Early or late booster for basic life support skill for laypeople: a simulation-based randomized controlled trial

Exploring effects of a booster workshop on progression and retention of resuscitation skills of residents when added to regular low-dose simulation

BACKGROUND

Improving the resuscitation and teamwork skills of residents is key to better outcomes of in-hospital cardiac arrest events. This study aims to explore the effects of regular low-dose simulation combined with a booster workshop on the progression and retention of resuscitation skills and teamwork among residents.

METHODS

This comparative study took place at a teaching hospital in Northern Taiwan from August 2019 to June 2021. Residents were divided into two groups: the control group received regular low-dose simulation with faculty-led debriefing at the 1st, 6th, and 11th months, while the intervention group participated in an additional 3-hour simulation workshop one week before the 6th-month scenario. The workshop focused on resuscitation and teamwork skills. The study evaluated medical task performance, teamwork, patient safety attitudes, and timing of key resuscitation actions through standardized simulation scenarios, with the assessments occurring at the 1st, 6th, and 11th months (pre-test, mid-test, post-test, respectively).

RESULTS

Outcome measures in medical task performance and team leader behavior showed statistically significant improvement in both groups (p < 0.05) from pre-test to mid-test. After the intervention, the exposure group demonstrated significantly better results in medical task performance, team leader behavior, patient safety attitudes, and the timing of chest compression initiation compared to the control group (p < 0.05). Five months after the intervention, a significant decline in most measured outcomes was observed in the exposure group (p < 0.05). Despite this decline, the exposure group still performed significantly higher than the control group across most measured outcomes.

CONCLUSIONS

This study demonstrates the potential and advantages of integrating simulation-based training into the clinical training curriculum for residents to improve medical task performance and teamwork behaviors for handling in-hospital cardiac arrest scenarios. The observed decline in skills over time supports the inclusion of regular refresher courses to maintain and advance these vital competencies.

The Effects of Serious Games on Cardiopulmonary Resuscitation Training and Education: Systematic Review With Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Serious games have emerged as an innovative educational strategy with the potential to significantly enhance the quality and effectiveness of cardiopulmonary resuscitation (CPR) training. Despite their promise, there remains a degree of controversy when comparing the advantages of serious games with traditional CPR training methods. This study seeks to provide a comprehensive assessment of the impact of serious games on CPR training and education by systematically analyzing the results of previous research.

OBJECTIVE

This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies.

METHODS

We conducted a thorough and systematic search across 9 prominent web-based databases, encompassing the period from the inception of these databases until April 1, 2023. The databases included in our search were PubMed, Cochrane Library, Wiley Online Library, EBSCO (PsycInfo), SpringerLink, Chinese Biology Medicine Disc, Vip Journal Integration Platform, Wanfang Database, and Chinese National Knowledge Infrastructure. The studies selected adhered to the following criteria: (1) being a randomized controlled trial comparing serious games and traditional methods for CPR training; (2) having participants aged 12 years or older in CPR; (3) having an experimental group using serious games and a control group using nongame methods for CPR instruction; and (4) having outcomes including theoretical and skill assessments, compression depth, and rate. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Data analysis was performed using RevMan (version 5.3; Cochrane Training), and mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables.

RESULTS

A total of 9 articles were included, involving 791 study participants, of whom 395 in the experimental group taught CPR training using serious games and 396 in the control group taught CPR training using traditional methods. The results of our meta-analysis indicate that the use of serious games in CPR training yields outcomes that are comparable in effectiveness to traditional training methods across several key areas. Specifically, serious games demonstrated equivalence to traditional formats in theory assessment (SMD -0.22, 95% CI - 0.96 to 0.51; P=.55), skill assessment (SMD -0.49, 95% CI -1.52 to 0.55; P=.36), compression depth (MD -3.17, 95% CI -0.18 to 6.53; P=.06), and compression rate (MD -0.20, 95% CI -7.29 to 6.89; P=.96).

CONCLUSIONS

In summary, serious games offer a viable and effective CPR education approach, yielding results comparable to traditional formats. This modality is a valuable addition to CPR training methodologies. However, caution is warranted in interpreting these findings due to limited controlled trials, small sample sizes, and low-quality meta-analyzed evidence.