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Hartslief B, Janse van Rensburg C, Maartens A, Marais PG, Meyer ET, Cairncross JP, Joubert G, Steinberg WJ. Accuracy of two-rescuer adult CPR performed by medical registrars at a South African university. Afr J Emerg Med 2023; 13:199-203. [PMID: 37456585 PMCID: PMC10344687 DOI: 10.1016/j.afjem.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) is performed to manually keep brain function intact until the patient's spontaneous blood circulation and breathing are restored. In South Africa, registrars, who are qualified doctors training to specialise in a medical field, are usually the team leaders and oversee junior doctors and nurses during resuscitation. Objectives This study aimed to determine the accuracy of the execution of two-rescuer adult CPR on a Resusci-Anne® manikin performed by registrars from the University of the Free State, South Africa. Methods A cross-sectional study was conducted. From a target population of 142 registrars, 47 participated, of whom 44 were included in the analysis. During five cycles of CPR, compression quality was assessed. During a subsequent five cycles, airway management was assessed. Participants were evaluated executing CPR on the Resusci-Anne® manikin, with a recently Basic Life Support trained student researcher as second rescuer. A modified version of the American Heart Association's tick sheet for two-rescuer adult CPR was completed by two student researchers. Department, gender and the date of the most recent CPR training attended were recorded. Results The median total percentage score was 82.2% (range 33.3% to 100.0%). Results showed that 88.6% of registrars consistently demonstrated correct hand placement, 25.0% correct compression rate, 93.2% correct compression depth, and 61.4% allowed complete chest recoil during compressions. Consistently correct E-C technique was found in 77.3%, and correct ventilation rate in 93.2%. Only 63.6% correctly managed an open airway, and 61.4% achieved visible chest rise. A consistently correct compression-to-ventilation ratio was performed by 59.1% of registrars. Conclusion The study found that registrars were not consistently performing high-quality CPR on a Resusci-Anne® manikin and identified areas needing attention. The results of this study highlight the need for compulsory CPR training and regular fire drills for registrars.
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Affiliation(s)
- Bianca Hartslief
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Carmen Janse van Rensburg
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Alicia Maartens
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Pieter G. Marais
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Erwain T. Meyer
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Joleen P. Cairncross
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Gina Joubert
- Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Wilhelm Johannes Steinberg
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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Saba PS, Canonico ME, Gambaro A, Gazale G, Piga S, Santomauro M, Roscio G. Systematic basic and advanced resuscitation training in medical students and fellows: a proposal from the Working Group on Cardiovascular Urgences and Emergencies of the Italian Society of Cardiology. J Cardiovasc Med (Hagerstown) 2023; 24:e128-e133. [PMID: 37186563 DOI: 10.2459/jcm.0000000000001421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Sudden cardiac arrest is a leading cause of death in Europe. High-quality cardiopulmonary resuscitation (CPR) and guidelines compliance of rescuers have been associated with better outcomes after cardiac arrest. However, wide variability in attempting bystander CPR manoeuvres has been reported. Educational programmes for teaching CPR to medical students and fellows are highly advisable in this context. However, there is no homogeneity regarding the CPR education offered by academic institutions. We surveyed 208 Italian medical students and 162 fellows in cardiology regarding the educational offer and needs in CPR. Among the 11 medical schools surveyed, 8 (73%) offer basic (BLS) courses but only 3 (38%) with formal certification of 'BLS provider', while none offers advanced (ACLS/ALS) courses. Among the 30 specialization schools in cardiology surveyed, 10 (33%) offer a BLS course (6 with formal certification of 'BLS provider'), and 8 (27%) offer an ACLS/ALS course (5 with formal certification). Only a minority of students and fellows perceive themselves as highly proficient either in BLS or ACLS/ALS, although most of the fellows were involved at least once in rescuing a cardiac arrest. The present position paper analyses and suggests the strategies that should be adopted by Italian medical and specialization schools to spread the CPR culture and increase the long-standing retention of CPR-related technical and nontechnical skills.
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Affiliation(s)
- Pier Sergio Saba
- Clinical and Interventional Cardiology, Azienda Ospedaliero-Universitaria di Sassari, Sassari
| | - Mario Enrico Canonico
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Alessia Gambaro
- Department of Cardiology, Azienda Ospedaliera Universitaria di Verona, Verona
| | - Giovanni Gazale
- Center for Sports Medicine and Cardiology- Azienda Sanitaria Locale 1, Sassari
| | - Stefania Piga
- Pediatric Cardiology, Azienda Ospedaliero-Universitaria di Sassari, Sassari
| | - Maurizio Santomauro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Giancarlo Roscio
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, University of Rome Sapienza, Rome, Italy
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Sianipar IR, Tantri AR, Muktiarti D, Dwijayanti A, Manggala SK, Muliyah E. Comparison Between Self-Deliberate Practice and Directed Learning Training Methods for Basic Life Support Knowledge and High-Quality Cardiopulmonary Resuscitation Skill Retention in Second-Year Medical Students 3 and 6 Months After Training. MEDICAL SCIENCE EDUCATOR 2023; 33:395-400. [PMID: 37261012 PMCID: PMC10226953 DOI: 10.1007/s40670-023-01746-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
Background Cardiopulmonary resuscitation (CPR) requires well-trained medical personnel. Multiple learning methods can be done for CPR skills training. This study aimed to compare self-deliberate practice (SDP) method and directed learning (DL) method to improve basic life support (BLS) knowledge and CPR skill performance in medical students. Methods This is an experimental, single-blind, randomized controlled trial study of 40 medical students from February to July 2019. Forty subjects were randomly assigned into SDP and DL groups through a voluntary sampling method. Both groups attended a 1-day course and then practiced once a month for 3 months. The DL group had practice sessions with assigned tutors, while the SDP group had to practice by themselves. Examination of BLS knowledge and CPR performance quality (compression depth, rate, and performance score) was collected before and after course lecture, after a skills training, 3 and 6 months after training. Results Subject characteristics of both groups were comparable. Significant knowledge and skill improvement were found in the DL group and the SDP group when compared to their knowledge and skill before training. There were no significant differences between both groups in BLS knowledge and CPR performance quality in all examination periods. Conclusion Both SDP and DL teaching methods show significant improvement and excellent retention in BLS knowledge and high-quality CPR performance. These two learning methods are both feasible and bring positive results for students. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01746-7.
