Comparison of two instructional modalities for nursing student CPR skill acquisition

Evaluating CPR training: simulation vs. webinars for Iranian emergency medical technicians during COVID-19

INTRODUCTION

The high prevalence of COVID-19 and the necessity for social distancing have impacted medical training. On the one hand, the high mortality rate following the disease led the American Heart Association (AHA) to issue guidelines in October 2020 for performing cardiopulmonary resuscitation on patients diagnosed or suspected of having COVID-19. Various methods exist for teaching these guidelines. However, the use of many of these methods is greatly challenged due to the high risk of disease transmission. Moreover, the published guidelines emphasize protection against COVID-19 infection. The present study aims to compare the impact of two educational methods, educational webinars and simulations, on the competence of performing cardiopulmonary resuscitation during the COVID-19 epidemic.

METHODS

This semi-experimental study was conducted on 70 emergency medical technicians. A pre-test was administered to all participants, and then they were randomly assigned into two groups: an educational webinar group (35 people) and a simulation group (35 people). The educational webinar group received online training using Adobe Connect software version 2.6.9, while the simulation group received in-person training using a manikin simulator. The competence of performing cardiopulmonary resuscitation during the COVID-19 epidemic was compared between the two groups immediately after the training and again two months later. Data collection instruments utilized in this research included a demographic questionnaire and a competency questionnaire in performing CPR during the COVID-19 pandemic. The data were analyzed using SPSS software version 19 and statistical tests for comparison.

RESULTS

The results indicated that in both the educational webinar and simulation groups, the average competence score for performing cardiopulmonary resuscitation (CPR) at the three stages under investigation showed significant differences (p < 0.001). Additionally, in both groups under study, the average competence score for performing CPR immediately and two months after training was significantly higher compared to before the training (p < 0.001); however, two months after training, it was significantly lower compared to immediately after the training (p < 0.001).

CONCLUSIONS

Based on the results obtained from the current research, both educational methods (educational webinar and simulation) had a significant effect on the competence of performing CPR during the COVID-19 epidemic and were equally effective. Moreover, the recall test results (two months later) showed a decrease in the competence of performing CPR during the COVID-19 epidemic in both training methods (webinar and simulation), indicating the need for periodic CPR training.

Effectiveness of video self-instruction training on cardiopulmonary resuscitation retention of knowledge and skills among nurses in north-western Nigeria

Background

Adaptable cardiopulmonary resuscitation/basic life support (CPR/BLS) training are required to reduce cardiac arrest mortality globally, especially among nurses. Thus, this study aims to compared CPR knowledge and skills retention level between instructor-led (control group) and video self-instruction training (intervention group) among nurses in northwestern Nigeria.

Methods

A two-arm randomized controlled trial study using double blinding method was conducted with 150 nurses from two referral hospitals. Stratified simple random method was used to choose eligible nurses. For video self-instruction training (intervention group), participants learnt the CPR training via computer in a simulation lab for 7 days, in their own available time whereas for instructor-led training (control group), a 1-day program was conducted by AHA certified instructors. A generalized estimated equation model was used for statistical analysis.

Results

Generalized Estimated Equation showed that there were no significant differences between the intervention group (p = 0.055) and control group (p = 0.121) for both CPR knowledge and skills levels respectively, whereas higher probability of having good knowledge and skills in a post-test, one month and three-month follow-up compared to baseline respectively, adjusted with covariates (p < 0.05). Participants had a lower probability of having good skills at 6-month follow-up compared to baseline, adjusted with covariates (p = 0.003).

Conclusion

This study showed no significant differences between the two training methods, hence video self-instruction training is suggested can train more nurses in a less cost-effective manner to maximize resource utilization and quality nursing care. It is suggested to be used to improve knowledge and skills among nurses to ensure cardiac arrest patients receive excellent resuscitation care.

