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Han S, Lee CA, Jeong WJ, Park J, Park HA. Framework Development of Non-Face-to-Face Training of Basic Life Support for Laypersons: A Multi-Method Study. Healthcare (Basel) 2023; 11:2110. [PMID: 37510551 PMCID: PMC10378845 DOI: 10.3390/healthcare11142110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/09/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The spread of infectious diseases has accelerated the transition from face-to-face (F2F) to non-F2F (NF2F) education. To maintain the effect of successful NF2F education in cardiopulmonary resuscitation, reorganizing the curriculum to suit the NF2F educational environment is necessary. We propose an appropriate learning curriculum for NF2F basic life support (BLS) training for laypersons based on expert surveys and learners' performance outcomes. This study included three stages and used multiple methods. A draft curriculum was created through a literature review and three-round Delphi approach, and then applied as a test for actual education. After the training, the final curriculum of the NF2F BLS training for laypersons was proposed by reflecting on the performance outcomes of learners and expert opinions. NF2F theoretical education was simplified into five content items: concept of chain of survival, legal protection for first aiders, importance of bystander cardiopulmonary resuscitation, how to recognize a patient in cardiac arrest and activate the emergency medical services system, and reduced training time. In the hands-on skills session, it was recommended to practice chest compressions using a simple intuitive feedback device and to use automated external defibrillators step-by-step more than in F2F training. In conclusion, NF2F training is a suitable option for BLS training methods in situations where F2F training is difficult.
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Affiliation(s)
- Sangsoo Han
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon 14584, Republic of Korea
| | - Choung Ah Lee
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong 14068, Republic of Korea
| | - Won Jung Jeong
- Department of Emergency Medicine, Catholic University of Korea, St. Vincent's Hospital, Suwon 16247, Republic of Korea
| | - JuOk Park
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong 14068, Republic of Korea
| | - Hang A Park
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong 14068, Republic of Korea
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Yao F, Subramaniam M, Satghare P, Zhang Y, Seow E. A resuscitation course designed for a psychiatric hospital. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:261-263. [PMID: 33855324 DOI: 10.47102/annals-acadmedsg.2020427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Fengyuan Yao
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore
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Yeo CL, Ho SKY, Tagamolila VC, Arunachalam S, Bharadwaj SS, Poon WB, Tan MG, Edison PE, Yip WY, Haium AAA, Jayagobi PA, Vora SJ, Khurana SK, Allen JC, Lustestica EI. Use of web-based game in neonatal resuscitation - is it effective? BMC MEDICAL EDUCATION 2020; 20:170. [PMID: 32456704 PMCID: PMC7249390 DOI: 10.1186/s12909-020-02078-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Knowledge and skills decline within months post simulation-based training in neonatal resuscitation. To empower 'Millennial' learners to take control of their own learning, a single-player, unguided web-based Neonatal Resuscitation Game was designed. The present study investigates the effectiveness of the game on retention of resuscitation knowledge and skills. METHODS The study evaluated 162 healthcare professionals who attended simulation-based training in neonatal resuscitation. Following standard simulation-based training, participants were assigned to either a gaming group (Gamers) with access to the web-based Neonatal Resuscitation Game or a control group (Controls) with no access to the game. Although Gamers were given access, game utilization was completely voluntary and at will. Some Gamers chose to utilize the web-based game (Players) and others did not (Non-players). Knowledge and skills in neonatal resuscitation were assessed upon completion of training and 6 months post-training using a multiple-choice question test and a manikin-based skills test. Changes in scores were compared statistically between Gamers vs Controls, Players vs Controls, and Players vs Controls + Non-players using two-sample t-tests. RESULTS At the final assessment, declines in knowledge scores were seen in all groups. Mean change from baseline in knowledge and skill performance scores at 6 months, adjusted for baseline skill performance and MCQ test scores, did not differ significantly between Players vs Controls and Players vs Controls + Non-players. CONCLUSION The web-based game in its current format may not be effective in facilitating retention of knowledge and technical skills in neonatal resuscitation.
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Affiliation(s)
- Cheo Lian Yeo
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore.
