The modern ACLS skills check has evolved. Many healthcare professionals now complete their “hands-on” portion using high-fidelity, voice-assisted manikins rather than a live instructor. While this removes the pressure of being watched by a person, it requires a different kind of precision. The manikin doesn’t “give you the benefit of the doubt”, it measures every millimeter of compression and every millisecond of a pause.
This checklist is designed to help you prepare for a technology-driven ACLS skills session, ensuring you meet the objective metrics required for success.
What is a Manikin-Based ACLS Skills Check?
Unlike traditional classroom testing, a manikin-based check (often used in RQI or HeartCode® programs) uses sensors to provide real-time feedback. This system uses sensors to measure the quality of your CPR and voice recognition to track your decision-making process.
Because this format is objective, you cannot “talk your way” through a mistake, the manikin records exactly what your hands do. This session is typically the practical requirement for those who have completed the online portion of their ACLS Certification course.
The ACLS Skills Check Checklist: Step-by-Step Preparation
To pass a manikin-based evaluation, you must master both the cognitive algorithms and the physical mechanics of resuscitation. Use this checklist to guide your study.
1. Master the Metrics (The Manikin is Watching)
In an instructor-led course, an instructor might subjectively grade your compressions as “good.” In a manikin-based session, the computer requires specific metrics. If you do not meet them, the system will not advance.
- Compression Rate: You must maintain a rate of 100–120 compressions per minute. The manikin will track this in real-time.
- Compression Depth: For adults, you must compress at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
- Full Recoil: You must allow the chest to recoil completely after each compression. The sensors detect if you are “leaning” on the chest.
2. Refresh Your BLS Foundation
The ACLS algorithms build upon High-Quality BLS. The manikin will not let you proceed to advanced interventions if the basic CPR quality is poor.
- The Adult Chain of Survival: Ensure your BLS Certification skills are current. You will be required to demonstrate the Adult Chain of Survival, including recognizing cardiac arrest and starting CPR immediately.
- Minimizing Interruptions: The system tracks “Hands-on Time.” You must minimize interruptions in compressions to less than 10 seconds for rhythm checks and shock delivery.
3. Know Your Algorithms Cold
In a Voice-Assisted Manikin (VAM) session, you act as the team leader. The manikin (via the computer) will present a scenario, and you must verbalize your actions and then perform them.
- Rhythm Interpretation: You will need to verbalize what you see on the monitor. “I see Ventricular Fibrillation, charging the defibrillator.”
- Post-Cardiac Arrest Care: Know the immediate steps for ROSC (Return of Spontaneous Circulation).
- H’s and T’s: Be ready to verbalize your search for reversible causes (H’s and T’s).
4. Prepare for Voice Recognition and Verbalization
One of the biggest adjustments in manikin-based testing is learning how to interact with the software.
- Speak Clearly: The system uses voice recognition to confirm your medical decisions (e.g., “Epinephrine 1 mg IV”). You must enunciate clearly.
- Verbalize Everything: Unlike a human instructor who might infer what you are thinking, the computer needs explicit commands. You cannot just look at the monitor; you must say, “I am analyzing the rhythm.”
Common Mistakes to Avoid in a Manikin Session
Because the testing is computerized, certain errors will instantly pause or fail your session. Watch out for these pitfalls:
- Failing to “Clear” for Shock: You must verbalize “Clear” and simulate looking at the patient. Say: “Charging… I am clear, you are clear, everyone is clear… Shock delivered.”
- Leaning on the Chest: This is the most common failure. Practice lifting your hands slightly at the top of each compression without losing contact.
- Long Pauses: If you stop compressions for more than 10 seconds to intubate or check a rhythm, your score will drop.
Conclusion: Confidence Through Preparation
The ACLS Skills Check is a validation of your ability to save a life. Whether you are testing in front of a human or a high-tech manikin, the goal is high-quality care.
By reviewing the checklist above and practicing high-quality CPR beforehand, healthcare professionals can approach their skills session with confidence and demonstrate their readiness to manage cardiac emergencies.
If you have completed your online learning and are ready to validate your skills, or if you need to start the process, we are here to help.
Register for an ACLS Skills Session Today or Explore Our Full ACLS Certification Course
Frequently Asked Questions (FAQs)
How long does the manikin-based ACLS skills check take?
The skills session typically takes 30 to 45 minutes. This includes time to log into the system, complete the required simulation scenarios.
Can I fail the skills check because of bad CPR form?
Yes. In a manikin-based session, the computer has strict settings for depth and rate. If you compress too shallow, too slow, or too fast, the system will flag the performance as “inadequate.”
What happens if I fail the simulation?
If the manikin system indicates a failure (due to incorrect algorithm choices or poor CPR quality), most training centers allow you to review your errors and retake the simulation scenario immediately.
Is the manikin test harder than a test with a human instructor?
It is different. Some find it harder because they cannot rely on an instructor’s hints or “soft” grading on compressions. Others find it easier because the computer provides immediate visual feedback on your CPR rate and depth, allowing you to self-correct in real-time.
Do I need to memorize ACLS medication doses?
No. Most ACLS skills sessions focus primarily on recognizing cardiac rhythms and following treatment algorithms. However, providers should understand when medications like epinephrine or amiodarone are indicated during cardiac arrest management.