Development and Validation of a Novel Ultra-Compact and Cost-Effective Device for Basic Hands-On CPR Training: A Randomized, Sham-Controlled, Blinded Trial

To examine the performance of a novel low-cost, ultra-compact, and attractive auditory feedback device for training laypeople in external chest compressions (ECCs), we conducted a quasi-experimental cross-sectional study from September to November 2021 at the Faculty of Nursing of Albacete, University of Castille-La Mancha, Spain. The ECC sequence was performed in the laboratory with the new device for basic hands-on CPR training. Results: One hundred college students were included in this study. The compression rate/min with the new device was 97.6, and the adequate %ECC was 52.4. According to the status of body mass index (BMI) and muscle strength of the upper limbs in the bivariate analysis, it was observed that the new device discriminated between those who performed correct ECCs according to their BMI and muscle strength and those who did not, which led to significantly influenced results in terms of the percentage of ECCs with correct depth. Conclusions: The new ultra-compact auditory feedback device "Salvando a Llanetes^®" demonstrated utility for teaching and learning ECCs in basic CPR. We can affirm that the analyzed device is an adequate, safe and economical method for teaching "CPR Hands-Only™" to the general population.

Comparison of Recertification Methods on CPR Quality

BACKGROUND

High-quality cardiopulmonary resuscitation (CPR) is vital to improving survival from cardiac arrest. This study compared participant performance of CPR with three American Heart Association (AHA)-approved CPR recertification programs because current literature does not show which method is superior. Our goal is to investigate the best training methods to deliver high-quality CPR.

METHOD

Participants were within 90 days of recertification in face-to-face, Heart Code, or Resuscitation Quality Improvement (RQI).

RESULTS

No statistically significant differences were found among training modalities or demographic characteristics. The only significant difference was among those who had performed CPR on a human.

CONCLUSION

Mean scores for the three modalities did not reach the passing requirement for AHA, suggesting that one method of CPR training is not better than the others. Recommendations for translating these findings into clinical practice include mock codes with the ability to measure CPR metrics and simulations of cardiac responses to provide vicarious CPR experience. [J Contin Educ Nurs. 2022;53(1):43-48.].

Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: a systematic literature review comparing different training methodologies

BACKGROUND

Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training.

METHODS

We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts.

RESULTS

Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology.

CONCLUSION

AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training.

Effects of situational simulation and online first-aid training programs for nurses in general medical wards: A prospective study

BACKGROUND

To maintain patient safety, effective first-aid skills are necessary during emergencies. It is important to develop in-service education programs to equip clinical nurses with first-aid skills.

OBJECTIVES

This study explored the effects of first-aid skills and knowledge between situational simulation training and online teaching. It also examined the different effects of two training programs associated with nurses' baseline first-aid ability.

DESIGN

This was a randomized, single-blind controlled study.

SETTING

The study was conducted from December 15, 2016 to May 28, 2018, in the nursing department of a medical center in Taiwan.

PARTICIPANTS

Participants were 92 general ward nurses.

METHODS

Participants were randomly assigned to either a situational simulation training or an online teaching group. We used a first-aid knowledge test (FAKT) and a first-aid skills test (FAST) to measure the participants' learning outcomes after intervention and we did cost comparisons between groups.

RESULTS

There were no significant differences in the changes in FAKT and FAST scores after intervention between situational simulation training and online teaching groups (p = 0.76, p = 0.45). All the participants in both training programs showed improvements via increased scores on FAST (M ± SD = 35.27 ± 12.08 for online teaching, M ± SD = 36.08 ± 10.78 for situational simulation training) and FAKT (M ± SD = 21.09 ± 18.59 for online teaching, M ± SD = 23.39 ± 15.36 for situational simulation training). However, for the subgroup of participants who scored <75% on the FAST pretest, better improvements only occurred in the situational simulation training, but the situational simulation training program had higher costs than the online teaching program.

CONCLUSIONS

The improvement was greater in the situational simulation training group among nurses who could not exceed scores of 75% for first-aid skills. First-aid skill scores below 75% are likely a sign of nurses who need more assistance, discussion, and debriefing from situational simulation training.

