The effects of teaching basic cardiopulmonary resuscitation--a comparison between first and sixth year medical students

An evaluation of basic life support training among medical students in Southwest Nigeria: A web-based study

Background

Basic Life Support (BLS) is considered a lifesaving measure and sound knowledge is expected among health professionals. Studies conducted among medical doctors and students in many developing countries show deficiencies in knowledge and practice of essential BLS skills. This study assessed the awareness, knowledge, perception, practice, accessibility and barriers to BLS training amongst medical students in South-Western Nigeria, exposing skill gaps and training challenges to inform appropriate solutions.

Methods

This was a cross-sectional descriptive e-survey involving 2^nd - 6^th year medical students enrolled in 12 regional medical schools. Overall, 553 responses were received over a 3-month period from November 2020 to January 2021 and analyzed using IBM-SPSS 26.

Results

Of the 553 respondents, 79.2% were aware of BLS however only 160 (29%) respondents had good knowledge of BLS principles. Increasing age, higher level of study, prior BLS training and being enrolled in College of Medicine, University of Lagos (CMUL) were significantly associated with a higher knowledge score (p<0.05). Majority (99.5%) considered BLS training necessary however, only 51.3% had prior training. Increased level of study correlated with prior BLS training (p<0.05) alongside higher BLS uptake by respondents from CMUL (26.7%) and College of Medicine, University of Ibadan (20.9%) compared to respondents from other schools (p<0.05). Only 35.4% had ever done Cardiopulmonary Resuscitation. Most respondents reported no confidence in performing BLS (67.1%) or in using an Automated External Defibrillator (85.7%). Unavailability of training opportunities in state (35%), town (42%) and cost (27%) were major barriers to BLS training identified.

Conclusion

Despite a high level of awareness of BLS training, knowledge of BLS principles and its practice is poor among Nigerian medical students, reflecting a need to integrate stand-alone/structured BLS trainings into the medical curriculum to increase participation and accessibility by medical students.

Effectiveness and perception of demonstration-observation- assistance-performance (DOAP) versus video-assisted learning (VAL) in training advanced cardiac life support (ACLS) among medical interns - A comparative study

BACKGROUND

Demonstration-Observation-Assistance-Performance (DOAP) and Video-Assisted Learning (VAL) are small-group teaching/learning methods (TLM) in medical education. Comparison studies between the two are scanty. There is a gap in knowledge, skills, and attitude among medical interns toward Advanced Cardiac Life Support (ACLS). The author studied the effectiveness of DOAP and VAL in training ACLS using mannequins and automated external defibrillator (AED)-simulators among interns in 2021.

MATERIALS AND METHODS

This descriptive study was done in the Emergency Department of a tertiary teaching hospital in South India. Out of 80 medical interns, 39 and 41 were allocated to ACLS training by DOAP (Group 1) and VAL (Group 2), respectively, by convenient sampling with random allocation, with the use of mannequins and AED-Simulators (10 interventions in each small group; three-five participants in each session). Pre-validated pre-test and posttest multiple-choice questionnaires (MCQs) and attitude questionnaires, OSCE by two blinded assessors, and perception by Likert-based questionnaire were analyzed with appropriate statistical analysis.

RESULTS

The mean pretest and posttest MCQs and Attitude and OSCE scores of DOAP and VAL showed no statistically significant difference between them (MCQ pre-test 44.51 (11.43); 42.54 (6.56); p = 0.350 and MCQ posttest, 78.97 (8.59); 77.22 (11.29); p = 0.438; OSCE 40.51 (2.43) and 40.63 (1.92); p = 0.804; Attitude: 11 (3), 11 (2); p = 0.567; 14 (2), 14 (3); p = 0.095). MCQ post-tests showed improved scores (p < 0.001) in both the methods and the standardized mean difference based on the MCQ scores for the DOAP group was 3.02, and for the VAL group 3, showed the effectiveness of both methods. Perception scores showed learners' interest and positive feedback to both methods and ACLS.

CONCLUSION

Both DOAP and VAL were equally effective TLMs in imparting knowledge, skills, and attitude to medical interns with positive feedback. In DOAP, the learner performs under supervision and clarifies doubts. As repeatable and cost-effective, VAL is useful in resource-limited settings. Both can be used as complementary methods in training ACLS. The attitude of learners towards ACLS improved with training.

