Saint Peter

Saint Peter's University Hospital


When educators and leaders at Saint Peter’s University Hospital transitioned from instructor-led courses to HeartCode®, a self-directed training program that pairs online learning with Voice Assisted Manikins (VAMs), they were able to:

  • Enhance the quality of life support training while improving overall employee satisfaction
  • Provide learning that adapts to an individual’s level while maintaining standardization
  • Reallocate labor costs for as many as 30 teaching positions
  • Realize significant cost savings
  • Establish a program to train and certify physicians that was a revenue generator for the hospital


Saint Peter’s University Hospital is a 478-bed regional care facility with 30,000 inpatient and more than 200,000 outpatient annual visits. The Roman Catholic-sponsored teaching hospital, which has been serving the healthcare needs of central New Jersey for more than a century, a major clinical affiliate of Rutgers Biomedical and Health Sciences and the New Jersey state-designated children’s hospital.Saint Peter’s University Hospital has made great strides to advance its Cardiopulmonary Resuscitation Program (CPR). Through collaboration with HealthStream, Saint Peter’s hospital eliminated all instructor-led classes and implemented HeartCode BLS and HeartCode ACLS, cutting-edge programs developed by the American Heart Association (AHA). Leaders knew the realistic learning experience and immediate audio feedback from the VAMs would improve the quality of care delivered by their staff, while boosting training compliance rates and lowering costs.

After fully implementing HeartCode, course participants, however, gave the program mixed reviews. While many learners were excited to use the VAMs, others needed help adjusting to the new technology and requested to have a live instructor present during the skills practice and testing portion of the BLS course. Some also stated that the technology did not match their learning style and were even going so far as to take BLS courses outside of the hospital at their own expense. Staff development leaders knew the VAMs system was superior due to the precise measurement and feedback provided that an instructor, alone, cannot provide. To help staff adapt to the new training methodology and to ensure the future success of the HeartCode program, adjustments would have to be made.

In order to get leadership buy-in, you have to present the evidence in support of the program… you can’t dispute the facts. If you look at the HeartCode program, the Voice Assisted Manikins assess all students objectively so you’re actually providing every student with the same type of learning which supports improved quality.
— Lisa DiGiovanni, EdD, MSN, RN-BC, Staff Development Instructor



Hospital educators decided to take a scientific look at why some students were resistant to using the VAMs. Staff Development Instructor Lisa DiGiovanni performed a year-long study that included surveys from 84 employees who took HeartCode BLS Part 1, 2 and 3 with VAMs. Using a mixed methodology approach of data analysis and qualitative interviews, the study examined how students’ learning styles affected their preference for using the VAMs vs. instructors. Ultimately, the study showed that learning style had no bearing on resistance to VAMs, rather those who were naturally resistant to change and the unknown simply needed more help adapting to the new approach.

Guided by these findings and with support from senior leadership, Saint Peter’s University Hospital began offering eight instructor hours each week for HeartCode BLS and HeartCode ACLS Part 2 and 3 courses. In addition, an instructor-led HeartCode PALS Parts 2 and 3 course is offered 2-3 times per month to accelerate skills acquisition and reduce fatigue. By having an instructor present during HeartCode 2 and 3 skills practice and testing to assist with navigating the new technology and facilitating appropriate body mechanics, previously resistant learners are now embracing HeartCode. Upon renewal, many have chosen to opt out of instructor facilitation since they are now more comfortable with the program.


Today, the streamlined HeartCode program features one part-time instructor, a training center coordinator, and and the assistance of the Clinical Education and Nursing Research Department secretary. Program administrators note that having an instructor who views the technology as a beneficial tool in critiquing students’ performance has been critical to the program’s success. With less overhead and a more consistent approach, the hospital is now able to offer HeartCode classes to independent physicians in the community through a HealthStream Express site that generates revenue for the education department.

"It was essential that leadership was aware of the need to support certain employees during the HeartCode skills practice and testing. Having an instructor present has reduced the stress responses felt by some participants, therefore enhancing their learning experience." 
— Lisa DiGiovanni, EdD, MSN, RN-BC, Staff Development Instructor

HealthStream Brands