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Affiliation(s)
- Imelda Rosalyn Sianipar
- Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Education Tower, 8 – 9th Floor, Jl. Salemba Raya No. 6, 10430 Jakarta, Indonesia
- Department of Medical Physiology and Biophysics, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, 10430 Indonesia
| | - Aida Rosita Tantri
- Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Education Tower, 8 – 9th Floor, Jl. Salemba Raya No. 6, 10430 Jakarta, Indonesia
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Dina Muktiarti
- Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Education Tower, 8 – 9th Floor, Jl. Salemba Raya No. 6, 10430 Jakarta, Indonesia
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Adisti Dwijayanti
- Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Education Tower, 8 – 9th Floor, Jl. Salemba Raya No. 6, 10430 Jakarta, Indonesia
- Department of Medical Pharmacy, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, 10430 Indonesia
| | - Sidharta Kusuma Manggala
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Evi Muliyah
- Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Education Tower, 8 – 9th Floor, Jl. Salemba Raya No. 6, 10430 Jakarta, Indonesia
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Ssewante N, Wekha G, Iradukunda A, Musoke P, Kanyike AM, Nabukeera G, Wamala NK, Zziwa W, Kamuhangire L, Kajjimu J, Luggya TS, Tagg A. Basic life support, a necessary inclusion in the medical curriculum: a cross-sectional survey of knowledge and attitude in Uganda. BMC MEDICAL EDUCATION 2022; 22:140. [PMID: 35241065 PMCID: PMC8892119 DOI: 10.1186/s12909-022-03206-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Uganda continues to depend on a health system without a well-defined emergency response system. This is in the face of the rising cases of out-of-hospital cardiac arrest contributed largely to the high incidence of road traffic accidents. Non-communicable diseases are also on the rise further increasing the incidence of cardiac arrest. Medical students are key players in the bid to strengthen the health system which warrants an assessment of their knowledge and attitude towards BLS inclusion in their study curriculum. METHODS A descriptive cross-sectional study was conducted in 2021 among undergraduate medical students across eight public and private universities in Uganda. An online-based questionnaire was developed using Google forms and distributed via identified WhatsApp groups. Chi-square or Fisher's exact test and logistic regression were performed in STATA 15 to assess the association between knowledge of BLS and demographics. P < 0.05 was considered statistically significant. RESULTS Out of the total 354 entries obtained, 351 were analyzed after eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years (n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone formal BLS training. Less than a third of participants (n = 103, 29.3%) had good knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level of academic progress (p = 0.001), and prior BLS training (p = 0.033) were associated with good knowledge. Participants with prior training were more likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1-2.7, p = 0.009). The majority (n = 348, 99.1%) believed that BLS was necessary and would wish (n = 343, 97.7%) to have it included in their curriculum. CONCLUSIONS Undergraduate medical students have poor BLS knowledge but understand its importance. Institutions need to adopt practical teaching methods such as clinical exposures, field experience in collaboration with local implementers, and participating in community health promotion campaigns.
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Affiliation(s)
- Nelson Ssewante
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Godfrey Wekha
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Angelique Iradukunda
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Phillip Musoke
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | - Nicholas Kisaakye Wamala
- Faculty of Clinical Medicine and Dentistry, Kampala International University, Ishaka-Bushenyi, Uganda
| | - Wilson Zziwa
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Lauben Kamuhangire
- Faculty of Biology, Medicine, and Health, King Caesar University, Kampala, Uganda
| | - Jonathan Kajjimu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Tonny Stone Luggya
- Department of Anesthesia and Emergency Medicine, Makerere University, Kampala, Uganda
| | - Andrew Tagg
- Emergency Department, Western Hospital-Footscray, Footscray, Victoria, Australia
- School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, El-Naggar W, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami MD, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation 2021; 145:e645-e721. [PMID: 34813356 DOI: 10.1161/cir.0000000000001017] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami M, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2021; 169:229-311. [PMID: 34933747 PMCID: PMC8581280 DOI: 10.1016/j.resuscitation.2021.10.040] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Schussler L. What We Talk About When We Talk About the Code. JAMA Cardiol 2021; 6:1235-1236. [PMID: 34431969 DOI: 10.1001/jamacardio.2021.3199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Kayadelen CL, Kayadelen AN, Durukan P. Factors influencing paramedics' and emergency medical technicians' level of knowledge about the 2015 basic life support guidelines. BMC Emerg Med 2021; 21:82. [PMID: 34247572 PMCID: PMC8273942 DOI: 10.1186/s12873-021-00474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background This study aimed to determine the cardiopulmonary resuscitation (CPR) knowledge level and factors affecting the current CPR knowledge level among EMTs and paramedics working in the Kayseri 112 emergency health system. Methods This survey aimed to reach all paramedics and emergency medical technicians working in the 112 emergency health system in Kayseri province. The data collection consists of sociodemographic/occupational characteristics, CPR training and practice characteristics and 20 four-choice CPR knowledge questions. Multiple linear regression analysis was used to determine the independent variables that affect the number of correct answers given to the questionnaire. Results 305 healthcare professionals were included in this study. 57.0% (n = 174) of the participants were female and 56.1% were under the age of 30. It was found that 65.6% (n = 200) of the healthcare professionals were EMTs, and 48.6% (n = 148) had been working for 6–10 years. The mean number of correct responses based on the 20 questions asked was 12.76 ± 3.11. In multivariable analysis, it was determined that having received training on CPR after 2015, having participated in a course or seminar on CPR in the last 3 months and having practiced defibrillation/cardioversion during CPR significantly increased the level of knowledge regarding CPR (respectively, p < 0.01, p = 0.025, p = 0.045). Conclusion CPR trainings, which have been received recently and based on the current guidelines, increase the level of CPR knowledge and the increasing knowledge level affects the use of defibrillation/cardioversion. Improving training increases knowledge and practice.
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Affiliation(s)
- Celal Levent Kayadelen
- Emergency Department, Kahramanmaras Elbistan State Hospital, Karaelbistan Neighbourhood, Istiklal Street, 9, Elbistan, KMaras, Turkey.
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Zackoff MW, Cruse B, Sahay RD, Fei L, Saupe J, Schwartz J, Klein M, Geis GL, Tegtmeyer K. Development and Implementation of Augmented Reality Enhanced High-Fidelity Simulation for Recognition of Patient Decompensation. Simul Healthc 2021; 16:221-230. [PMID: 32910102 DOI: 10.1097/sih.0000000000000486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Simulation is a core aspect of training and assessment; however, simulation laboratories are limited in their ability to visually represent mental, respiratory, and perfusion status. Augmented reality (AR) represents a potential adjunct to address this gap. METHODS A prospective, observational pilot of interprofessional simulation assessing a decompensating patient was conducted from April to June 2019. Teams completed 2 simulations: (1) traditional training (TT) using a manikin (Laerdal SimJunior) and (2) AR-enhanced training (ART) using a manikin plus an AR patient. The primary outcome was self-assessed effectiveness at the assessment of patient decompensation. Secondary outcomes were attitudes toward and adverse effects during the AR training. RESULTS Twenty-one simulation sessions included 84 participants in headsets. Participants reported improved ability to assess the patient's mental status, respiratory status, and perfusion status (all P < 0.0001) during ART in comparison to TT. Similar findings were noted for recognition of hypoxemia, shock, apnea, and decompensation (all P ≤ 0.0003) but not for recognition of cardiac arrest (P = 0.06). Most participants agreed or strongly agreed that ART accurately depicted a decompensating patient (89%), reinforced key components of the patient assessment (88%), and will impact how they care for patients (68%). Augmented reality-enhanced training was rated more effective than manikin training and standardized patients and equally as effective as bedside teaching. CONCLUSIONS This novel application of AR to enhance the realism of manikin simulation demonstrated improvement in self-assessed recognition of patient decompensation. Augmented reality may represent a viable modality for increasing the clinical impact of training.