| | - Selina Kah Ying Ho
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Vina Canlas Tagamolila
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Sridhar Arunachalam
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Srabani Samanta Bharadwaj
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Woei Bing Poon
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Mary Grace Tan
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Priyantha Ebenezer Edison
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
| | - Wai Yan Yip
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore 229899, Singapore
| | - Abdul Alim Abdul Haium
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore 229899, Singapore
| | - Pooja Agarwal Jayagobi
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore 229899, Singapore
| | - Shrenik Jitendrakumar Vora
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore 229899, Singapore
| | - Simrita Kaur Khurana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore 229899, Singapore
| | | | - Ereno Imelda Lustestica
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Lee Kong Chian School of Medicine, Singapore 308232, Singapore
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Wahabi HA, Esmaeil SA, Bahkali KH, Titi MA, Amer YS, Fayed AA, Jamal A, Zakaria N, Siddiqui AR, Semwal M, Car LT, Posadzki P, Car J. Medical Doctors' Offline Computer-Assisted Digital Education: Systematic Review by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e12998. [PMID: 30821689 PMCID: PMC6418481 DOI: 10.2196/12998] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/06/2019] [Accepted: 01/31/2019] [Indexed: 01/19/2023] Open
Abstract
Background The widening gap between innovations in the medical field and the dissemination of such information to doctors may affect the quality of care. Offline computer-based digital education (OCDE) may be a potential solution to overcoming the geographical, financial, and temporal obstacles faced by doctors. Objective The objectives of this systematic review were to evaluate the effectiveness of OCDE compared with face-to-face learning, no intervention, or other types of digital learning for improving medical doctors’ knowledge, cognitive skills, and patient-related outcomes. Secondary objectives were to assess the cost-effectiveness (CE) of OCDE and any adverse effects. Methods We searched major bibliographic databases from 1990 to August 2017 to identify relevant articles and followed the Cochrane methodology for systematic reviews of intervention. Results Overall, 27 randomized controlled trials (RCTs), 1 cluster RCT (cRCT), and 1 quasi-RCT were included in this review. The total number of participants was 1690 in addition to the cRCT, which included 24 practices. Due to the heterogeneity of the participants, interventions, and outcomes, meta-analysis was not feasible, and the results were presented as narrative summary. Compared with face-to-face learning, the effect of OCDE on knowledge gain is uncertain (ratio of the means [RM] range 0.95-1.17; 8 studies, 495 participants; very low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 0.1-0.9; 8 studies, 375 participants; very low grade of evidence). OCDE may have little or no effect on patients’ outcome compared with face-to-face education (2 studies, 62 participants; low grade of evidence). Compared with no intervention, OCDE may improve knowledge gain (RM range 1.36-0.98; 4 studies, 401 participants; low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 1.1-1.15; 4 trials, 495 participants; very low grade of evidence). One cRCT, involving 24 practices, investigated patients’ outcome in this comparison and showed no difference between the 2 groups with low-grade evidence. Compared with text-based learning, the effect of OCDE on cognitive skills gain is uncertain (RM range 0.91-1.46; 3 trials with 4 interventions; 68 participants; very low-grade evidence). No study in this comparison investigated knowledge gain or patients’ outcomes. One study assessed the CE and showed that OCDE was cost-effective when compared with face-to-face learning if the cost is less than or equal to Can $200. No trial evaluated the adverse effect of OCDE. Conclusions The effect of OCDE compared with other methods of education on medical doctors’ knowledge and cognitive skill gain is uncertain. OCDE may improve doctors’ knowledge compared with no intervention but its effect on doctors’ cognitive skills is uncertain. OCDE may have little or no effect in improving patients’ outcome.
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Affiliation(s)
- Hayfaa Abdelmageed Wahabi
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia
| | - Samia Ahmed Esmaeil
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia
| | - Khawater Hassan Bahkali
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia.,Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Maher Abdelraheim Titi
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia.,Patient Safety Unit, Quality Management Department, King Khalid University Hospital, King Saud Medical City, Riyadh, Saudi Arabia
| | - Yasser Sami Amer
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia.,Clinical Practice Guidelines Unit, Quality Management Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Amel Ahmed Fayed
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.,High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Amr Jamal
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deanship of Research, King Saud University, Riyadh, Saudi Arabia.,Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nasriah Zakaria
- Medical Informatics and e-Learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amna Rehana Siddiqui
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Monika Semwal
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Paul Posadzki
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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George PP, Ooi CK, Leong E, Jarbrink K, Car J, Lockwood C. Return on investment in blended advanced cardiac life support training compared to face-to-face training in Singapore. PROCEEDINGS OF SINGAPORE HEALTHCARE 2018. [DOI: 10.1177/2010105818760045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Internet adoption during the past decade has provided opportunities for innovation in advanced cardiac life support (ACLS) training. With pressure on budgets across health care systems, there is a need for more cost-effective solutions. Recently, traditional ACLS training has evolved from passive to active learning technologies. The objective of this study is to compare the cost, cost-savings and return on investment (ROI) of blended ACLS (B-ACLS) and face-to-face ACLS (F-ACLS) in Singapore. Methods: B-ACLS and F-ACLS courses are offered in two training institutes in Singapore. Direct and indirect costs of training were obtained from one of the training providers. ROI was computed using cost-savings over total cost if B-ACLS was used instead of F-ACLS. Results: The estimated annual cost to conduct B-ACLS and F-ACLS were S$43,467 and S$72,793, respectively. Discounted total cost of training over the life of the course (five years) was S$107,960 for B-ACLS and S$280,162 for F-ACLS. Annual productivity loss cost account for 52% and 23% of the costs among the F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested. There would be 61% savings over the life of the course if B-ACLS were to be used instead of F-ACLS. Conclusion: The B-ACLS course provides significant cost-savings to the provider and a positive ROI. B-ACLS should be more widely adopted as the preferred mode of ACLS training. As a start, physicians looking for reaccreditation of the ACLS training should be encouraged to take B-ACLS instead of F-ACLS.
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Affiliation(s)
- Pradeep Paul George
- Health Services & Outcomes Research (HSOR), National Healthcare Group, Singapore
| | - Chee Kheong Ooi
- Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore
| | - Edwin Leong
- Singapore First Aid Training Centre Pte Ltd, Singapore
| | - Krister Jarbrink
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Josip Car
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Craig Lockwood
- Implementation Science, The University of Adelaide, Australia
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Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, Tramacere I, Moja L. E-learning for health professionals. Cochrane Database Syst Rev 2018; 1:CD011736. [PMID: 29355907 PMCID: PMC6491176 DOI: 10.1002/14651858.cd011736.pub2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive. OBJECTIVES To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies. SELECTION CRITERIA Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals. DATA COLLECTION AND ANALYSIS Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible. MAIN RESULTS We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies. AUTHORS' CONCLUSIONS When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.
