# Developing a learning tool for advanced life support and resuscitation: Performance Reflection Model for Resuscitation (PRM-Resus)

## TL;DR

This study developed a new learning tool called PRM-Resus to improve advanced life support training by helping learners reflect on their performance and understand team roles better.

## Contribution

The study introduces PRM-Resus, a structured performance reflection model integrated with team models and video examples for advanced life support training.

## Key findings

- PRM-Resus includes four domains with behavioral descriptors that experts found clear and educationally valuable.
- The tool showed high internal consistency (α > 0.95) and supported deeper performance analysis in simulation training.
- Combining PRM-Resus with the ALS Team Model and video exemplars enhanced post-simulation reflection and feedback delivery.

## Abstract

Acquiring proficiency in advanced life support (ALS) can pose challenges for novice learners. Simulation-based training (SBT) is widely used to address this, offering learners opportunities to practise and receive feedback during debriefing. However, existing performance tools often lack the clarity, behavioural specificity, and educational scaffolding required to support deep reflective learning. This study aimed to develop and evaluate the Performance Reflection Model for Resuscitation (PRM-Resus) and to integrate it with the ALS Team Model and structured video exemplars as a comprehensive learning package to enhance ALS training.

The study involved four phases. Phase 1 created the ALS Team Model to clarify individual roles. Phase 2 focused on co-designing PRM-Resus, using team expertise and the Team Model to create behaviourally anchored performance descriptors. In Phase 3, video scenarios were produced to represent ALS team performance at varying proficiency levels. Phase 4 evaluated the PRM-Resus through expert think-aloud studies. Qualitative content analysis was used alongside Cronbach’s alpha to assess internal consistency and its use for SBT.

The PRM-Resus comprises four domains—clinical skills, clinical knowledge, team management, and leadership—each defined by behavioural descriptors across three performance levels. The participating experts endorsed the tool’s clarity, structure, and educational value for novice learners. Internal consistency was high (α > 0.95). When used alongside the ALS Team Model and video exemplars, PRM-Resus facilitated deeper performance analysis, which had potential for enhancing post-simulation reflection and supporting faculty development.

This study presents a novel, interdisciplinary framework that integrates PRM-Resus, the ALS Team Model, and video exemplars to support reflective learning in ALS simulation. Together, these tools help novice learners build a concrete understanding of effective team performance and enable educators to deliver more structured feedback. Further research should explore its impact on learner development and potential translation into improved clinical outcomes.

The online version contains supplementary material available at 10.1186/s12909-025-07509-9.