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Affiliation(s)
- Matthew W Zackoff
- From the Department of Pediatrics (M.W.Z., R.D.S., L.F., M.K., G.L.G., K.T.), University of Cincinnati College of Medicine; and Division of Critical Care Medicine (M.W.Z., K.T.), Center for Simulation and Research (B.C.), Division of Biostatistics and Epidemiology (R.D.S., L.F.), Center for Professional Excellence (J.Sa., J.Sc.), and Divisions of General and Community Pediatrics (M.K.) and Emergency Medicine (G.L.G.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Ettl F, Fischer E, Losert H, Stumpf D, Ristl R, Ruetzler K, Greif R, Fischer H. Effects of an Automated External Defibrillator With Additional Video Instructions on the Quality of Cardiopulmonary Resuscitation. Front Med (Lausanne) 2021; 8:640721. [PMID: 33816528 PMCID: PMC8009965 DOI: 10.3389/fmed.2021.640721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Aim of the Study: The aim was to compare cardiopulmonary resuscitation (CPR) quality of an automated external defibrillator (AED) with and without additional video instruction during basic life support (BLS) by laypersons. Methods: First-year medical students were randomized either to an AED with audio only or audio with additional video instructions during CPR. Each student performed 4 min of single-rescuer chest compression only BLS on a manikin (Ambu Man C, Ballerup, Denmark) using the AED. The primary outcome was the effective compression ratio during this scenario. This combined parameter was used to evaluate the quality of chest compressions by multiplying compressions with correct depth, correct hand position, and complete decompression by flow time. Secondary outcomes were percentages of incomplete decompression and hand position, mean compression rate, time-related parameters, and subjective assessments. Results: Effective compression ratio did not differ between study groups in the overall sample (p = 0.337) or in students with (p = 0.953) or without AED experience (p = 0.278). Additional video instruction led to a higher percentage of incorrect decompressions (p = 0.014). No significant differences could be detected in time-related resuscitation parameters. An additional video was subjectively rated as more supporting (p = 0.001). Conclusions: Audio-video instructions did not significantly improve resuscitation quality in these laypersons despite that it was felt more supportive. An additional video to the verbal AED prompts might lead to cognitive overload. Therefore, future studies might target the influence of the video content and the potential benefits of video instructions in specific populations.
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Affiliation(s)
- Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Eva Fischer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesiology and Intensive Care, Klinik Donaustadt, Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Dominik Stumpf
- Department of Anaesthesia and Intensive Care, Ordensklinikum Linz - Hospital of the Sisters of Charity, Linz, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Kurt Ruetzler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
| | - Robert Greif
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Medical School, Sigmund Freud Private University, Vienna, Austria
| | - Henrik Fischer
- Medical School, Sigmund Freud Private University, Vienna, Austria
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11
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Nas J, Thannhauser J, Vart P, van Geuns RJ, Muijsers HEC, Mol JQ, Aarts GWA, Konijnenberg LSF, Gommans DHF, Ahoud-Schoenmakers SGAM, Vos JL, van Royen N, Bonnes JL, Brouwer MA. Effect of Face-to-Face vs Virtual Reality Training on Cardiopulmonary Resuscitation Quality: A Randomized Clinical Trial. JAMA Cardiol 2021; 5:328-335. [PMID: 31734702 DOI: 10.1001/jamacardio.2019.4992] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Bystander cardiopulmonary resuscitation (CPR) is crucial for survival after cardiac arrest but not performed in most cases. New, low-cost, and easily accessible training methods, such as virtual reality (VR), may reach broader target populations, but data on achieved CPR skills are lacking. Objective To compare CPR quality between VR and face-to-face CPR training. Design, Setting, and Participants Randomized noninferiority trial with a prospective randomized open blinded end point design. Participants were adult attendees from the science section of the Lowlands Music Festival (August 16 to 18, 2019) in the Netherlands. Analysis began September 2019. Interventions Two standardized 20-minute protocols on CPR and automated external defibrillator use: instructor-led face-to-face training or VR training using a smartphone app endorsed by the Resuscitation Council (United Kingdom). Main Outcomes and Measures During a standardized CPR scenario following the training, we assessed the primary outcome CPR quality, measured as chest compression depth and rate using CPR manikins. Overall CPR performance was assessed by examiners, blinded for study groups, using a European Resuscitation Council-endorsed checklist (maximum score, 13). Additional secondary outcomes were chest compression fraction, proportions of participants with mean depth (50 mm-60 mm) or rate (100 min-1-120 min-1) within guideline ranges, and proportions compressions with full release. Results A total of 381 participants were randomized: 216 women (57%); median (interquartile range [IQR]) age, 26 (22-31) years. The VR app (n = 190 [49.9%]) was inferior to face-to-face training (n = 191 [50.1%]) for chest compression depth (mean [SD], VR: 49 [10] mm vs face to face: 57 [5] mm; mean [95% CI] difference, -8 [-9 to -6] mm), and noninferior for chest compression rate (mean [SD]: VR: 114 [12] min-1 vs face to face: 109 [12] min-1; mean [95% CI] difference, 6 [3 to 8] min-1). The VR group had lower overall CPR performance scores (median [IQR], 10 [8-12] vs 12 [12-13]; P < .001). Chest compression fraction (median [IQR], 61% [52%-66%] vs 67% [62%-71%]; P < .001) and proportions of participants fulfilling depth (51% [n = 89] vs 75% [n = 133], P < .001) and rate (50% [n = 87] vs 63% [n = 111], P = .01) requirements were also lower in the VR group. The proportion of compressions with full release was higher in the VR group (median [IQR], 98% [59%-100%] vs 88% [55%-99%]; P = .002). Conclusions and Relevance In this randomized noninferiority trial, VR training resulted in comparable chest compression rate but inferior compression depth compared with face-to-face training. Given the potential of VR training to reach a larger target population, further development is needed to achieve the compression depth and overall CPR skills acquired by face-to-face training. Trial Registration ClinicalTrials.gov identifier: NCT04013633.
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Affiliation(s)
- Joris Nas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jos Thannhauser
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Priya Vart
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Robert-Jan van Geuns
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hella E C Muijsers
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan-Quinten Mol
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Goaris W A Aarts
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lara S F Konijnenberg
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D H Frank Gommans
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Jacqueline L Vos
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith L Bonnes
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marc A Brouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
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12
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Suet G, Blanie A, de Montblanc J, Roulleau P, Benhamou D. External Cardiac Massage Training of Medical Students: A Randomized Comparison of Two Feedback Methods to Standard Training. J Emerg Med 2020; 59:270-277. [PMID: 32536496 DOI: 10.1016/j.jemermed.2020.04.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND The most recent recommendations support learning of external cardiac massage (ECM) through feedback devices. OBJECTIVES The objective was to compare the effects on immediate and 3-month retention of ECM technical skills when using feedback devices compared with training without feedback as part of a half-day training session in medical students. METHODS This randomized study was performed using the Resusci Anne QCPR manikin in 64 medical students. We compared the quality of ECM with nonfeedback training in the control group (group 1) vs. 2 feedback learning methods (group 2, PocketCPR and group 3, Skill Reporter each used with visual display available to the trainee). At the end of the training session and 3 months later, students performed chest compressions blindly during a 2-min assessment session. The median compression score was the primary outcome for assessing immediate and long-term retention. RESULTS Regarding immediate retention, the median compression score was significantly lower in group 1 (23%) than in groups 2 (81%) and 3 (72%) (p < 0.05) with no difference between the 2 feedback methods. At 3 months, mean compression scores remained high but not significantly different between the 2 feedback groups. CONCLUSION The use of a feedback device used for ECM training improves the quality of immediate retention of technical ECM skills compared with traditional teaching in medical students. At 3 months, the 2 groups with feedback retained a high level of performance. No significant difference could be demonstrated between the 2 feedback methods.