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Affiliation(s)
- Alberto Vaona
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | - Rita Banzi
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Koren H Kwag
- IRCCS Galeazzi Orthopaedic InstituteClinical Epidemiology UnitVia R. Galeazzi, 4MilanItaly20161
| | - Giulio Rigon
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | | | - Valentina Pecoraro
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Irene Tramacere
- Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of Research and Clinical Development, Scientific DirectorateVia Giovanni Celoria, 11MilanItaly20133
| | - Lorenzo Moja
- University of MilanDepartment of Biomedical Sciences for HealthVia Pascal 36MilanSwitzerland20133
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Holm JH. Is the current level of training in the use of equipment for prehospital radio communication sufficient? A cross-sectional study among prehospital physicians in Denmark. BMJ Open 2017; 7:e015017. [PMID: 28667210 PMCID: PMC5734367 DOI: 10.1136/bmjopen-2016-015017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Physicians working in prehospital care are expected to handle radio communication both within their own sector as well as with other divisions of the National Emergency Services. To date, no study has been conducted on the level of training received by physicians in the use of the equipment provided or on the level of competency acquired by physicians. METHODS In order to investigate the self-assessed skill level acquired in the use of the TETRA (TErrestrial Trunked RAdio) authority radio for communication in a prehospital setting, a cross-sectional study was conducted by questionnaire circulated to all 454 physicians working in the Danish Emergency Medical Services. RESULTS A lack of training was found among physicians working in prehospital care in Denmark in relation to the proper use of essential communication equipment. Prior to starting their first shift in a prehospital setting 38% of physicians reported having received no training in the use of the equipment, while 80% of physicians reported having received one1 hour of training or less. Among the majority of physicians their current level of training was sufficient for their everyday needs for prehospital communication but for 28% of physicians their current level of training was insufficient as they were unable to handle communication at this level. CONCLUSION As the first study in its field, this study investigated the training received in the use of essential communication equipment among physicians working in prehospital care in Denmark. The study found that competency does not appear to have been prioritised as highly as other technical skills needed to function in these settings. For the majority of physicians their current level of training was sufficient for everyday use but for a substantial minority further training is required, especially if the redundancy of the prehospital system is to be preserved.
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Affiliation(s)
- Jimmy Højberg Holm
- Department of Anesthesiology and Intensive Care, Mobile Emergency Care Unit, Odense University Hospital, Odense, Denmark
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
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Thorne CJ, Lockey AS, Kimani PK, Bullock I, Hampshire S, Begum-Ali S, Perkins GD. e-Learning in Advanced Life Support-What factors influence assessment outcome? Resuscitation 2017; 114:83-91. [PMID: 28242211 DOI: 10.1016/j.resuscitation.2017.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/15/2017] [Accepted: 02/17/2017] [Indexed: 11/17/2022]
Abstract
AIM To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. METHOD Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. RESULTS The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. CONCLUSION Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs.
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Affiliation(s)
- C J Thorne
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK.
| | - A S Lockey
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Calderdale & Huddersfield NHS Foundation Trust, Halifax HX3 0PW, UK
| | - P K Kimani
- University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK
| | - I Bullock
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Royal College of Physicians, London NW1 4LE, UK
| | - S Hampshire
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - S Begum-Ali
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - G D Perkins
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK
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Krogh CL, Steinmetz J, Rudolph SS, Hesselfeldt R, Lippert FK, Berlac PA, Rasmussen LS. Effect of ultrasound training of physicians working in the prehospital setting. Scand J Trauma Resusc Emerg Med 2016; 24:99. [PMID: 27491760 PMCID: PMC4973524 DOI: 10.1186/s13049-016-0289-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 07/26/2016] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Advances in technology have made ultrasound (US) devices smaller and portable, hence accessible for prehospital care providers. This study aims to evaluate the effect of a four-hour, hands-on US training course for physicians working in the prehospital setting. The primary outcome measure was US performance assessed by the total score in a modified version of the Objective Structured Assessment of Ultrasound Skills scale (mOSAUS). METHODS Prehospital physicians participated in a four-hour US course consisting of both hands-on training and e-learning including a pre- and a post-learning test. Prior to the hands-on training a pre-training test was applied comprising of five videos in which the participants should identify pathology and a five-minute US examination of a healthy volunteer portraying to be a shocked patient after a blunt torso trauma. Following the pre-training test, the participants received a four-hour, hands-on US training course which was concluded with a post-training test. The US examinations and screen output from the US equipment were recorded for subsequent assessment. Two blinded raters assessed the videos using the mOSAUS. RESULTS Forty participants completed the study. A significant improvement was identified in e-learning performance and US performance, (37.5 (SD: 10.0)) vs. (51.3 (SD: 5.9) p = < 0.0001), total US performance score (15.3 (IQR: 12.0-17.5) vs. 17.5 (IQR: 14.5-21.0), p = < 0.0001) and in each of the five assessment elements of the mOSAUS. CONCLUSION In the prehospital physicians assessed, we found significant improvements in the ability to perform US examinations after completing a four-hour, hands-on US training course.
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Affiliation(s)
- Charlotte Loumann Krogh
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, København Ø, Denmark. .,Emergency Medical Services Copenhagen, The Capital Region of Denmark, Telegrafvej 5, 2750, Ballerup, Denmark. .,, Sankt Thomas Allé 13, 3 th., 1824, Frederiksberg C, Denmark.
