Indian and United States paramedic students: comparison of examination performance for the American Heart Association Advanced Cardiovascular Life Support (ACLS) training

J Emerg Med. 2012 Aug;43(2):298-302. doi: 10.1016/j.jemermed.2011.05.096. Epub 2012 Jan 12.


Background: The American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) course is taught worldwide. The ACLS course is designed for consistency, regardless of location; to our knowledge, no previous study has compared the cognitive performance of international ACLS students to those in the United States (US).

Study objectives: As international health educational initiatives continue to expand, an assessment of their efficacy is essential. This study assesses the AHA ACLS curriculum in an international setting by comparing performance of a cohort of US and Indian paramedic students.

Methods: First-year paramedic students at the Emergency Management and Research Institute, Hyderabad, India, and a cohort of first-year paramedic students from the United States comprised the study population. All study participants had successfully completed the standard 2-day ACLS course, taught in English. Each student was given a 40-question standardized AHA multiple-choice examination. Examination performance was calculated and compared for statistical significance.

Results: There were 117 Indian paramedic students and 43 US paramedic students enrolled in the study. The average score was 86% (± 11%) for the Indian students and 87% (± 6%) for the US students. The difference between the average examination scores was not statistically significant in an independent means t-test (p=0.508) and a Wilcoxon test (p=0.242).

Conclusion: Indian paramedic students demonstrated excellent ACLS cognitive comprehension and performed at a level equivalent to their US counterparts on an AHA ACLS written examination. Based on the study results, the AHA ACLS course proved effective in an international setting despite being taught in a non-native language.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advanced Cardiac Life Support / education*
  • Allied Health Personnel / education*
  • Allied Health Personnel / statistics & numerical data
  • Curriculum
  • Educational Measurement
  • Female
  • Humans
  • India
  • Male
  • Statistics, Nonparametric
  • Students* / statistics & numerical data
  • United States
  • Young Adult