Monday, November 28, 2005

An interesting question from Bard Parker.

I started teaching ACLS in 1990. It wasn't until 1992 that it became "kindler and gentler." As many of remember, you actually had to lead the megacode yourself and there was a possibility that your "patient" would die. The megacodes were more difficult for the docs than for the EMT's, to be sure.

However, only the docs were required to pass for their jobs and many of the non-physician participants would fail. They would often return at another class just to retest the portion they had failed.

In 1998, I was told by the course director that I was too hard on the class DURING THE LECTURE and that I would not be needed during the megacode testing!

Nowadays, you are right, it is expected that everyone will pass. Teaching ACLS is a money-maker for the institution and you want the students to recommend your classes. The last few times I taught, I was given the test before my lecture so I could, basically, tell the students what the questions were from my subject area. I have seen instructors teaching with the test in their hands.

Given the emphasis that everyone pass and the evidence that a drug company can buy its way onto an algorithm, I think ACLS is a big waste of time. It is ridiculous that a physician will complete a residency in EM and pass the boards and the hospital will require an ACLS card in order to be on the ER schedule.