Basic Life Support Training for undergraduate nursing students: An integrative review

The aim of this review was to identify the role of basic life support training interventions in international undergraduate nursing education, that support optimal acquisition and retention of knowledge, psychomotor skills and resuscitation self-efficacy. Twenty-four articles were identified and analysed using an integrative review approach. Studies were reviewed for quality using a Critical Appraisal Skills Programme checklist. Common objective and standardised methods of basic life support education practice were identified: instructor led, simulation experiences, self-directed learning, skills training combined with clinical practicum, and computer-based training. Evaluation of competency was collected primarily from multiple-choice questionnaires or researcher-designed checklists, with a lack of objective performance data noted. Importantly, current teaching approaches do not guarantee acquisition or retention of basic life support skills. Objective feedback from technologies supporting cardiopulmonary resuscitation training may be useful in acquisition and retention of psychomotor skills, and therefore requires further exploration. Development of robust, psychometrically sound instruments are needed to accurately and consistently measure nursing students' skills performance.

Comparing Nursing Student Competence in CPR before and after a Pedagogical Intervention

Nursing students must be able to initiate and perform effective cardiopulmonary resuscitation (CPR) when they start their career in nursing. Studies show that students' competency in CPR is deficient, indicating that better training is necessary during nursing education. This study reports on the differences in nursing students' competence in CPR before and after a longitudinal pedagogical intervention across the curriculum. Changes in the curriculum were relocation and added testing of CPR skills, inclusion of a course in defibrillation, a knowledge test as stimuli before simulation, and more simulation practice with deteriorating patients. This was a comparative study between two cohorts of students in the bachelor in nursing education. We measured knowledge and compression performance in the students' final year of education. Students in cohort 2, who received the pedagogical intervention, had a significant higher total knowledge score than students in cohort 1. Students' mean depth and number of correct compressions was similar. Students in cohort 2 had a significantly higher mean rate of compressions, number of compressions per minute, and mean number of compressions with incorrect hand positions. Although the new curriculum afforded more hands-on practice of CPR, it was not enough to improve the students' performance to match the demands set out in national and international guidelines.

Use of Selected Telemedicine Tools in Monitoring Quality of In-Hospital Cardiopulmonary Resuscitation: A Prospective Observational Pilot Simulation Study

Background

The aim of this study was to assess the quality of in-hospital cardiopulmonary resuscitation components performed by nurses under simulated conditions, with the use of selected telemedicine tools.

Material/Methods

This prospective observational pilot simulation study was carried out with a group of 48 nurses working in hospital wards specializing in conservative treatment (HOS/C=22; mean age of 30.27 years; SD 9.30) or interventional therapy (HOS/I=26 nurses; mean age of 30.35 years; SD 9.77). Each nurse performed CPR for two minutes (a sequence of 30 compressions: 2 breaths) on a Laerdal Resusci-Anne manikin that was positioned on an examination couch using a self-inflating bag and face mask in accordance with their knowledge of and skills related to in-hospital resuscitation. The study was conducted in two stages, separated with an intervention (refresh online training by using Polycom RealPresence Group Devices). Analyses of selected chest compression and relaxation parameters were performed with the use of the TrueCPR Coaching Device.

Results

The finding showed improved compression depth (HOS/C: 46.68 mm vs. 51.50 mm; HOS/I: 46.92 mm vs. 50.57 mm), improved full recoil (HOS/C: 81.68% vs. 94.67%; HOS/I: 75.92% vs. 82.13%), and sustained standard compression rate (HOS/C: 115.23/min vs. 105.11/min; HOS/I: 113.65/min vs. 111.04/min) in the study group, 2 months after the intervention. A significant difference between the groups was observed in the rate of chest compressions with complete recoil (HOS/C: 94.67% vs. HOS/I: 82.13%; p<0.042).

Conclusions

The use of selected telemedicine tools leads to improved chest compression and relaxation parameters during in-hospital sudden cardiac arrest.