| | - Jacob Steinmetz
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, København Ø, Denmark.,Emergency Medical Services Copenhagen, The Capital Region of Denmark, Telegrafvej 5, 2750, Ballerup, Denmark
| | - Søren Steemann Rudolph
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, København Ø, Denmark.,Emergency Medical Services Copenhagen, The Capital Region of Denmark, Telegrafvej 5, 2750, Ballerup, Denmark
| | - Rasmus Hesselfeldt
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, København Ø, Denmark
| | - Freddy K Lippert
- Emergency Medical Services Copenhagen, The Capital Region of Denmark, Telegrafvej 5, 2750, Ballerup, Denmark
| | - Peter A Berlac
- Emergency Medical Services Copenhagen, The Capital Region of Denmark, Telegrafvej 5, 2750, Ballerup, Denmark
| | - Lars S Rasmussen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, København Ø, Denmark
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Monsieurs K, Nolan J, Bossaert L, Greif R, Maconochie I, Nikolaou N, Perkins G, Soar J, Truhlář A, Wyllie J, Zideman D. Kurzdarstellung. Notf Rett Med 2015. [DOI: 10.1007/s10049-015-0097-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Greif R, Lockey A, Conaghan P, Lippert A, De Vries W, Monsieurs K. Ausbildung und Implementierung der Reanimation. Notf Rett Med 2015. [DOI: 10.1007/s10049-015-0092-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, Perkins GD, Soar J, Truhlář A, Wyllie J, Zideman DA, Alfonzo A, Arntz HR, Askitopoulou H, Bellou A, Beygui F, Biarent D, Bingham R, Bierens JJ, Böttiger BW, Bossaert LL, Brattebø G, Brugger H, Bruinenberg J, Cariou A, Carli P, Cassan P, Castrén M, Chalkias AF, Conaghan P, Deakin CD, De Buck ED, Dunning J, De Vries W, Evans TR, Eich C, Gräsner JT, Greif R, Hafner CM, Handley AJ, Haywood KL, Hunyadi-Antičević S, Koster RW, Lippert A, Lockey DJ, Lockey AS, López-Herce J, Lott C, Maconochie IK, Mentzelopoulos SD, Meyran D, Monsieurs KG, Nikolaou NI, Nolan JP, Olasveengen T, Paal P, Pellis T, Perkins GD, Rajka T, Raffay VI, Ristagno G, Rodríguez-Núñez A, Roehr CC, Rüdiger M, Sandroni C, Schunder-Tatzber S, Singletary EM, Skrifvars MB, Smith GB, Smyth MA, Soar J, Thies KC, Trevisanuto D, Truhlář A, Vandekerckhove PG, de Voorde PV, Sunde K, Urlesberger B, Wenzel V, Wyllie J, Xanthos TT, Zideman DA. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 2015; 95:1-80. [PMID: 26477410 DOI: 10.1016/j.resuscitation.2015.07.038] [Citation(s) in RCA: 564] [Impact Index Per Article: 62.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Koenraad G Monsieurs
- Emergency Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
| | - Jerry P Nolan
- Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK; School of Clinical Sciences, University of Bristol, Bristol, UK
| | | | - Robert Greif
- Department of Anaesthesiology and Pain Medicine, University Hospital Bern, Bern, Switzerland; University of Bern, Bern, Switzerland
| | - Ian K Maconochie
- Paediatric Emergency Medicine Department, Imperial College Healthcare NHS Trust and BRC Imperial NIHR, Imperial College, London, UK
| | | | - Gavin D Perkins
- Warwick Medical School, University of Warwick, Coventry, UK; Heart of England NHS Foundation Trust, Birmingham, UK
| | - Jasmeet Soar
- Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK
| | - Anatolij Truhlář
- Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jonathan Wyllie
- Department of Neonatology, The James Cook University Hospital, Middlesbrough, UK
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Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG, Ballance JH, Barelli A, Biarent D, Bossaert L, Castrén M, Handley AJ, Lott C, Maconochie I, Nolan JP, Perkins G, Raffay V, Ringsted C, Soar J, Schlieber J, Van de Voorde P, Wyllie J, Zideman D. European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 2015; 95:288-301. [DOI: 10.1016/j.resuscitation.2015.07.032] [Citation(s) in RCA: 272] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Cordero Torres JA, Caballero Oliver A. [The Moodle platform: A useful tool for training in life support. Analysis of satisfaction questionnaires from students and instructors of the semFYC advanced life support courses]. Aten Primaria 2015; 47:376-84. [PMID: 25934346 PMCID: PMC6983694 DOI: 10.1016/j.aprim.2015.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 02/07/2015] [Accepted: 02/10/2015] [Indexed: 11/30/2022] Open
Abstract
Objetivo Medir la utilidad del método semipresencial en la formación en soporte vital. El uso de Moodle para implementar una fase no presencial previa a la fase presencial «clásica» en la metodología docente es su principal novedad. Diseño Analizamos encuestas de satisfacción a alumnos e instructores de cursos semipresenciales de soporte vital avanzado del programa de Enseñanza de Soporte Vital en Atención Primaria (ESVAP). Emplazamiento : plataforma Moodle. Aula Virtual de semFYC. Participantes y/o contextos Alumnos e instructores del curso de soporte vital avanzado del programa ESVAP de semFYC. Método Análisis cualitativo. Resultados A la mayoría de los alumnos les parece muy útil (50%) o útil (45,37%) el hecho de que haya una fase no presencial previa y considera que esta fase les ha ayudado mucho (42,20%) o bastante (48,62%) a aprovechar la fase presencial. Los instructores consideraron que la fase no presencial había resultado muy útil (89%) o útil (11%) para el desarrollo de la fase presencial. Discusión De los resultados se concluye que: 1) para los alumnos resulta muy útil una fase no presencial previa y consideran que ayuda bastante/mucho a aprovechar la fase presencial, y 2) los instructores consideran que la fase no presencial ha ayudado bastante en el aprovechamiento y eficiencia de los talleres en la fase presencial.