Assessment of life support skills of resident dentists using OSCE: cross-sectional survey

BACKGROUND

The aim of this cross-sectional survey was to apply the Objective Structured Clinical Examination (OSCE) to evaluate the cardiopulmonary resuscitation (CPR) and endotracheal intubation skills of resident dentists for stage assessment in standardized training.

METHODS

A total of 146 third-year resident dentists were recruited and randomly assigned to perform either CPR or endotracheal intubation. Their performance was scored by experienced anesthesiologists with standardized scoring criteria. Participants were also asked to rated their self-assessed competence, willingness, and perceptions on training status using Likert-type scales in a questionnaire. Student's ttest was applied to compare scores for CPR and endotracheal intubation performed by resident dentists with different characteristics. The results of the questionnaires were analyzed and visualized by the R package 'Likert'. Significance was set at the P < 0.05 level.

RESULTS

The mean OSCE score for endotracheal intubation (59.1 ± 12.5) was lower than that of CPR (72.4 ± 8.8). Participants with Master's degrees scored higher than those with Bachelor's degrees and Doctor of Philosophy (PhD) degrees in the assessment of CPR and endotracheal intubation. Low scores of self-assessed competence and willingness were observed, especially for endotracheal intubation. Resident dentists showed poor satisfaction on training volume and frequency of CPR and endotracheal intubation.

CONCLUSION

Resident dentists showed poor performance on CPR and endotracheal intubation assessed by the OSCE. Relatively low self-assessed competence and willingness were reported in endotracheal intubation. The medical emergency curriculum for resident dentists should be more consistent and standardized to help resident dentists enhance the proficiency of life support skills.

Periodic reinforcement of knowledge and attitude towards basic life support skills among the medical undergraduates: A necessity of undergraduate medical education

Introduction and Aim: A sudden cardiac arrest can be a life-threatening emergency with poor survival rates. By learning basic life support (BLS) and practicing simple cardiopulmonary resuscitation (CPR), the patient is likely to survive until arrival of expert medical help. The study therefore aims to determine if trained medical undergraduate students retain knowledge and attitude regarding skills.   Methods: About 150 students in the first year of medical school participated in the current study. The students attended two BLS training sessions of three hours each. The students were evaluated at six weeks and followed up at six months following the initial training session. The psychomotor skills were check-listed, and the performance was scored between 0 to 5. Data on knowledge and attitudes were collected with a pre-validated self-administered questionnaire.   Results: Among the participants, 69% were males, and 33% were females. The mean age group of study subjects was 21 ± three years. The skill scores (p=0.001) and knowledge scores (p=0.001) were significantly different at six weeks and six months after the initial training. Six weeks after the initial training session, the percentage of correct responses for knowledge questions was significantly higher than six months later. Approximately 86.3% of participants felt the BLS training was adequate to perform resuscitation confidently, while only 66.7% were confident after six months of training (p=0.001). Also, the number of students confident to give BLS during a medical emergency was significantly higher at six weeks after the initial training session than six months (p=0.001).   Conclusion: The study shows significant decay in psychomotor skills and knowledge and attitude among the medical undergraduates. Therefore, regular hands-on training with certifiable courses is required to reinforce skills and update knowledge regarding BLS.

A Short Intervention and an Interactive E-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study (Preprint)

Background

Prompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students.

Objective

Our objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders.

Methods

A short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders.

Results

Out of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9%) initially agreed to participate. Moreover, 102 (19.3%) attended the practice sessions, and 48 (9.1%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56).

Conclusions

This study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders.

International Registered Report Identifier (IRRID)

RR2-10.2196/24664

Peer-led pediatric resuscitation training: effects on self-efficacy and skill performance

BACKGROUND

Peer-led basic life support training in medical school may be an effective and valued way of teaching medical students, yet no research has been conducted to evaluate the effect on the self-efficacy of medical students. High self-efficacy stimulates healthcare professionals to initiate and continue basic life support despite challenges.