Basic Life Support Training Methods for Health Science Students: A Systematic Review

The acquisition of competencies in basic life support (BLS) among university students of health sciences requires specific and updated training; therefore, the aim of this review was to identify, evaluate, and synthesise the available scientific knowledge on the effect of training in cardiorespiratory resuscitation in this population. A comprehensive literature search was conducted in MEDLINE, CUIDEN, Web of Science, Wiley Online Library, CINAHL, and Cochrane, including all randomised clinical trials published in the last ten years that evaluated basic life support training methods among these students. We selected a total of 11 randomissed clinical trials that met the inclusion criteria. Participants were nursing and medicine students who received theoretical and practical training in basic life support. The studies showed a great heterogeneity in training methods and evaluators, as did the feedback devices used in the practical evaluations and in the measurement of quality of cardiorespiratory resuscitation. In spite of the variety of information resulting from the training methods in basic life support, we conclude that mannequins with voice-guided feedback proved to be more effective than the other resources analysed for learning.

Acquisition of Knowledge and Practical Skills after a Brief Course of BLS-AED in First-Year Students in Nursing and Physiotherapy at a Spanish University

Out-of-hospital cardiorespiratory arrest is one of the leading causes of death in the Western world. Early assistance with quality Cardiopulmonary Resuscitation (CPR) and the use of a defibrillator may increase the percentage of survival after this process. The objective of this study was to evaluate the effect of CPR training and the management of an Automatic External Defibrillator (AED). A descriptive, cross-sectional, observational study was carried out among students in the first year of a Nursing and Physiotherapy degree of the University of León. To achieve this goal, a theoretical-practical educational intervention of four hours’ duration which included training on CPR, AED and Basic Life Support (BLS) was carried out. A total of 112 students were included. The results showed an increase in theoretical knowledge on BLS as well as on CPR and AED, and practical skills in CPR and AED management. A theoretical exposition of fifteen minutes and the practical training of CPR wasenough for the students to acquire the necessary theoretical knowledge, although the participants failed to reach quality criteria in CPR. Only 35.6% of students reached the right depth in compressions. Also, ventilation was not performed properly. Based on the results, we cannot determine that the percentage of overall quality of CPR was appropriate, since 57.6% was obtained in this respect and experts establish a value higher than 70% for quality CPR. There was a clear relationship between sex, weight, height and body max index (BMI), and quality CPR performance, being determinant variables to achieve quality parameters. Currently, Basic Life Support training in most universities is based on training methods similar to those used in the action described. The results obtained suggest implementing other training methods that favour the acquisition of quality CPR skills.

Benefits of Visual Feedback on Cardiopulmonary Resuscitation Training: A Non-Randomised Manikin Study with Bystanders

Introduction

Cardiopulmonary resuscitation (CPR) is vital for the survival of people who has suffered a cardiac arrest. In order to achieve a good quality CPR performance, rescuer needs a good training which could be gotten with the use of feedback devices. The aim of this study was to compare the use of visual feedback device in CPR training to learning without feedback.

Methods

Ninety-nine subjects without basic life support knowledge participating in the study were divided into three groups. All of them carried out two tests: 2 minutes of CPR with compressions and ventilations. First two groups received trainings on CPR between the tests (experimental groups): one group with instructor-led training and the other one with visual feedback device. The third group did not receive any training between the tests (control group).

Results

In the first test no differences among the three groups were found. The experimental groups improved their scores in the last test. The number of correct chest compressions by hand position and depth, and the number of correct rescue breaths was increased. The experimental group with visual feedback CPR training achieved better scores of quality CPR in the second test than the instructor-led training group.

Conclusions

The visual feedback and instruction-led training have positive effects on the quality CPR. The use of visual feedback during learning has greater benefits than instruction-led training in the three variables analysed.

Effectiveness of teaching automated external defibrillators use using a traditional classroom instruction versus self-instruction video in non-critical care nurses

Objectives:

To evaluate the effectiveness and retention of learning automated external defibrillator (AED) usage taught through a traditional classroom instruction (TCI) method versus a novel self instructed video (SIV) technique in non-critical care nurses (NCCN).

Methods:

A prospective single-blind randomized study was conducted over 7 months (April-October 2014) at the Universiti Kebangsaan Malaysia Medical Center, Kuala Lampur, Malaysia. Eighty nurses were randomized into either TCI or SIV instructional techniques. We assessed knowledge, skill and confidence level at baseline, immediate and 6-months post-intervention. Knowledge and confidence were assessed via questionnaire; skill was assessed by a calibrated and blinded independent assessor using an objective structured clinical examination (OSCE) method.