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Affiliation(s)
- Juan Antonio Cordero Torres
- Unidad de Emergencias de Badajoz, Servicio Extremeño de Salud, España; Ciencias de la Salud en Emergencias, Universidad de Extremadura, Badajoz, España.
| | - Antonio Caballero Oliver
- Unidad de Urgencias, Hospital General Universitario Virgen del Rocío de Sevilla, Servicio Andaluz de Salud, Sevilla, España
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Taplin J, McConigley R. Advanced life support (ALS) instructors experience of ALS education in Western Australia: a qualitative exploratory research study. NURSE EDUCATION TODAY 2015; 35:556-561. [PMID: 25586006 DOI: 10.1016/j.nedt.2014.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 12/10/2014] [Accepted: 12/16/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND When cardiac arrest occurs, timely competent advanced life support (ALS) interventions by nursing staff can influence patient outcomes. Ongoing ALS education influences maintenance of competency and avoids skill decay. OBJECTIVES To explore the methods of ALS education delivery for nurses in the workplace; describe the issues relating to maintaining ALS competency; explore ALS competency decay for nurses and develop recommendations for the provision of continuing ALS education. DESIGN A qualitative exploratory design was used to study ALS education provision in the workplace. PARTICIPANTS Data were collected from ALS nurse experts in Western Australia by face-to-face and phone interviews. METHODS Semi-structured interviews were conducted and organised around a set of predetermined questions. RESULTS Two major themes were identified; the first theme Demand and Supply describes the increasing demand for ALS education for nurses and the challenges with providing timely cost effective traditional face-to-face ALS education. The second theme, Choosing The Best Education Options describes new ways to provide ALS education using emerging technologies. CONCLUSIONS The study suggested that using e-learning methods would assist with educating the maximum amount of nurses in a timely manner and e-learning and teleconferencing offer opportunities to reach nurses in distant locations. Delivering ALS education more frequently than annually would increase skills maintenance and lessen skill decay. Further research is required to explore which blended e-learning model is best suited to ALS education.
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Affiliation(s)
- John Taplin
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University Bentley Campus, GPO Box U1987, Perth W.A. 6845, Australia.
| | - Ruth McConigley
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University Bentley Campus, GPO Box U1987, Perth W.A. 6845, Australia.
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Thorne CJ, Lockey AS, Bullock I, Hampshire S, Begum-Ali S, Perkins GD. E-learning in advanced life support--an evaluation by the Resuscitation Council (UK). Resuscitation 2015; 90:79-84. [PMID: 25766092 DOI: 10.1016/j.resuscitation.2015.02.026] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/01/2015] [Accepted: 02/15/2015] [Indexed: 11/26/2022]
Abstract
AIM To descriptively analyse the outcomes following the national roll out of an e-Learning advanced life support course (e-ALS) compared to a conventional 2-day ALS course (c-ALS). METHOD Between 1st January 2013 and 30th June 2014, 27,170 candidates attended one of the 1350 Resuscitation Council (UK) ALS courses across the UK. 18,952 candidates were enrolled on a c-ALS course and 8218 on an e-ALS course. Candidates participating in the e-ALS course completed 6-8h of online e-Learning prior to attending the 1 day modified face-to-face course. Candidates participating in the c-ALS course undertook the Resuscitation Council (UK) 2-day face-to-face course. All candidates were assessed by a pre- and post-course MCQ and a practical cardiac arrest simulation (CAS-test). Demographic data were collected in addition to assessment outcomes. RESULTS Candidates on the e-ALS course had higher scores on the pre-course MCQ (83.7%, SD 7.3) compared to those on the c-ALS course (81.3%, SD 8.2, P<0.001). Similarly, they had slightly higher scores on the post-course MCQ (e-ALS 87.9%, SD 6.4 vs. c-ALS 87.4%, SD 6.5; P<0.001). The first attempt CAS-test pass rate on the e-ALS course was higher than the pass rate on the c-ALS course (84.6% vs. 83.6%; P=0.035). The overall pass rate was 96.6% on both the e-ALS and c-ALS courses (P=0.776). CONCLUSION The e-ALS course demonstrates equivalence to traditional face-to-face learning in equipping candidates with ALS skills when compared to the c-ALS course. Value is added when considering benefits such as increased candidate autonomy, cost-effectiveness, decreased instructor burden and improved standardisation of course material. Further dissemination of the e-ALS course should be encouraged.
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Affiliation(s)
- C J Thorne
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK.
| | - A S Lockey
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Calderdale & Huddersfield NHS Foundation Trust, Halifax HX3 0PW, UK
| | - I Bullock
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Royal College of Physicians, London NW1 4LE, UK
| | - S Hampshire
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - S Begum-Ali
- Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK
| | - G D Perkins
- Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK
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Liaw SY, Chan SWC, Chen FG, Hooi SC, Siau C. Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial. J Med Internet Res 2014; 16:e214. [PMID: 25230684 PMCID: PMC4180357 DOI: 10.2196/jmir.3322] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 08/04/2014] [Accepted: 08/21/2014] [Indexed: 11/27/2022] Open
Abstract
Background Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients. Objective The objective of this study was to describe the development of the virtual patient simulation and evaluate its efficacy, by comparing with a conventional mannequin-based simulation, for improving the nursing students’ performances in assessing and managing patients with clinical deterioration. Methods A randomized controlled study was conducted with 57 third-year nursing students who were recruited through email. After a baseline evaluation of all participants’ clinical performance in a simulated environment, the experimental group received a 2-hour fully automated virtual patient simulation while the control group received 2-hour facilitator-led mannequin-based simulation training. All participants were then re-tested one day (first posttest) and 2.5 months (second posttest) after the intervention. The participants from the experimental group completed a survey to evaluate their learning experiences with the newly developed virtual patient simulation. Results Compared to their baseline scores, both experimental and control groups demonstrated significant improvements (P<.001) in first and second post-test scores. While the experimental group had significantly lower (P<.05) second post-test scores compared with the first post-test scores, no significant difference (P=.94) was found between these two scores for the control group. The scores between groups did not differ significantly over time (P=.17). The virtual patient simulation was rated positively. Conclusions A virtual patient simulation for a refreshing training course on assessing and managing clinical deterioration was developed. Although the randomized controlled study did not show that the virtual patient simulation was superior to mannequin-based simulation, both simulations have demonstrated to be effective refresher learning strategies for improving nursing students’ clinical performance. Given the greater resource requirements of mannequin-based simulation, the virtual patient simulation provides a more promising alternative learning strategy to mitigate the decay of clinical performance over time.