METHODS

A randomized controlled trial, in which medical students received pediatric basic life support (PBLS) training, provided by either near-peer instructors or expert instructors. The students were randomly assigned to the near-peer instructor group (n = 105) or expert instructor group (n = 108). All students received two hours of PBLS training in groups of approximately 15 students. Directly after this training, self-efficacy was assessed with a newly developed questionnaire, based on a validated scoring tool. A week after each training session, students performed a practical PBLS exam and completed another questionnaire to evaluate skill performance and self-efficacy, respectively.

RESULTS

Students trained by near-peers scored significantly higher on self-efficacy regarding all aspects of PBLS. Theoretical education and instructor feedback were equally valued in both groups. The scores for the practical PBLS exam and the percentage of students passing the exam were similar in both groups.

CONCLUSIONS

Our findings point towards the fact that near-peer-trained medical students can develop a higher level of PBLS-related self-efficacy than expert-trained students, with comparable PBLS skills in both training groups. The exact relationship between peer teaching and self-efficacy and between self-efficacy and the quality of real-life pediatric resuscitation should be further explored.

TRIAL REGISTRATION

ISRCTN, ISRCTN69038759 . Registered December 12th, 2019 - Retrospectively registered.

Professionalizing peer instructor skills in basic life support training for medical students: A randomized controlled trial

Background:

The Radboud university medical center designed an obligatory basic life support and first-aid course for first-year medical students.

Objectives:

We evaluated the value of an additional train-the-trainer course following European Resuscitation Council guidelines, which focuses on practical basic life support training and providing feedback, in comparison with standard in-service instructor training.

Methods:

This study was a prospective randomized controlled trial. A total of 10 intervention instructors, 14 control instructors, and 337 first-year medical students participated in the study. Students, blinded for the type of instructor, completed questionnaires evaluating the quality of the basic life support training (theoretical and practical) and provided feedback. The secondary endpoint was the basic life support examination to assess whether the instructors’ training influenced the quality of the participants’ basic life support.

Results:

The response rate of the questionnaire was 82% on average. No differences were found between intervention and control group concerning theoretical basic life support training. The intervention instructors scored significantly higher on practical basic life support training according to student evaluations ( p < 0.001). The pass rate on basic life support examinations did not differ significantly ( p = 0.669). Appreciation of given feedback was independent of instructors’ educational training.

Conclusion:

This study is the first to establish that the 12-h train-the-trainer course following European Resuscitation Council guidelines improves students’ appreciation of practical basic life support training. The additional course did not influence appreciation of theoretical basic life support training or perceived feedback.

Impact of Additional Short Session of Video Training on Performance of Basic Life Support Skills in 2nd-Year Medical Students

CONTEXT

Basic life support (BLS) is a core life-saving skill which everyone should know, but knowledge of BLS is poor even among medical students.

AIMS

The aim of our study was to assess the knowledge regarding BLS among medical students and see impact of training and also to know whether a short session of video training made an impact on their cardiopulmonary resuscitation (CPR) skills.

SETTINGS AND DESIGN

Ninety-two 2^nd-year medical students were included in the study.

MATERIALS AND METHODS

Their baseline knowledge regarding BLS was assessed before workshop with pretest 1. Following workshop posttest 1 and 1 month later, posttest 2 was conducted. A short duration video training on BLS was done after posttest 2 and its impact was assessed 2 months later with performance of CPR skills on a mannequin.

STATISTICAL ANALYSIS USED

Data analysis was done using SPSS version 23.0. Pearson's Chi-square test was used to evaluate the differences between groups for categorized variables. Unpaired and paired t-test was used to calculate the difference of means for quantitative variables.

RESULTS

There was significant improvement in knowledge regarding BLS after the workshop. Even after 1 month, though there was decline in knowledge, still it was significantly higher than the baseline. Short duration video training session did not lead to any improvement in BLS skills.

CONCLUSIONS

BLS training should start early in medical curriculum with reinforcement at regular intervals. Single short duration video training session did not have any impact on improvement of skills.