Results:

Pre-test mean scores for knowledge in the TCI group was 10.87 ± 2.34, and for the SIV group was 10.37 ± 1.85 (maximum achievable score 20.00); 4.05 ± 2.87 in the TCI and 3.71 ± 2.66 in the SIV (maximum score 11.00) in the OSCE evaluation and 9.54 ± 3.65 in the TCI and 8.56 ± 3.47 in the SIV (maximum score 25.00) in the individual’s personal confidence level. Both methods increased the mean scores significantly during immediate post-intervention (0-month). At 6-months, the TCI group scored lower than the SIV group in all aspects 11.13 ± 2.70 versus 12.95 ± 2.26 (p=0.03) in knowledge, 7.27 ± 1.62 versus 7.68 ± 1.73 (p=0.47) in the OSCE, and 16.40 ± 2.72 versus 18.82 ± 3.40 (p=0.03) in confidence level.

Conclusion:

In NCCN’s, SIV is as good as TCI in providing the knowledge, competency, and confidence in performing AED defibrillation.

Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial

BACKGROUND

Clinical simulations can provide students with realistic clinical learning environments to increase their knowledge, self-confidence, and decrease their anxiety prior to entering clinical practice settings.

OBJECTIVE

To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation.

DESIGN

Randomized pretest-posttest design.

SETTING

A public research university in Canada.

PARTICIPANTS

Fifty-six third year Bachelor of Science in Nursing students.

METHODS

Participants were randomized to either face-to-face or virtual clinical simulation and then to dyads for completion of two clinical simulations. Measures included: (1) Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM) (White, 2011), (2) knowledge pretest and post-test related to preeclampsia and group B strep, and (3) Simulation Completion Questionnaire. Before and after each simulation students completed a knowledge test and the NASC-CDM and the Simulation Completion Questionnaire at study completion.

RESULTS

There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations. Anxiety scores were higher for students in the virtual clinical simulation than for those in the face-to-face simulation. Students' self-reported preference was face-to-face citing the similarities to practicing in a 'real' situation and the immediate debrief. Students not liking the virtual clinical simulation most often cited technological issues as their rationale.

CONCLUSIONS

Given the equivalency of knowledge and self-confidence when undergraduate nursing students participate in either maternal newborn clinical scenarios of face-to-face or virtual clinical simulation identified in this trial, it is important to take into the consideration costs and benefits/risks of simulation implementation.

Comparison between an instructor-led course and training using a voice advisory manikin in initial cardiopulmonary resuscitation skill acquisition

Objective

We compared training using a voice advisory manikin (VAM) with an instructor-led (IL) course in terms of acquisition of initial cardiopulmonary resuscitation (CPR) skills, as defined by the 2010 resuscitation guidelines.

Methods

This study was a randomized, controlled, blinded, parallel-group trial. We recruited 82 first-year emergency medical technician students and distributed them randomly into two groups: the IL group (n=41) and the VAM group (n=37). In the IL-group, participants were trained in “single-rescuer, adult CPR” according to the American Heart Association’s Basic Life Support course for healthcare providers. In the VAM group, all subjects received a 20-minute lesson about CPR. After the lesson, each student trained individually with the VAM for 1 hour, receiving real-time feedback. After the training, all subjects were evaluated as they performed basic CPR (30 compressions, 2 ventilations) for 4 minutes.

Results

The proportion of participants with a mean compression depth ≥50 mm was 34.1% in the IL group and 27.0% in the VAM group, and the proportion with a mean compression depth ≥40 mm had increased significantly in both groups compared with ≥50 mm (IL group, 82.9%; VAM group, 86.5%). However, no significant differences were detected between the groups in this regard. The proportion of ventilations of the appropriate volume was relatively low in both groups (IL group, 26.4%; VAM group, 12.5%; P=0.396).

Conclusion

Both methods, the IL training using a practice-while-watching video and the VAM training, facilitated initial CPR skill acquisition, especially in terms of correct chest compression.

