Effect of Simulation-Based Training on Paramedics’ Competence in Transcutaneous Pacemaker Application: An Experimental Study

Purpose This experimental study aimed to evaluate a structured training program on paramedics' competence in transcutaneous pacemaker (TCP) application and to explore how paramedics’ self-efficacy and perceived stress affect TCP application. Methods The study involved 60 paramedics, members of TAPDER, who graduated in 2021–2022 and had basic ECG training. Initially, paramedics received TCP training, and their knowledge was tested before and after. Then, Self-Efficacy Scale (SES) and Perceived Stress Level Scale (PSL) were administered. Results Pre-training, the experimental group correctly answered 32.2% of knowledge questions. There was no significant difference in self-efficacy between groups (p > 0.05), with both showing high SES scores (experimental: 62.13, control: 63.73). The experimental group exhibited higher perceived stress levels. Post-training, according to the TCP competency guide, 72.56% of the experimental group mastered the skill compared to 39.08% in the control group. The control group had a higher proportion needing improvement (39.64%). Conclusion Participants demonstrated above-average self-efficacy but experienced elevated stress levels, reflecting the high-pressure nature of cardiovascular emergencies. Transcutaneous pacing (TCP) skills significantly improved following simulation-based training, which not only enhances skill retention but also reduces the time required to perform this critical intervention. For prehospital emergency professionals responsible for maintaining cardiac stability, prioritizing simulation-based training is essential to ensure rapid, accurate application of TCP, ultimately improving patient outcomes in life-threatening bradycardic events.