ObjectiveTo determine whether an advanced cardiac life support (ACLS) computer simulation program improves retention of ACLS guidelines more effectively than textbook review.DesignRandomized, controlled trial.SettingAcademic medical center.ParticipantsForty-five anesthesia residents and faculty tested 10 to 11 months after ACLS provider course training.InterventionParticipants were randomized and asked to prepare for a mock resuscitation (Mega Code) with either textbooks or a computerized ACLS simulation program.Main Outcome MeasurePerformance on a standardized Mega Code examination that required application of supraventricular tachycardia, ventricular fibrillation, and second-degree Type II atrioventricular block algorithms. Mega Code sessions were administered by an instructor who was blinded as to the subject group. The sessions were videotaped and scored by two evaluators who also were blinded as to the subject group.ResultsParticipants who used the ACLS simulation program scored significantly higher (mean 34.9 +/- 5.0 [SD] of 47 possible points) than participants who reviewed using a textbook (29.2 +/- 4.9); p < .001. Pass-fail rates for the algorithms were also higher for the group that reviewed with the simulator (mean 2.5 +/- 0.5 of 3 possible passes) than the group that used the textbook (1.6 +/- 1.0); p = .001.ConclusionsUse of a computerized ACLS simulation program improves retention of ACLS guidelines better than textbook review. (Crit Care Med 1999; 27:821-824)