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Affiliation(s)
- Guillaume Suet
- Department of Anesthesia and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Paris Sud Medical School, Paris Sud University, Le Kremlin Bicêtre, France
| | - Antonia Blanie
- Department of Anesthesia and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Paris Sud Medical School, Paris Sud University, Le Kremlin Bicêtre, France
| | - Jacques de Montblanc
- Department of Anesthesia and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Paris Sud Medical School, Paris Sud University, Le Kremlin Bicêtre, France
| | - Philippe Roulleau
- Department of Anesthesia and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Paris Sud Medical School, Paris Sud University, Le Kremlin Bicêtre, France
| | - Dan Benhamou
- Department of Anesthesia and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Paris Sud Medical School, Paris Sud University, Le Kremlin Bicêtre, France
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13
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Formación de población adulta lega en soporte vital básico. Una revisión sistemática. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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14
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Rascón-Hernán C, Fullana-Noell J, Fuentes-Pumarola C, Romero-Collado A, Vila-Vidal D, Ballester-Ferrando D. Measuring self-directed learning readiness in health science undergraduates: A cross-sectional study. NURSE EDUCATION TODAY 2019; 83:104201. [PMID: 31493619 DOI: 10.1016/j.nedt.2019.08.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/18/2019] [Accepted: 08/25/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The European Higher Education Area places students at the centre of the teacher-guided learning process and requires them to participate more in their education and to be responsible for acquiring the professional competences relevant to their career. Self-directed learning is a key means for developing the skills necessary for professional careers. OBJECTIVE To measure self-directed learning readiness in health science undergraduates. METHOD Observational descriptive cross-sectional study of a convenience sample drawn from the total health science (medicine, nursing, physiotherapy and psychology) undergraduate population (n = 1699) at the University of Girona (Spain). The data collection instrument was a self-directed learning readiness scale with 38 items administered to the 1134 undergraduates who agreed to participate. RESULTS Just over three quarters of the sample (n = 865; 76.27%) completed the full questionnaire. Self-directed learning readiness was indicated by an overall mean (standard deviation) score of 143.65 (11.76) points. Nursing undergraduates obtained the highest mean (SD) score - 145.08 (14.13) - in the overall scale. Associations were observed between degree course and self-directed learning readiness in the learning planning, desire for learning, self-confidence, self-management and self-evaluation subscales. Women scored better than men (p < 0.13) and scores progressively improved with each additional academic year. CONCLUSION The sampled students exhibited good self-directed learning readiness. Training students in self-directed learning skills is a necessary part of the teaching-learning process. This kind of training in universities needs to be reinforced to develop learning autonomy, promote lifelong learning and prepare competent future health professionals.
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Affiliation(s)
| | | | | | | | - Dalmau Vila-Vidal
- Faculty of Nursing, University of Girona, Emili Grahit, 77.17071 Girona, Spain.
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15
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Dudzik LR, Heard DG, Griffin RE, Vercellino M, Hunt A, Cates A, Rebholz M. Implementation of a Low-Dose, High-Frequency Cardiac Resuscitation Quality Improvement Program in a Community Hospital. Jt Comm J Qual Patient Saf 2019; 45:789-797. [PMID: 31630977 DOI: 10.1016/j.jcjq.2019.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 08/30/2019] [Accepted: 08/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND In 2015 the American Heart Association launched the Resuscitation Quality ImprovementⓇ (RQIⓇ) Program to address the urgent need to improve in-hospital cardiac arrest survival through a novel competency-based model for health care provider (HCP) cardiopulmonary resuscitation (CPR) training. This innovation differs from the traditional Basic Life Support (BLS) training model by providing self-directed, low-dose, high-frequency CPR skill activities with the objectives of skills mastery and retention. A program implementation study was conducted at the first hospital in the state of Illinois to adopt RQI in 2016. METHODS The study was designed to evaluate implementation of the RQI program, CPR performance during RQI simulation sessions, and participant impressions at a community hospital. Quantitative data were evaluated based on psychomotor compression and ventilation performance. Quantitative and qualitative data were evaluated based on a perceptual CPR confidence and program satisfaction survey. RESULTS Statistical analysis demonstrates significant improvement in HCPs' quarterly psychomotor CPR skill performance over a one-year period in first compression score, and first and highest ventilation score per quarterly session. The number of attempts to pass the ventilation skill session decreased between the first and fourth quarter. Survey results of HCPs' program perceptions 30 months post-RQI implementation indicate satisfaction with the RQI program and an increase in CPR skill confidence. CONCLUSION Findings demonstrate that the RQI program for ongoing verification of BLS skill and knowledge provides improvements in HCPs' CPR psychomotor competence and confidence/satisfaction using an efficient and sustainable method at a community hospital.
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Affiliation(s)
- Lorna Rozanski Dudzik
- College of Nursing and Health Sciences, Lewis University, Romeoville, Illinois; AHA Instructor and Get With The Guidelines(Ⓡ)-Resuscitation Data Abstractor, Edward Hospital, Naperville, Illinois.
| | | | | | - Mary Vercellino
- Clinical Education, Edward Hospital and Health Services, Naperville
| | - Amanda Hunt
- Simulation and Training, Edward-Elmhurst Health, Naperville
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16
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Zackoff MW, Real FJ, Cruse B, Davis D, Klein M. Medical Student Perspectives on the Use of Immersive Virtual Reality for Clinical Assessment Training. Acad Pediatr 2019; 19:849-851. [PMID: 31201953 DOI: 10.1016/j.acap.2019.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Matthew W Zackoff
- Division of Critical Care Medicine, Department of Pediatrics (MW Zackoff), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh; Department of Pediatrics (MW Zackoff, FJ Real, B Cruse, D Davis, and M Klein), University of Cincinnati College of Medicine, Cincinnati, Oh.