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Affiliation(s)
- Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
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Tarantinos K, Chalkias A, Giotakis E, Athanasopoulou P, Xanthos T. Retention of knowledge and skills after Advanced Cardiovascular Life Support courses. Am J Emerg Med 2014; 32:1143-7. [DOI: 10.1016/j.ajem.2014.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022] Open
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Effect of engaging trainees by assessing peer performance: a randomised controlled trial using simulated patient scenarios. BIOMED RESEARCH INTERNATIONAL 2014; 2014:610591. [PMID: 24967383 PMCID: PMC4054978 DOI: 10.1155/2014/610591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 04/23/2014] [Accepted: 04/29/2014] [Indexed: 11/17/2022]
Abstract
Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training. Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees' performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees' satisfaction with the training was also evaluated.
Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65) P = 0.003 and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09) P = 0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00) versus 5.74 (SD 1.33) P = 0.025. Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.
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Giotakis E, Chalkias A, Tarantinos K, Castrén M, Papadopoulos G, Iacovidou N, Xanthos T. Pretest-based group forming in advanced cardiovascular life support courses increases acquisition and retention of resuscitation knowledge. Am J Emerg Med 2014; 32:478-9. [PMID: 24612596 DOI: 10.1016/j.ajem.2014.01.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 01/26/2014] [Accepted: 01/26/2014] [Indexed: 11/26/2022] Open
Affiliation(s)
- Efthymios Giotakis
- National and Kapodistrian University of Athens, Medical School, MSc "Cardiopulmonary Resuscitation", Athens, Greece
| | - Athanasios Chalkias
- National and Kapodistrian University of Athens, Medical School, MSc "Cardiopulmonary Resuscitation", Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
| | - Kyriakos Tarantinos
- National and Kapodistrian University of Athens, Medical School, MSc "Cardiopulmonary Resuscitation", Athens, Greece
| | - Maaret Castrén
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset and Section of Emergency Medicine, Södersjukhuset, Stockholm, Sweden
| | - Georgios Papadopoulos
- Department of Anesthesiology, University of Ioannina, Medical School, Ioannina, Greece
| | - Nicoletta Iacovidou
- Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; 2nd Department of Obstetrics and Gynecology, Neonatal Division, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Theodoros Xanthos
- National and Kapodistrian University of Athens, Medical School, MSc "Cardiopulmonary Resuscitation", Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece
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Milanese SF, Grimmer-Somers K, Souvlis T, Innes-Walker K, Chipchase LS. Is a blended learning approach effective for learning in allied health clinicians? PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x13y.0000000113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lippert FK. Education as standardised teaching or individual training or both. Resuscitation 2013; 84:1171-2. [PMID: 23791811 DOI: 10.1016/j.resuscitation.2013.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 11/24/2022]
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Buttussi F, Pellis T, Cabas Vidani A, Pausler D, Carchietti E, Chittaro L. Evaluation of a 3D serious game for advanced life support retraining. Int J Med Inform 2013; 82:798-809. [PMID: 23763908 DOI: 10.1016/j.ijmedinf.2013.05.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 04/22/2013] [Accepted: 05/15/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Advanced life support (ALS) knowledge and skills decrease in as little as three months, but only a few ALS providers actually attend retraining courses. We assess the effectiveness of a 3D serious game as a new tool for frequent ALS retraining. METHODS We developed a 3D serious game for scenario-based ALS retraining. The serious game, called EMSAVE, was designed to promote self-correction while playing. We organized a retraining course in which 40 ALS providers played two cardiac arrest scenarios with EMSAVE and took a test with 38 multiple-choice questions before and after playing. We administered the same test again 3 months later to evaluate retention. Participants also rated EMSAVE and the overall retraining experience. RESULTS After using EMSAVE, the number of correct answers per participant increased by 4.8 (95%CI +3.4, +6.2, p<0.001) and all but one participant improved. After 3 months, despite an expected decrease in ALS knowledge and skills (-1.9 correct answers, 95%CI -0.6, -3.3, p<0.01), there was a significant retention benefit (+2.9 correct answers per participant, 95%CI +1.5, +4.2, p<0.001). Moreover, all but one participant regarded EMSAVE as a valuable tool to refresh ALS knowledge and skills, and 85% of participants were also willing to devote 1h/month to retrain with the serious game. CONCLUSIONS A 3D serious game for scenario-based retraining proved effective to retrain in ALS and supported retention of acquired knowledge and skills at 3 months. EMSAVE also positively engaged and motivated participants.
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Affiliation(s)
- Fabio Buttussi
- Human-Computer Interaction Lab, Department of Mathematics and Computer Science, University of Udine, Italy.
