Open Access Research article

Cost-efficiency assessment of Advanced Life Support (ALS) courses based on the comparison of advanced simulators with conventional manikins

José Antonio Iglesias-Vázquez1*, Antonio Rodríguez-Núñez2, Mónica Penas-Penas1, Luís Sánchez-Santos3, Maria Cegarra-García1 and Maria Victoria Barreiro-Díaz1

Author Affiliations

1 Public Emergency Medical System of Galicia-061 (PEMSG), Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain

2 Pediatric Emergency and Critical Care Division, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Servicio Galego de Saúde (SERGAS) and University of Santiago de Compostela, Spain

3 Arzúa's Primary Care Center, Servicio Galego de Saúde (SERGAS), Arzúa, A Coruña, Spain

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BMC Emergency Medicine 2007, 7:18  doi:10.1186/1471-227X-7-18

Published: 22 October 2007



Simulation is an essential tool in modern medical education. The object of this study was to assess, in cost-effective measures, the introduction of new generation simulators in an adult life support (ALS) education program.


Two hundred fifty primary care physicians and nurses were admitted to ten ALS courses (25 students per course). Students were distributed at random in two groups (125 each). Group A candidates were trained and tested with standard ALS manikins and Group B ones with new generation emergency and life support integrated simulator systems.


In group A, 98 (78%) candidates passed the course, compared with 110 (88%) in group B (p < 0.01). The total cost of conventional courses was €7689 per course and the cost of the advanced simulator courses was €29034 per course (p < 0.001). Cost per passed student was €392 in group A and €1320 in group B (p < 0.001).


Although ALS advanced simulator systems may slightly increase the rate of students who pass the course, the cost-effectiveness of ALS courses with standard manikins is clearly superior.