| | - Francis J Real
- Department of Pediatrics (MW Zackoff, FJ Real, B Cruse, D Davis, and M Klein), University of Cincinnati College of Medicine, Cincinnati, Oh; Division of General and Community Pediatrics, Department of Pediatrics (FJ Real and M Klein), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh
| | - Bradley Cruse
- Department of Pediatrics (MW Zackoff, FJ Real, B Cruse, D Davis, and M Klein), University of Cincinnati College of Medicine, Cincinnati, Oh; Center for Simulation Research (B Cruse and D Davis), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh
| | - David Davis
- Department of Pediatrics (MW Zackoff, FJ Real, B Cruse, D Davis, and M Klein), University of Cincinnati College of Medicine, Cincinnati, Oh; Center for Simulation Research (B Cruse and D Davis), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh
| | - Melissa Klein
- Department of Pediatrics (MW Zackoff, FJ Real, B Cruse, D Davis, and M Klein), University of Cincinnati College of Medicine, Cincinnati, Oh; Division of General and Community Pediatrics, Department of Pediatrics (FJ Real and M Klein), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh; Division of Hospital Medicine, Department of Pediatrics (M Klein), Cincinnati Children's Hospital Medical Center, Cincinnati, Oh
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Berger C, Brinkrolf P, Ertmer C, Becker J, Friederichs H, Wenk M, Van Aken H, Hahnenkamp K. Combination of problem-based learning with high-fidelity simulation in CPR training improves short and long-term CPR skills: a randomised single blinded trial. BMC MEDICAL EDUCATION 2019; 19:180. [PMID: 31151450 PMCID: PMC6544917 DOI: 10.1186/s12909-019-1626-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/22/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Performance of sufficient cardiopulmonary resuscitation (CPR) by medical personnel is critical to improve outcomes during cardiac arrest. It has however been shown that even health care professionals possess a lack of knowledge and skills in CPR performance. The optimal method for teaching CPR remains unclear, and data that compares traditional CPR instructional methods with newer modalities of CPR instruction are needed. We therefore conducted a single blinded, randomised study involving medical students in order to evaluate the short- and long-term effects of a classical CPR education compared with a bilateral approach to CPR training, consisting of problem-based learning (PBL) plus high fidelity simulation. METHODS One hundred twelve medical students were randomized during a curricular anaesthesiology course to a control (n = 54) and an intervention (n = 58) group. All participants were blinded to group assignment and partook in a 30-min-lecture on CPR basics. Subsequently, the control group participated in a 90-min tutor-guided CPR hands-on-training. The intervention group took part in a 45-min theoretical PBL module followed by 45 min of high fidelity simulated CPR training. The rate of participants recognizing clinical cardiac arrest followed by sufficiently performed CPR was the primary outcome parameter of this study. CPR performance was evaluated after the intervention. In addition, a follow-up evaluation was conducted after 6 months. RESULTS 51.9% of the intervention group met the criteria of sufficiently performed CPR as compared to only 12.5% in the control group on the day of the intervention (p = 0.007). Hands-off-time as a marker for CPR continuity was significantly less in the intervention group (24.0%) as compared to the control group (28.3%, p = 0.007, Hedges' g = 1.55). At the six-month follow-up, hands-off-time was still significantly lower in the intervention group (23.7% vs. control group: 31.0%, p = 0.006, Hedges' g = 1.88) but no significant difference in sufficiently performed CPR was detected (intervention group: 71.4% vs. control group: 54.5%, p = 0.55). CONCLUSION PBL combined with high fidelity simulation training leads to a measurable short-term increase in initiating sufficient CPR by medical students immediately after training as compared to classical education. At six month post instruction, these differences remained only partially.
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Affiliation(s)
- Christian Berger
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany
| | - Peter Brinkrolf
- Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Cristian Ertmer
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Jan Becker
- Institute for Education and Students Affairs-IFAS, Medical Faculty, University of Münster, Münster, Germany
| | - Hendrik Friederichs
- Institute for Education and Students Affairs-IFAS, Medical Faculty, University of Münster, Münster, Germany
| | - Manuel Wenk
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Hugo Van Aken
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Klaus Hahnenkamp
- Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
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de Sena DP, Fabrício DD, da Silva VD, Bodanese LC, Franco AR. Comparative evaluation of video-based on-line course versus serious game for training medical students in cardiopulmonary resuscitation: A randomised trial. PLoS One 2019; 14:e0214722. [PMID: 30958836 PMCID: PMC6453387 DOI: 10.1371/journal.pone.0214722] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/08/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose To estimate the effect size of a serious game for cardiopulmonary resuscitation (CPR) training in comparison with a video-based on-line course in terms of learning outcomes among medical students before simulation-based CPR using a manikin. Methods Participants were 45 first-year medical students randomly assigned to CPR self-training using either a video-based Apple Keynote presentation (n = 22) or a serious game developed in a 3D learning environment (n = 23) for up to 20 min. Each participant was evaluated on a written, multiple-choice test (theoretical test) and then on a scenario of cardiac arrest (practical test) before and after exposure to the self-learning methods. The primary endpoint was change in theoretical and practical baseline scores during simulated CPR. This study was conducted in 2017. Results Both groups improved scores after exposure. The video group had superior performance in both the theoretical test (7.56±0.21 vs 6.51±0.21 for the game group; p = 0.001) and the practical test (9.67±0.21 vs 8.40±0.21 for the game group; p < 0.001). However, students showed a preference for using games, as suggested by the longer time they remained interested in the method (18.57±0.66 min for the game group vs 7.41±0.43 for the video group; p < 0.001). Conclusions The self-training modality using a serious game, after a short period of exposure, resulted in inferior students’ performance in both theoretical and practical CPR tests compared to the video-based self-training modality. However, students showed a clear preference for using games rather than videos as a form of self-training.
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Affiliation(s)
- David P. de Sena
- School of Health Sciences, Post-Graduate Program in Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Daniela D. Fabrício
- Department of Otolaryngology, PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinícius D. da Silva
- Department of Pathological Anatomy, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | | | - Alexandre R. Franco
- Brain Institute of Rio Grande do Sul, PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
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Więch P, Sałacińska I, Muster M, Bazaliński D, Kucaba G, Fąfara A, Przybek-Mita J, Januszewicz P. Use of Selected Telemedicine Tools in Monitoring Quality of In-Hospital Cardiopulmonary Resuscitation: A Prospective Observational Pilot Simulation Study. Med Sci Monit 2019; 25:2520-2526. [PMID: 30952832 PMCID: PMC6463638 DOI: 10.12659/msm.913191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Paweł Więch
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Izabela Sałacińska
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Marek Muster
- Center for Innovative Research in Medical and Natural Sciences, University of Rzeszów, Rzeszów, Poland
| | - Dariusz Bazaliński
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Grzegorz Kucaba
- Institute of Midwifery and Medical Lifesaving, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Anna Fąfara
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | | | - Paweł Januszewicz
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
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García-Suárez M, Méndez-Martínez C, Martínez-Isasi S, Gómez-Salgado J, Fernández-García D. Basic Life Support Training Methods for Health Science Students: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050768. [PMID: 30832440 PMCID: PMC6427599 DOI: 10.3390/ijerph16050768] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/28/2019] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
| | | | - Santiago Martínez-Isasi
- Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Campus de Esteiro, 15403 Ferrol, Spain.
| | - Juan Gómez-Salgado
- Department of Nursing, University of Huelva, 21007 Huelva, Spain.
- Safety and Health Posgrade Program, Espíritu Santo University, Samborondón, 092301 Guayaquil, Ecuador.