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Roh YS, Lee WS, Chung HS, Park YM. The effects of simulation-based resuscitation training on nurses' self-efficacy and satisfaction. NURSE EDUCATION TODAY 2013; 33:123-128. [PMID: 22153054 DOI: 10.1016/j.nedt.2011.11.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 11/02/2011] [Accepted: 11/10/2011] [Indexed: 05/31/2023]
Abstract
BACKGROUND Nurses are often the first responders in clinical emergencies that require effective training to ensure high-quality resuscitation and patient safety. The aim of the study was to evaluate the efficacy of simulation-based resuscitation training by assessing two different training modalities (computer-based simulation versus mannequin-based simulation) with practicing nurses. METHOD The study used a comparative study design with random assignment to two simulation-based training modalities. A total of 38 nurses participated in the study: 18 nurses with computer-based simulation, and 20 nurses with mannequin-based simulation. Participants rated their self-efficacy and satisfaction after participating in a simulated scenario involving managing a cardiac arrest patient. RESULTS On a 10-point scale, the participants' overall self-efficacy rating was 6.50 (SD=1.66), and satisfaction rating was 7.53 (SD=1.20) for both groups. There were no significant differences between the groups. The computer-based simulation group had significant higher satisfaction ratings in 'Setting priorities for nursing intervention' and 'Implementing nursing skills as protocol' compared to the mannequin-based simulation group. Most nurses felt the simulation experience was useful for future performance in their workplace, but rated realism of simulation as unsatisfactory. CONCLUSION The introduction of simulation-based resuscitation training as an active-learning format was positively embraced by nurses. Computer-based simulation might be beneficial for acquiring nursing skills and decision making skills in resuscitation. Further study is needed to verify the effects of simulation-based resuscitation training with more rigorous outcomes.
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Affiliation(s)
- Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University (CAU), CAU Health Care System, Republic of Korea
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Secher N, Mikkelsen MM, Adelborg K, Mikkelsen R, Grove EL, Rubak JM, Vedsted P, Løfgren B. Direct mail improves knowledge of basic life support guidelines in general practice: a randomised study. Scand J Trauma Resusc Emerg Med 2012; 20:72. [PMID: 23062629 PMCID: PMC3493296 DOI: 10.1186/1757-7241-20-72] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS). The aim of this study was to describe knowledge of the most recent European Resuscitation Council (ERC) Guidelines for BLS among general practitioners (GPs) and investigate whether direct mail improves theoretical knowledge of these guidelines. METHODS All general practice clinics (n=351) in Central Denmark Region were randomised to receive either direct mail (intervention) or no direct mail (control). The direct mail consisted of the official ERC BLS/AED poster and a cover letter outlining changes in compression depth and frequency in the new guidelines. In general practice clinics randomised to intervention, every GP received a direct mail addressed personally to him/her. Two weeks later, a multiple-choice questionnaire on demographics and BLS guidelines were mailed to GPs in both groups. RESULTS In total, 830 GPs were included in this study (direct mail, n=408; control, n=422). The response rate was 58%. The majority (91%) of GPs receiving direct mail were familiar with BLS Guidelines 2010 compared to 72% in the control group (P<0.001). Direct mail improved knowledge of the new recommended chest compression depth (67% vs. 40%, P<0.001) and chest compression frequency (62% vs. 40%, P<0.001). CONCLUSION Direct mail improved knowledge of changes in BLS guidelines and thus facilitated the implementation of this knowledge into clinical practice. Resuscitation councils and medical societies may consider using direct mail as a simple strategy to facilitate implementation of changes in clinical guidelines.
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Affiliation(s)
- Niels Secher
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Allen JA, Currey J, Considine J. Annual resuscitation competency assessments: a review of the evidence. Aust Crit Care 2012; 26:12-7. [PMID: 22840436 DOI: 10.1016/j.aucc.2012.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 06/23/2012] [Accepted: 07/03/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Australian critical care nurses generally undertake assessment of resuscitation competencies on an annual or biannual basis. International resuscitation evidence and guidelines released in 2010 do not support this practice, instead advocating more frequent retraining. AIM To review the evidence for annual assessment of resuscitation knowledge and skills, and for the efficacy of resuscitation training practices. METHODS A search of the Medline and CINAHL databases was conducted using the key search words/terms 'resuscitation' 'advanced life support' 'advanced cardiac life support' 'assessment' 'cardiac arrest', 'in-hospital cardiac arrest', 'competence', 'training', 'ALS', 'ACLS' 'course' and 'competency'. The search was limited to English language publications produced during the last 10 years. The International Liaison Committee On Resuscitation worksheets were reviewed for key references, as were the reference lists of articles from the initial search. RESULTS There is little evidence to support the current practice of annual resuscitation competency assessments. Theoretical knowledge has no correlation with resuscitation performance, and current practical assessment methods are problematic. Both knowledge and skills decline well before the 12-month mark. There is emerging support in the literature for frequent practice sessions using simulation technology. CONCLUSION The current practice of annual assessments is not supported by evidence. Emerging evidence for regular resuscitation practice is not conclusive, but it is likely to produce better outcomes. Changing practice in Australia also represents an opportunity to generate data to inform practice further.