Improvement in Confidence Levels for the Management of Paediatric Cardiac Arrests in Medical Students Following a Training Course

BACKGROUND

Newly qualified doctors lack competency in handling a cardiopulmonary resuscitation. The ability to recall CPR fundamentals have been shown to be inadequate. Of greater concern is that medical students over - estimate their ability to deliver such aid in a real - world setting. As most medical students are only taught adult BLS they are often unskilled and/or unhelpful in managing paediatric specific emergencies. This fact is supported by the poor outcomes demonstrated in delivering successful Paediatric Basic Life Support (PBLS).

OBJECTIVES

Our aim was to evaluate the baseline confidence levels of medical students in dealing with a paediatric cardiac arrest (PCA) and the improvement seen following a PBLS training course.

METHODS

A prospective study was conducted on 51 medical students who attended an established one - day PBLS and first aid course at one UK medical school. Participants were requested to complete a questionnaire directly prior to and after the course.

RESULTS

Following the delivery of the training, the cohort reported a statistically significant (P < 0.05) increase in mean confidence with PCA from 2.2/10 (2.2 out of 10) to 7.5/10. A pre - training mean confidence score of 2.6/10 was observed for Year 4 and 5 students who are close to graduating.

CONCLUSIONS

Our findings clearly demonstrate very poor confidence among medical students with PCA at all stages of their training. We would strongly advocate the inclusion of a PBLS component in medical school curriculums so that future doctors are adequately prepared to deliver PBLS with confidence.

Quality of Basic Life Support - A Comparison between Medical Students and Paramedics

INTRODUCTION

Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals.

AIM

This study aimed to assess quality of basic life support in medical students and paramedics.

MATERIALS AND METHODS

We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR.

RESULTS

In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups.

CONCLUSION

Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.

Effectiveness of basic life support instruction in physical education students--a pilot study

BACKGROUND

According to the literature, 40% of injuries affecting school-age children are sports related. The role of physical education students, as future teachers, seems to be of high importance in terms of protecting children's safety during sports classes.

PURPOSES

The aim is to evaluate the level of basic life support (BLS) knowledge and skills in physical education students instructed with the use of different methods.

METHODS

Second-year physical education students (n=104, M age=20±0.6 years) were randomly assigned to three groups: experimental 1 (E1), experimental 2 (E2), and control (C). Group E1 students participated in a 2-hour BLS course based on computer-assisted presentations. Group E2 trainees practiced BLS algorithm in pairs during a 2-hour course. No manikins were used in both intervention groups. Students of Group C were asked to learn BLS algorithm on their own. All groups fulfilled a 10-question multiple-choice test on BLS at the beginning and the end of the experiment. After completing the course participants performed BLS on a manikin.

RESULTS

The results of knowledge test were not significant before an experiment but differed essentially among the groups afterward (analysis of variance contrast analysis, p<.05). Regardless of teaching method used, no significant differences were found among the students in preparatory BLS actions and cardiopulmonary resuscitation (CPR) performance on a manikin. The level of CPR performance was very low in all groups.

CONCLUSIONS

Students of both intervention groups improved their BLS knowledge after the training. Teaching methods used in the current study seemed to be ineffective in terms of practical CPR skills. Access to greater number of modern manikins should improve the BLS training in physical education students. Moreover, permanent consultation on instructional methods with emergency medicine experts is recommended for university teachers.

How to Improve Interactions between Police and the Mentally Ill

There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law-enforcement officers. Some of the key findings are the benefits of training utilizing realistic "hands-on" scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioral change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues.

Four-stage teaching technique and chest compression performance of medical students compared to conventional technique

AIM

To compare the 2-stage and 4-stage basic life support teaching technique. The second aim was to test if students' self-evaluated knowledge was in accordance with their actual knowledge.

METHODS

A total of 126 first-year students of the Faculty of Medicine in Ljubljana were involved in this parallel study conducted in the academic year 2009/2010. They were divided into ten groups. Five groups were taught the 2-stage model and five the 4-stage model. The students were tested in a scenario immediately after the course. Questionnaires were filled in before and after the course. We assessed the absolute values of the chest compression variables and the proportions of students whose performance was evaluated as correct according to our criteria. The results were analyzed with independent samples t test or Mann-Whitney-U test. Proportions were compared with χ(2) test. The correlation was calculated with the Pearson coefficient.