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Training adult laypeople in basic life support. A systematic review. ACTA ACUST UNITED AC 2019; 73:53-68. [PMID: 30808611 DOI: 10.1016/j.rec.2018.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
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Affiliation(s)
- Violeta González-Salvado
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Emilio Rodríguez-Ruiz
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Cristian Abelairas-Gómez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alberto Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carlos Peña-Gil
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - José Ramón González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Lund-Kordahl I, Mathiassen M, Melau J, Olasveengen TM, Sunde K, Fredriksen K. Relationship between level of CPR training, self-reported skills, and actual manikin test performance-an observational study. Int J Emerg Med 2019; 12:2. [PMID: 31179947 PMCID: PMC6327595 DOI: 10.1186/s12245-018-0220-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 12/28/2018] [Indexed: 11/21/2022] Open
Abstract
Background Quality of bystander cardiopulmonary resuscitation (CPR) skills may influence out of hospital cardiac arrest (OHCA) outcomes. We analyzed how the level of CPR training related to indicators of good CPR quality and also the relationship between self-reported skills and actual CPR performance. Methods Two hundred thirty-seven persons trained in standardized BLS curricula were divided into three groups according to the level of training: group I (40 h basic first aid training), group II, and group III (96 h advanced first aid, group III had also some limited additional life support training courses). We recorded the participants’ real-life CPR experience and self-reported CPR skills, and then assessed selected CPR quality indicators on a manikin. The data were analyzed with multivariate logistic regression. Differences between groups were analyzed with ANOVA/MANOVA. Results Out of 237 participants, 125 had basic training (group I), 84 reported advanced training (group II), and 28 advanced training plus additional courses (group III). Group II and III had shorter start-up time, better compression depth and hand positioning, higher fraction of effective rescue ventilations, shorter hands-off time, and thus a higher chest compression fraction. Chest compression rate did not differ between groups. The participants in group I assessed their own skills and preparedness significantly lower than groups II and III both before and after the test. In addition, group III reported higher confidence in examining the critically ill patient and preparedness in doing CPR before the manikin test than both groups I and II. However, the observed differences between groups II and III in self-reported skills and preparedness were not statistically significant after the test. Conclusion As expected, higher levels of BLS training correlated with better CPR quality. However, this study showed that ventilations and hands-on time were the components of CPR that were most affected by the level of training. Self-assessments of CPR ability correlated well to actual test performance and may have a role in probing CPR skills in students. The results may be important for BLS instructors and program developers.
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Affiliation(s)
- Inger Lund-Kordahl
- Anaesthesia and Critical Care Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | - Maria Mathiassen
- Anaesthesia and Critical Care Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | - Jørgen Melau
- Division of Pre-hospital Services, Vestfold Hospital Trust, N 3103, Tønsberg, Norway
| | - Theresa Mariero Olasveengen
- Norwegian National Advisory Unit for Prehospital Emergency Care (NAKOS), Oslo University Hospital, Oslo, Norway.,Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Fredriksen
- Anaesthesia and Critical Care Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. .,Division of Emergency Medical Services, University Hospital of North Norway, N-9038, Tromsø, Norway.
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Lau Y, Nyoe RSS, Wong SN, Ab Hamid ZB, Leong BSH, Lau ST. Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials. Resuscitation 2018; 131:14-23. [PMID: 30071263 DOI: 10.1016/j.resuscitation.2018.07.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/11/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Abstract
AIM This review aims to evaluate the effectiveness of digital resuscitation training in improving knowledge and skill compared with standard resuscitation training. METHODS We searched through the CINAHL, Cochrane Library, EMBASE, ERIC, ProQuest Dissertations and Thesis, PsycINFO, PubMed and Scopus from inception of our review until 5 March 2018. The quality of individual and overall evidence was evaluated according to the risk of bias, Medical Education Research Study Quality Instrument (MERSQI) and Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system, respectively. Meta-analyses were performed with the Review Manger software. Z-statistics were used to evaluate the overall effect of training, and I2 test was used to assess heterogeneity. Sensitivity and subgroup analyses were used for additional meta-analyses. RESULTS Amongst the 15,528 studies retrieved, 20 randomised controlled trials (RCTs) were selected from 13 countries across different ethnicities. More than half (52%) of the trials had a low risk of bias, and MERSQI scores ranged from 13.5 to 15.5. The overall quality of evidence was very low according to GRADE criteria. Meta-analyses revealed that trainees in digital resuscitation training had better knowledge scores but poorer chest compression rates than that of trainees in standard resuscitation training. Digital resuscitation trainings were non-inferior to standard resuscitation trainings in skill performance scores. Subgroup analyses suggested that digital resuscitation training might consider using blended learning approach with virtual patient, computer-screen based, learning theories and video-recorded assessment, especially for basic life support trainings amongst health professionals. CONCLUSION Despite the wide variation in digital resuscitation trainings, evidence suggesting the use of digital resuscitation training for improving knowledge and skills is inadequate. Well-designed non-inferiority RCTs in multiple settings with follow-up data and large sample size are needed to ensure the robustness of the evidence.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Suei Nee Wong
- Medical Resource Team, National University of Singapore Libraries, National University of Singapore, Singapore.
| | | | | | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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McGrath JL, Taekman JM, Dev P, Danforth DR, Mohan D, Kman N, Crichlow A, Bond WF. Using Virtual Reality Simulation Environments to Assess Competence for Emergency Medicine Learners. Acad Emerg Med 2018; 25:186-195. [PMID: 28888070 DOI: 10.1111/acem.13308] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 01/13/2023]
Abstract
Immersive learning environments that use virtual simulation (VS) technology are increasingly relevant as medical learners train in an environment of restricted clinical training hours and a heightened focus on patient safety. We conducted a consensus process with a breakout group of the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change Through Health Care Simulation: Systems, Competency, and Outcomes." This group examined the current uses of VS in training and assessment, including limitations and challenges in implementing VS into medical education curricula. We discuss the role of virtual environments in formative and summative assessment. Finally, we offer recommended areas of focus for future research examining VS technology for assessment, including high-stakes assessment in medical education. Specifically, we discuss needs for determination of areas of focus for VS training and assessment, development and exploration of virtual platforms, automated feedback within such platforms, and evaluation of effectiveness and validity of VS education.