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Affiliation(s)
- Joshua A Allen
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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Kononowicz AA, Krawczyk P, Cebula G, Dembkowska M, Drab E, Frączek B, Stachoń AJ, Andres J. Effects of introducing a voluntary virtual patient module to a basic life support with an automated external defibrillator course: a randomised trial. BMC MEDICAL EDUCATION 2012; 12:41. [PMID: 22709278 PMCID: PMC3408380 DOI: 10.1186/1472-6920-12-41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 06/18/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND The concept of virtual patients (VPs) encompasses a great variety of predominantly case-based e-learning modules with different complexity and fidelity levels. Methods for effective placement of VPs in the process of medical education are sought. The aim of this study was to determine whether the introduction of a voluntary virtual patients module into a basic life support with an automated external defibrillator (BLS-AED) course improved the knowledge and skills of students taking the course. METHODS Half of the students were randomly assigned to an experimental group and given voluntary access to a virtual patient module consisting of six cases presenting BLS-AED knowledge and skills. Pre- and post-course knowledge tests and skills assessments were performed, as well as a survey of students' satisfaction with the VP usage. In addition, time spent using the virtual patient system, percentage of screen cards viewed and scores in the formative questions in the VP system throughout the course were traced and recorded. RESULTS The study was conducted over a six week period and involved 226 first year medical students. The voluntary module was used by 61 (54%) of the 114 entitled study participants. The group that used VPs demonstrated better results in knowledge acquisition and in some key BLS-AED action skills than the group without access, or those students from the experimental group deliberately not using virtual patients. Most of the students rated the combination of VPs and corresponding teaching events positively. CONCLUSIONS The overall positive reaction of students and encouraging results in knowledge and skills acquisition suggest that the usage of virtual patients in a BLS-AED course on a voluntary basis is feasible and should be further investigated.
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Affiliation(s)
- Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Lazarza 16, Krakow, 31-530, Poland
| | - Paweł Krawczyk
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
| | - Grzegorz Cebula
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
| | - Marta Dembkowska
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
| | - Edyta Drab
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
| | - Bartosz Frączek
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
| | - Aleksandra J Stachoń
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Lazarza 16, Krakow, 31-530, Poland
| | - Janusz Andres
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kopernika 17, Krakow, 31-501, Poland
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Norris EM, Lockey AS. Human factors in resuscitation teaching. Resuscitation 2011; 83:423-7. [PMID: 22120456 DOI: 10.1016/j.resuscitation.2011.11.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 10/30/2011] [Accepted: 11/02/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION There is an increasing interest in human factors within the healthcare environment reflecting the understanding of their impact on safety. The aim of this paper is to explore how human factors might be taught on resuscitation courses, and improve course outcomes in terms of improved mortality and morbidity for patients. The delivery of human factors training is important and this review explores the work that has been delivered already and areas for future research and teaching. METHOD Medline was searched using MESH terms Resuscitation as a Major concept and Patient or Leadership as core terms. The abstracts were read and 25 full length articles reviewed. RESULTS Critical incident reporting has shown four recurring problems: lack of organisation at an arrest, lack of equipment, non functioning equipment, and obstructions preventing good care. Of these, the first relates directly to the concept of human factors. Team dynamics for both team membership and leadership, management of stress, conflict and the role of debriefing are highlighted. Possible strategies for teaching them are discussed. CONCLUSIONS Four strategies for improving human factors training are discussed: team dynamics (including team membership and leadership behaviour), the influence of stress, debriefing, and conflict within teams. This review illustrates how human factor training might be integrated further into life support training without jeopardising the core content and lengthening the courses.
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Affiliation(s)
- Elizabeth M Norris
- Grandes Maisons Road, St Sampson's Medical Practice, Guernsey, Channel Islands GY2 4JS, United Kingdom.
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López-Messa J, Martín-Hernández H, Pérez-Vela J, Molina-Latorre R, Herrero-Ansola P. Novelities in resuscitation training methods. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.medine.2011.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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López-Messa J, Martín-Hernández H, Pérez-Vela J, Molina-Latorre R, Herrero-Ansola P. Novedades en métodos formativos en resucitación. Med Intensiva 2011; 35:433-41. [DOI: 10.1016/j.medin.2011.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 03/12/2011] [Indexed: 10/18/2022]
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Kromann CB, Bohnstedt C, Jensen ML, Ringsted C. The testing effect on skills learning might last 6 months. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2010; 15:395-401. [PMID: 19838814 DOI: 10.1007/s10459-009-9207-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 10/01/2009] [Indexed: 05/05/2023]
Abstract
In a recent study we found that testing as a final activity in a skills course increases the learning outcome compared to spending an equal amount of time practicing. Whether this testing effect measured as skills performance can be demonstrated on long-term basis is not known. The research question was: does testing as a final activity in a cardio-pulmonary resuscitation (CPR) skills course increase learning outcome when assessed after half a year, compared to spending an equal amount of time practicing? The study was an assessor-blinded randomised controlled trial. A convenient sample of 7th semester medical students attending a mandatory CPR course was randomised to intervention course or control course. Participants were taught in small groups. The intervention course included 3.5 h skills training plus 30 min of skills testing. The practice-only control course lasted 4 h. Both groups were invited to a retention assessment of CPR skills half a year later. Participants included 89/180 (50%) of those invited to participate in the study. Mean performance score was 75.9 (SD 11.0) in the intervention group (N = 48) and 70.3 (SD 17.1) in the control group, effect size 0.4. The difference between groups was not statistically significant, P = 0.06. This study suggests that testing as a final activity in a CPR skills course might have an effect on long-term learning outcome compared to spending an equal amount of time practicing the skills. Although this difference was not statistically significant, the identified effect size of 0.4 can have important clinical and educational implications.
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Affiliation(s)
- C B Kromann
- Centre for Clinical Education, Copenhagen University and Capital Region of Denmark, Rigshospitalet, Denmark.
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The effect of pre-course e-learning prior to advanced life support training: A randomised controlled trial. Resuscitation 2010; 81:877-81. [DOI: 10.1016/j.resuscitation.2010.03.019] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 03/08/2010] [Accepted: 03/14/2010] [Indexed: 11/24/2022]
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Resuscitation training for healthcare workers. Resuscitation 2009; 80:841-2. [DOI: 10.1016/j.resuscitation.2009.06.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 06/09/2009] [Accepted: 06/10/2009] [Indexed: 11/20/2022]
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