Effects of an integrated simulation-based resuscitation skills training with clinical practicum on mastery learning and self-efficacy in nursing students

BACKGROUND

This study evaluates the effectiveness of integrated simulation-based resuscitation skills training combined with a clinical practicum by assessing nursing students' knowledge, psychomotor skills, and self-efficacy.

METHODS

In a pretest-posttest design, 255 second-year nursing students participated in an emergency nursing clinical course consisting of a two-hour simulation-based resuscitation skills training component along with an 80-hour clinical placement in an emergency department. Knowledge, self-efficacy, and psychomotor skill errors were measured. Analyses of pre- and post-test data were performed on three subgroups: the simulation-only group, the simulation with clinical observation group, and the simulation with clinical performance group. Stu- dents were divided into these groups based on resuscitation experiences during their clinical practicum in the emergency department.

RESULTS

Mean scores of knowledge (z = -13.879, p < .001) and self-efficacy (z = -10.969, p < .001) significantly improved after the clinical practicum compared to baseline. Knowl- edge (F = .502, p = .606), psychomotor skill error (F = 1.587, p = .207), and self-efficacy (F = .481, p = .619) did not significantly differ among the three subgroups after controlling for two covari- ates (age, Basic Life Support certification) in the analysis of covariance models.

CONCLUSION

Integrated simulation-based resuscitation skills training combined with a clinical practicum might be beneficial for enhancing mastery learning and self-efficacy in nursing students through learner engagement and feedback.

An assessment of CPR skills using simulation: Are first responders prepared to save lives?

The American Heart Association's (AHA) recommendation for biyearly recertification and annual mandatory CPR training may be suboptimal for first responders (nurses and technicians) working in outpatient clinics (American Heart Association, 2013). To determine the efficacy of the AHA guidelines, 40 simulated sudden cardiac arrest (SCA) encounters were conducted followed by debriefing and a subsequent SCA to determine a basic level of CPR proficiency. First responders' CPR skills were evaluated using a 19-item assessment form to quantify the event. A comparison of scores using two different viewing modalities was performed to provide an assessment of the training program. Of the 40 sessions, group mean performance scores for the first encounter were just above the organization's minimum required score of 24. Performance scores increased slightly (27-28) after the second encounter. Proficiency of skills was poor and frequent basic life support training may be indicated to help first responders provide high-quality CPR.

Comparison of two training programmes on paramedic-delivered CPR performance

OBJECTIVE

To compare CPR performance in two groups of paramedics who received CPR training from two different CPR training programmes.

METHODS

Conducted in June 2014 at the Hamad Medical Corporation Ambulance Service, the national ambulance service of the State of Qatar, the CPR performances of 149 new paramedic recruits were evaluated after they had received training from either a traditional CPR programme or a tailored CPR programme. Both programmes taught the same content but differed in the way in which this content was delivered to learners. Exclusive to the tailored programme was mandatory precourse work, continuous assessments, a locally developed CPR instructional video and pedagogical activities tailored to the background education and learner style preferences of paramedics. At the end of each respective training programme, a single examiner who was blinded to the type of training paramedics had received, rated them as competent or non-competent on basic life support skills, condition specific skills, specific overall skills and non-technical skills during a simulated out-of-hospital cardiac arrest (OHCA) assessment.

RESULTS

Paramedics who received CPR training with the tailored programme were rated competent 70.9% of the time, compared with paramedics who attended the traditional programme and who achieved this rating 7.9% of the time (p<0.001). Specific improvements were seen in the time required to detect cardiac arrest, chest compression quality, and time to first monitored rhythm and delivered shock.

CONCLUSIONS

In an OHCA scenario, CPR performance rated as competent was significantly higher when training was received using a tailored CPR programme.

Effects of two retraining strategies on nursing students' acquisition and retention of BLS/AED skills: A cluster randomised trial

AIM

To determine and compare the effects of two different retraining strategies on nursing students' acquisition and retention of BLS/AED skills.