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Affiliation(s)
- Jillian L. McGrath
- Department of Emergency Medicine; The Ohio State University Wexner Medical Center; Columbus OH
| | | | - Parvati Dev
- Stanford University School of Medicine; Los Altos CA
| | - Douglas R. Danforth
- Department of Obstetrics and Gynecology; The Ohio State University Wexner Medical Center; Columbus OH
| | - Deepika Mohan
- Department of Surgery; University of Pittsburgh Medical Center; Pittsburgh PA
| | - Nicholas Kman
- Department of Emergency Medicine; The Ohio State University Wexner Medical Center; Columbus OH
| | - Amanda Crichlow
- Department of Emergency Medicine; Drexel University College of Medicine; Philadelphia PA
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Tobase L, Peres HH, Gianotto-Oliveira R, Smith N, Polastri TF, Timerman S. The effects of an online basic life support course on undergraduate nursing students' learning. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:309-313. [PMID: 28850944 PMCID: PMC5699862 DOI: 10.5116/ijme.5985.cbce] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe learning outcomes of undergraduate nursing students following an online basic life support course (BLS). METHODS An online BLS course was developed and administered to 94 nursing students. Pre- and post-tests were used to assess theoretical learning. Checklist simulations and feedback devices were used to assess the cardiopulmonary resuscitation (CPR) skills of the 62 students who completed the course. RESULTS A paired t-test revealed a significant increase in learning [pre-test (6.4 ± 1.61), post-test (9.3 ± 0.82), p < 0.001]. The increase in the average grade after taking the online course was significant (p<0.001). No learning differences (p=0.475) had been observed between 1st and 2nd year (9.20 ± 1.60), and between 3rd and 4th year (9.67 ± 0.61) students. A CPR simulation was performed after completing the course: students checked for a response (90%), exposed the chest (98%), checked for breathing (97%), called emergency services (76%), requested for a defibrillator (92%), checked for a pulse (77%), positioned their hands properly (87%), performed 30 compressions/cycle (95%), performed compressions of at least 5 cm depth (89%), released the chest (90%), applied two breaths (97%), used the automated external defibrillator (97%), and positioned the pads (100%). CONCLUSIONS The online course was an effective method for teaching and learning key BLS skills wherein students were able to accurately apply BLS procedures during the CPR simulation. This short-term online training, which likely improves learning and self-efficacy in BLS providers, can be used for the continuing education of health professionals.
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Affiliation(s)
- Lucia Tobase
- Personnel Management, Mobile Emergency Care Service, Sao Paulo, Brazil
| | - Heloisa H.C. Peres
- Department of Professional Counseling, School of Nursing, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Nicole Smith
- Heart Sarver Center, University of Arizona College of Medicine, Tucson, USA
| | - Thatiane F. Polastri
- Laboratory of Cardiovascular Emergencies Training, Heart Institute (InCor), Clinicals Hospital of the Sao Paulo University, Sao Paulo, Brazil
| | - Sergio Timerman
- Laboratory of Cardiovascular Emergencies Training, Heart Institute (InCor), Clinicals Hospital of the Sao Paulo University, Sao Paulo, Brazil
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Hsieh MJ, Bhanji F, Chiang WC, Yang CW, Chien KL, Ma MHM. Comparing the effect of self-instruction with that of traditional instruction in basic life support courses—A systematic review. Resuscitation 2016; 108:8-19. [DOI: 10.1016/j.resuscitation.2016.08.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 08/17/2016] [Accepted: 08/20/2016] [Indexed: 10/21/2022]
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Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, Sinz EH, Cheng A. Part 14: Education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2016; 132:S561-73. [PMID: 26473002 DOI: 10.1161/cir.0000000000000268] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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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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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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Mardegan KJ, Schofield MJ, Murphy GC. Comparison of an interactive CD-based and traditional instructor-led Basic Life Support skills training for nurses. Aust Crit Care 2015; 28:160-7. [DOI: 10.1016/j.aucc.2014.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 04/10/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022] Open
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McGrath D, Crowley L, Rao S, Toomey M, Hannigan A, Murphy L, Dunne CP. Outcomes of Irish graduate entry medical student engagement with self-directed learning of clinical skills. BMC MEDICAL EDUCATION 2015; 15:21. [PMID: 25890332 PMCID: PMC4336507 DOI: 10.1186/s12909-015-0301-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 02/04/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Existing literature is mixed as to whether self-directed learning (SDL) delivers improvements in knowledge, skills or attitudes of medical students compared with traditional learning methods. This study aimed to determine whether there is an association between engagement in SDL and student performance in clinical examinations, the factors that influence student engagement with SDL in clinical skills, and student perceptions of SDL. METHODS A retrospective analysis of electronic records of student bookings of SDL sessions from 2008 to 2010 was performed for students in the pre-clinical years of an Irish Graduate Entry Medical programme to assess their level of engagement with SDL. The extent to which this engagement influenced their performance in subsequent summative examinations was evaluated. A cross-sectional survey of students across the four years of the programme was also conducted to determine student perceptions of SDL and the factors that affect engagement. RESULTS The level of engagement with SDL decreased over time from 95% of first years in 2008 to 49% of first years in 2010. There was no significant difference between the median exam performance for any clinical skills tested by level of engagement (none, one or more sessions) except for basic life support in first year (p =0.024). The main reason for engaging with SDL was to practice a clinical skill prior to assessment and the majority of respondents agreed that SDL sessions had improved their performance of the specific clinical skills being practised. CONCLUSION Students viewed SDL as an opportunity to practise skills prior to assessment but there were no significant differences in subsequent summative assessment by the level of engagement for most clinical skills.
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Affiliation(s)
- Deirdre McGrath
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Louise Crowley
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Sanath Rao
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Margaret Toomey
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Ailish Hannigan
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Lisa Murphy
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
| | - Colum P Dunne
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
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Rasmussen K, Belisario JM, Wark PA, Molina JA, Loong SL, Cotic Z, Papachristou N, Riboli-Sasco E, Tudor Car L, Musulanov EM, Kunz H, Zhang Y, George PP, Heng BH, Wheeler EL, Al Shorbaji N, Svab I, Atun R, Majeed A, Car J. Offline eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction. J Glob Health 2014; 4:010405. [PMID: 24976964 PMCID: PMC4073241 DOI: 10.7189/jogh.04.010405] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The world is short of 7.2 million health-care workers and this figure is growing. The shortage of teachers is even greater, which limits traditional education modes. eLearning may help overcome this training need. Offline eLearning is useful in remote and resource-limited settings with poor internet access. To inform investments in offline eLearning, we need to establish its effectiveness in terms of gaining knowledge and skills, students' satisfaction and attitudes towards eLearning. METHODS We conducted a systematic review of offline eLearning for students enrolled in undergraduate, health-related university degrees. We included randomised controlled trials that compared offline eLearning to traditional learning or an alternative eLearning method. We searched the major bibliographic databases in August 2013 to identify articles that focused primarily on students' knowledge, skills, satisfaction and attitudes toward eLearning, and health economic information and adverse effects as secondary outcomes. We also searched reference lists of relevant studies. Two reviewers independently extracted data from the included studies. We synthesized the findings using a thematic summary approach. FINDINGS Forty-nine studies, including 4955 students enrolled in undergraduate medical, dentistry, nursing, psychology, or physical therapy studies, met the inclusion criteria. Eleven of the 33 studies testing knowledge gains found significantly higher gains in the eLearning intervention groups compared to traditional learning, whereas 21 did not detect significant differences or found mixed results. One study did not test for differences. Eight studies detected significantly higher skill gains in the eLearning intervention groups, whilst the other 5 testing skill gains did not detect differences between groups. No study found offline eLearning as inferior. Generally no differences in attitudes or preference of eLearning over traditional learning were observed. No clear trends were found in the comparison of different modes of eLearning. Most of the studies were small and subject to several biases. CONCLUSIONS Our results suggest that offline eLearning is equivalent and possibly superior to traditional learning regarding knowledge, skills, attitudes and satisfaction. Although a robust conclusion cannot be drawn due to variable quality of the evidence, these results justify further investment into offline eLearning to address the global health care workforce shortage.