RESULTS

There was no difference between the 2-stage (2S) and the 4-stage approach (4S) in the compression rate (126±13 min-1 vs 124±16 min -1, P=0.180, independent samples t test), compression depth (43±7 mm vs 44±8 mm, P=0.368, independent samples t test), and the number of compressions with correct hand placement (79±32% vs 78±12, P=0.765, Mann-Whitney U-test). However, students from the 4-stage group had a significantly higher average number of compressions per minute (70±13 min -1 2S, 78±12 min-1 4S, P=0.02, independent samples t test). The percentage of students with all the variables correct was the same (13% 2S, 15% 4S, P=0.741, χ2 test). There was no correlation between the students' actual and self-evaluated knowledge (P=0.158, Pearson coefficient=0.127).

CONCLUSIONS

The 4-stage teaching technique does not significantly improve the quality of chest compressions. The students' self-evaluation of their performance after the course was too high.

Educational polymorphisms of basic life support algorithms

BACKGROUND

A systematic review of the pooled effect of articles presenting current basic life support (BLS) algorithms for the treatment of cardiac arrest has never been carried.

AIMS

We aimed to record and classify potential inherent factors influencing simplicity negatively in teaching, learning and retention of cardiopulmonary resuscitation (CPR) delivered by health care providers or lay persons.

METHODS

We performed a search of the relevant literature exploring MEDLINE, COCHRANE LIBRARY and SCOPUS databases. Potential inhibitory factors in the structure of available algorithms influencing simplicity in teaching, learning and retention of BLS were recorded and stratified accordingly. In a second phase of this study, we tested the hypothesis that different options of a BLS algorithm might influence CPR retention negatively, by asking 348 health care provider participants of our CPR seminars to describe their predicted response in an emergency to: (1) a real-time model implicating the various victims and rescuers; and (2) a hypothetical challenging 'all-in-one' BLS algorithm model.

RESULTS

Fifteen articles presenting current BLS algorithms evidenced 163 suggestions that produced 23 different CPR options: five contrasting algorithms (21.8%); three two-option models (13%); six vague technical or scientific suggestions (26%); and nine multiple choices of action (39.1%). Identified references contributed differently in the development of educationally polymorphic BLS options in each of the four categories (P < 0.0001) and were all brought about by variants of victims and rescuers. Participants of CPR seminars answered that in an emergency they could remember the hypothetical BLS model (90%, P = 0.007) rather than a current BLS algorithm for adults (42.2%) or children (36%).

CONCLUSIONS

Educational polymorphisms of BLS algorithms could build unpredictable barriers between rescuers and cardiac arrest victims and might seriously limit instructors' educational effectiveness. These findings might support an alternative trial hypothesis of a simple 'all-in-one algorithm' educational approach in future.

Reduced resident "code blue" experience in the era of quality improvement: new challenges in physician training

PURPOSE

Emergency resuscitation or "code blue" is a clinical event through which responding medical residents gain experience and proficiency. A retooling of practice has occurred at academic medical centers since the emergence of quality improvement initiatives and resident duty hours limits. The authors investigated how these changes may impact code blue frequency and resident opportunities to gain clinical experience.

METHOD

The authors conducted a single-center, retrospective (2002-2009) review of monthly code blue frequency. They compared code blue frequency with corresponding monthly first-year internal medicine resident call schedules (2002-2008 academic years). Using a Monte Carlo simulation they estimated annual code blue experience, and using Poisson regression, they estimated annual trends in resident code blue experience.

RESULTS

The authors detected a 41% overall reduction in code blue events between 2002 and 2008; code blue events decreased by 13% annually (P < .001). These trends persisted, even after accounting for hospital census fluctuations: Rates fell from approximately 12 code blue events/1,000 admissions in 2002 to 3.8 events/1,000 in 2008. Overall, the model of code blue frequency and resident call schedules shows a dramatic reduction in the predicted number of code blue experiences, falling from 29 events (empirical 95% CI 18-40) in academic year 2002 to 5 events (CI 1-9) in 2008.

CONCLUSIONS

Physicians-in-training at one facility are seeing far fewer code blue events than their predecessors. Whether current numbers of in-hospital code blue events are sufficient to provide adequate experience without supplemental practice for trainees is unclear.