METHODS

Nursing students (N = 177) from two European universities were randomly assigned to either an instructor-directed (IDG) or a student-directed (SDG) 4-h retraining session in BLS/AED. A multiple-choice questionnaire, the Cardiff Test, Laerdal SkillReporter(®) software and a self-efficacy scale were used to assess students' overall competency (knowledge, psychomotor skills and self-efficacy) in BLS/AED at pre-test, post-test and 3-month retention-test. GEE, chi-squared and McNemar tests were performed to examine statistical differences amongst groups across time.

RESULTS

There was a significant increase in the proportion of students who achieved competency for all variables measuring knowledge, psychomotor skills and self-efficacy between pre-test and post-test in both groups (all p-values<0.05). However, at post-test, significantly more students in the SDG achieved overall BLS/AED competency when compared to IDG. In terms of retention at 3 months, success rates of students within the IDG deteriorated significantly for all variables except ≥ 70% of chest compressions with correct hand position (p-value = 0.12). Conversely, the proportion of students who achieved competency within the SDG only decreased significantly in 'mean no flow-time ≤ 5s' (p-value = 0.02). Furthermore, differences between groups' success rates at retention-test also proved to be significantly different for all variables measured (all p-values < 0.05).

CONCLUSION

This study demonstrated that using a student-directed strategy to retrain BLS/AED skills has resulted in a higher proportion of nursing students achieving and retaining competency in BLS/AED at three months when compared to an instructor-directed strategy.

Comparison of methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles

AIM

To compare the methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles.

BACKGROUND

The methodologic quality of quantitative nursing education research needs to advance to a higher level. Clinical research can provide guidance for nursing education to reach this level.

METHOD

One hundred quantitative clinical research articles from-high impact journals published in 2007 and 37 education research articles from high impact journals published in 2006 to 2007 were chosen for analysis.

RESULTS

Clinical articles had significantly higher quality scores than education articles in three domains: number of institutions studied, type of data, and outcomes.

CONCLUSION

The findings indicate three ways in which nursing education researchers can strengthen the methodologic quality of their quantitative research. With this approach, greater funding may be secured for advancing the science of nursing education.

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines

OBJECTIVE

To present a series of evidence-based, consensus guidelines for veterinary CPR in dogs and cats.

DESIGN

Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Questions in five domains were examined: Preparedness and Prevention, Basic Life Support, Advanced Life Support, Monitoring, and Post-Cardiac Arrest Care. Standardized worksheet templates were used for each question, and the results reviewed by the domain members, by the RECOVER committee, and opened for comments by veterinary professionals for 4 weeks. Clinical guidelines were devised from these findings and again reviewed and commented on by the different entities within RECOVER as well as by veterinary professionals.

SETTING

Academia, referral practice and general practice.

RESULTS

A total of 74 worksheets were prepared to evaluate questions across the five domains. A series of 101 individual clinical guidelines were generated. In addition, a CPR algorithm, resuscitation drug-dosing scheme, and postcardiac arrest care algorithm were developed.

CONCLUSIONS

Although many knowledge gaps were identified, specific clinical guidelines for small animal veterinary CPR were generated from this evidence-based process. Future work is needed to objectively evaluate the effects of these new clinical guidelines on CPR outcome, and to address the knowledge gaps identified through this process.

Literature review: instructional design and pedagogy science in healthcare simulation

This article is a review of the literature focused on simulation as an educational intervention in healthcare. The authors examined the literature based on four key levels: (1) the validity and reliability of the simulator, (2) the validity and reliability of the performance evaluation tool, (3) the study design, and (4) the translational impact. The authors found that the majority of research literature in healthcare simulation does not address the validity and reliability of the simulator or the performance evaluation tool. However, there are well-designed research studies that address the translation into clinical settings and have positive patient safety outcomes.

Deliberate practice of motor skills in nursing education: CPR as exemplar

Our study explored the effects of deliberate practice on the retention ofcardiopulmonary resuscitation (CPR) psychomotor skills among nursing students. The practice sessions were short, six minutes a session one time a month. Differences in performance between students who had deliberate practice and a control group, with no practice beyond the initial training, were compared every three months for one year. The intervention group performed better than the control over the 12 months. There is a need in nursing education for deliberate practice of relevant and high-use skills for students to improve their performance and gradually develop their expertise.