trained in a similar anaphylaxis simulation scenario using the within event debriefing method RCDP. The course ended with an OSCE where performance in adherence with anaphylaxis guideline was tested in an anaphylaxis scenario. The primary outcome was the systematic performance of the anaphylaxis algorithm directly evaluated at the OSCE.
Results: A total of 65 ambulance technicians participated in the study and completed both training and OSCE. Though the intervention group´s mean point score at the OSCE anaphylaxis simulation was better than that of the control group, the difference was not significant (P=0.46). No single primary outcome showed significant differences between the two groups.
Conclusion:  RCDP did not improve the adherence to anaphylaxis guidelines in our population of trainee ambulance technicians, however it was not found to impact performance in a negative way compared to after event debriefing either.

2 - Ambulance technician trainee’s performance in adherence to anaphylaxis guidelines after “rapid cycle deliberate practice” compared to standard after event debriefing.