Are We Training New Healthcare Providers for Emergencies Wrong?

Few scenarios are more frightening for a patient or family member than a medical emergency. In those moments of crisis, we place our complete trust in the medical team, assuming every responder is flawlessly prepared to perform life-saving procedures. We expect perfection because the stakes are unimaginably high. But how do new staff get the training they need to achieve that level of skill, especially for events that are, thankfully, rare?

This is a core problem facing medical educators across all disciplines. Pediatric cardiopulmonary arrests are classic high-risk, low-occurrence (HALO) events meaning that while providers (nurses, doctors, respiratory therapists, pharmacists, and more) must be experts in handling them, they may not encounter many during their training. The standard certification, Pediatric Advanced Life Support (PALS), is required for all emergency responders in medical facilities (hospitals, surgical centers, etc.). However, studies show that adherence to these guidelines is often poor.

To solve this, many have turned to high-fidelity simulation. A recent study sought to find the best way to teach these skills by comparing a traditional training method with a newer, more intense technique called "Rapid Cycle Deliberate Practice" (RCDP). The assumption was that the intense new method would prove far superior for long-term skill retention. The results, however, were not what anyone expected.

The "Superior" Training Method Wasn't Superior Overall

The study's most surprising finding was that over 12 months, the more intense RCDP method showed no overall superiority to traditional training for long-term skill retention. To understand why this is significant, it’s important to know the difference between the two approaches:

• Traditional Debriefing: The standard method, where a team runs through an entire simulated emergency without interruption. Afterward, the group discusses what went right and wrong.

• Rapid Cycle Deliberate Practice (RCDP): An intense, hands-on method where a facilitator is in the room, pausing, rewinding, and restarting the scenario to provide "in-the-moment, time-sensitive feedback" and allow for "repeated practice" of a specific skill until it is mastered.

The study’s main finding was that there was no statistically significant difference in overall skill acquisition or retention between the learners trained with RCDP and those trained with the traditional method over the full year. Given that RCDP is a more resource-intensive form of training, requiring specialized facilitators, this finding challenges the assumption that programs should universally adopt it without considering its specific benefits and costs.

But for a Quick Boost, Timing is Everything

While RCDP wasn't better for long-term retention, the study uncovered a crucial nuance: the method showed a significant advantage for immediate skill acquisition at one specific time point.

The cohort of learners who received a repeat RCDP training session at the three-month mark showed a statistically significant improvement in their mean skill scores from their pre-session assessment to their post-session assessment. This gain was significantly greater than that of the group receiving traditional training at the same time, whose scores actually decreased slightly.

Importantly, this superiority did not persist at later check-ins at six, nine, or 12 months. This suggests RCDP's greatest power may be as an early "booster" session to rapidly solidify skills. This may be due to a lack of simulation throughout the year, or other confounding factors. However, this finding shifts the debate from simply asking which method is better to a more complex question of when and how often different training methods should be deployed.

The Healthcare Staff-in-Training Skills Gap is Real

This study doesn't just compare teaching methods; it highlights the urgent need for effective simulation in the first place. This reinforces a worrying reality: despite standard certifications, new staff are often underprepared for real-world emergencies.

The demographic data of this study’s participants underscores the problem. A staggering 54% reported never having experienced a real-life patient "code," and only 25% had ever performed CPR in a clinical setting. This skills gap is precisely what high-fidelity simulation is designed to close. This context elevates the importance of simulation research from interesting to essential for patient safety.

Any Kind of Deliberate Practice is Better Than None

While the debate between RCDP and traditional debriefing continues, the study delivered one unequivocally positive result: simulation works. Across the board, there was significant improvement found in the various groups.

However, the study also revealed a critical insight about the importance of timing and frequency. While average skill scores were higher for those who had received a repeat session during the year than for those who had not, the difference was not statistically significant. This suggests that while any practice is helpful, the timing and nature of that practice are what truly matter for achieving measurable gains.

The core principle of focused repetitive practice with expert feedback remains the foundation of skill development. Consistent, simulation-based education is an essential tool for preparing doctors for the moments that matter most.

The Quest for the Perfectly Prepared Healthcare Staff

This study suggests a critical shift in perspective for medical educators of all disciplines: from a "which method is best?" mindset to a more strategic "how do we best combine methods in a curriculum?" approach. The much-hyped RCDP method is not a silver bullet for long-term skill retention, but a powerful, specialized tool to be deployed for rapid skill acquisition early in training.

Of course, the study has limitations, including a small sample size, the use of a novel assessment tool, and a non-randomized schedule for repeat education. The authors call for future "higher power randomized controlled trials" and qualitative studies to build on their findings. But their work pushes the conversation forward, challenging us to think more deliberately about curriculum design. It leaves the medical education community with a new, more sophisticated question: How do we design programs that strategically layer different simulation techniques, using RCDP for its immediate impact and traditional debriefing for other goals, to build and sustain mastery over time?

(Study Reviewed: Flood S M, Mittga M, Higgins J, et al. (November 17, 2025) Rapid Cycle Deliberate Practice Compared With Traditional Simulation Debriefing for Resuscitation Skills Training in Pediatric Residents. Cureus 17(11): e97096. doi:10.7759/cureus.97096)