The analysis of self and tutor assessment in the skill of basic life support (BLS) and endotracheal intubation: focused on the discrepancy in assessment

INTRODUCTION

This paper reports the results of a study of fourth year medical students that assessed whether assessments of basic life support (BLS) and intubation performance differ when assessed by the students themselves or by tutors. This information should be helpful for designing the contents of a complementary education core.

METHODS

Tutor assessments and student-assessments were conducted using a checklist and a fivepoint rating scale, and then compared. For the two skill performance tests, Resusci(®) Anne SkillGuide™ and Laerdal(®) Airway Management Trainer (Laerdal, Norway) devices were used. The check-lists used to evaluate students were based on International Liasion Committee on Resuscitation (ILCOR) guidelines and Korean Emergency Airway Management Society (KEAMS) tutor guidelines.

RESULTS

A total of 83 medical students participated in the study, intra-class correlation coefficient between tutor and student assessment were 0.542 (95% CI 0.371-0.678) in BLS and 0.693 (0.538-0.802). There were also no significant differences between self-assessments and tutor assessments based on the five-point. In BLS skill session, we found out that "maintenance of airway" and "palpating a carotid pulse" were the mostly missed parts. In the intubation skill, omitting the parts of 'securing the airway' while preparing for intubation, proper positioning of blade tip in the valleculae, and appropriate insertion of endotracheal tube were demonstrated.

CONCLUSION

We observed correlations between student self-assessments and tutor assessments for both BLS and intubation. Analyzing the discrepancies between self-assessment and tutor assessment will be helpful in focusing training on the steps that were omitted by students or during which students demonstrated incompetence.

Retention into internship of resuscitation skills learned in a medical student resuscitation program incorporating an Immediate Life Support course

AIMS

This study describes the acquisition and retention of resuscitation skills by medical students during and following a vertically integrated training program incorporating an Immediate Life Support course (ILS): and the skills demonstrated by interns on entry to clinical practice.

METHODS

Yearly resuscitation workshops were held in the final 3 years of a 6-year undergraduate medical curriculum. These consisted of a basic life support course in year 4; a resuscitation workshop including shock-advisory defibrillation in year 5; and an ILS course in year 6. A medical student cohort was tested during the course and at the beginning of internship.

RESULTS

Before year 5 training, an average of 36.6% of students passed each criterion and this increased to 72.3% 10 weeks after training. Prior to the ILS course (approximately 6-18 months following year 5 training), this proportion had decreased to 35.2%; and on retesting as interns the proportion was 64.1%, with delay between ILS training and testing of between 3 and 9 months. The proportion of interns correctly performing airway opening, initial rescue breathing and ventilation technique was lower than other measured skills. Those with ILS training performed better in initial rescue breaths (p=0.03), ventilation technique (p=0.04), and recommencement of CPR without delay following defibrillation (p=0.02).

CONCLUSIONS

A vertically integrated undergraduate resuscitation course appears to reinforce the maintenance of resuscitation skills until internship. Skills are maintained for at least 6-9 months following an ILS course. This may be due to the ILS course embedding the skills more thoroughly.

The effects of teaching basic cardiopulmonary resuscitation--a comparison between first and sixth year medical students

The purpose of this study was to check if medical students of one of the Universities of Medical Sciences in Poland are prepared to do basic cardiopulmonary resuscitation. The research was undertaken on groups of 50 first year students and 50 sixth year students at the time when they take an exam. To have wider insight into students' ability to perform basic cardiopulmonary resuscitation, quantitative and qualitative methods were used. Students' knowledge of resuscitation was checked by a written test including open questions, their skills of doing resuscitation were checked on manikins. Students also completed a questionnaire. The results showed that first year medical students have a better knowledge of basic cardiopulmonary resuscitation compared with sixth year students. The skills of advanced cardiopulmonary resuscitation are better in sixth year students compared with first year students. The study showed that skills of ventilation and chest compressions need more practice. The students' own estimation of the ability to perform cardiopulmonary resuscitation both in the first and sixth years is very high, but it does not correlate with their knowledge and skills. Our conclusions indicate the need to improve the programme of teaching cardiopulmonary resuscitation with a refresher course in theory and skills at least once a year.