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Affiliation(s)
- Kristine Rasmussen
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | | | - Petra A Wark
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | | | - Stewart Lee Loong
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Ziva Cotic
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Nikos Papachristou
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Eva Riboli-Sasco
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Lorainne Tudor Car
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Eve Marie Musulanov
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Holger Kunz
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Chaoyang District Beijing, 100020, P.R. China
| | | | | | | | - Najeeb Al Shorbaji
- Knowledge, Ethics and Research, World Health Organization, Geneva, Switzerland
| | - Igor Svab
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Rifat Atun
- Department of Global Health and Population, Harvard School of Public Health, Harvard, MA, USA
| | - Azeem Majeed
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK
| | - Josip Car
- Global eHealth Unit, School of Public Health, Imperial College London, London, UK ; Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore
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Mohd Saiboon I, Jaafar MJ, Ahmad NS, Nasarudin NMA, Mohamad N, Ahmad MR, Gilbert JHV. Emergency skills learning on video (ESLOV): A single-blinded randomized control trial of teaching common emergency skills using self-instruction video (SIV) versus traditional face-to-face (FTF) methods. MEDICAL TEACHER 2014; 36:245-50. [PMID: 24295218 DOI: 10.3109/0142159x.2013.857013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Self-instruction video (SIV) has been widely explored as a teaching mode for cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED), but not with other basic emergency skills. AIM To evaluate the effectiveness of SIV in teaching other basic emergency skill in comparison with traditional face-to-face (FTF) methods. METHODS Participants were randomized into SIV and FTF groups. Each group was assigned to learn basic airway management (BAM), cervical collar application (CCA), manual cardiac defibrillation (MCD), and emergency extremity splinting (EES) skills. Confidence level was assessed using questionnaires, and skills performances were assessed using calibrated-blinded assessors through an Objective Structured Clinical Examination (OSCE). RESULTS Forty-five participants took part in the assessment exercises. There were no significant differences between both groups, on all four skill categories. The mean OSCE-score of an individual category between the FTF-group vs. the SIV-group were as follows: BAM (10.23 ± 1.04 vs. 10.04 ± 1.49; p = 0.62); CCA (7.86 ± 4.39 vs. 7.13 ± 4.12; p = 0.57); MCD (8.24 ± 0.89 vs. 7.58 ± 1.14; p = 0.39); EES (5.43 ± 2.11 vs. 4.63 ± 2.30; p = 0.23). The composite mean score for the FTF-group was 6.85, and for the SIV-group was 6.20 (p < 0.05). There was no significant different in the level of confidence for both groups. CONCLUSION SIV is as effective as FTF in teaching and learning basic emergency skills.
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Roh YS, Kim SS. The Effect of Computer-Based Resuscitation Simulation on Nursing Students’ Performance, Self-Efficacy, Post-Code Stress, and Satisfaction. Res Theory Nurs Pract 2014; 28:127-39. [DOI: 10.1891/1541-6577.28.2.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Computer-based simulation has intuitive appeal to both educators and learners with the flexibility of time, place, immediate feedback, and self-paced and consistent curriculum. The purpose of this study was to assess the effects of computer-based simulation on nursing students’ performance, self-efficacy, post-code stress, and satisfaction between computer-based simulation plus instructor-led cardiopulmonary resuscitation training group and instructor-led resuscitation training-only group. This study was a nonequivalent control group posttest-only design. There were 213 second year nursing students randomly assigned to one of two groups: 109 nursing students with computer-based simulation or 104 with control group. Overall nursing students’ performance score was higher in the computer-based simulation group than in the control group but reached no statistical significance (t = 1.086, p = .283). There were no significant differences in resuscitation-specific self-efficacy, post-code stress, and satisfaction between the two groups. Computer-based simulation combined with hands-on practice did not affect in nursing students’ performance, self-efficacy, post-code stress, and satisfaction in nursing students. Further study must be conducted to inform instructional design and help integrate computer-based simulation and rigorous scoring rubrics.
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Fisher J, Lin M, Coates WC, Kuhn GJ, Farrell SE, Maggio LA, Shayne P. Critical appraisal of emergency medicine educational research: the best publications of 2011. Acad Emerg Med 2013; 20:200-8. [PMID: 23406080 DOI: 10.1111/acem.12070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 08/21/2012] [Accepted: 08/30/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research studies published in 2011 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2011 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008, 2009, and 2010. RESULTS Forty-eight educational research papers were identified. Comparing the literature of 2011 to that of 2008 through 2010, the number of published educational research papers meeting the criteria increased over time from 30, to 36, to 41, and now to 48. Five medical education research studies met the a priori criteria for inclusion as exemplary and are reviewed and summarized in this article. The number of funded studies remained fairly stable over the past 3 years, at 13 (2008), 16 (2009), 9 (2010), and 13 (2011). As in past years, research involving the use of technology accounted for almost half (n = 22) of the publications. Observational study designs accounted for 28 of the papers, while nine studies featured an experimental design. CONCLUSIONS Forty-eight EM educational studies published in 2011 and meeting the criteria were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2011 papers are noted.
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Affiliation(s)
- Jonathan Fisher
- Department of Emergency Medicine; Beth Israel Deaconess Medical Center; Boston; MA
| | - Michelle Lin
- The Department of Emergency Medicine; University of California at San Francisco; San Francisco; CA
| | - Wendy C. Coates
- The Department of Emergency Medicine; Harbor-UCLA Medical Center; University of California, Los Angeles-David Geffen School of Medicine, and Los Angeles Biomedical Research Institute at Harbor-UCLA; Los Angeles; CA
| | - Gloria J. Kuhn
- The Department of Emergency Medicine; Wayne State University; Farming Hills; MI
| | - Susan E. Farrell
- The Office of Graduate Medical Education; Partners Healthcare System; Center for Teaching and Learning; Harvard Medical School; and Department of Emergency Medicine; Brigham and Women's Hospital; Boston; MA
| | - Lauren A. Maggio
- The Lane Medical Library; Stanford University School of Medicine; Stanford; CA
| | - Philip Shayne
- and The Department of Emergency Medicine; Emory University School of Medicine; Atlanta; GA
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Sopka S, Biermann H, Rossaint R, Knott S, Skorning M, Brokmann JC, Heussen N, Beckers SK. Evaluation of a newly developed media-supported 4-step approach for basic life support training. Scand J Trauma Resusc Emerg Med 2012; 20:37. [PMID: 22647148 PMCID: PMC3461483 DOI: 10.1186/1757-7241-20-37] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 05/30/2012] [Indexed: 01/25/2023] Open
Abstract
Objective The quality of external chest compressions (ECC) is of primary importance within basic life support (BLS). Recent guidelines delineate the so-called 4“-step approach” for teaching practical skills within resuscitation training guided by a certified instructor. The objective of this study was to evaluate whether a “media-supported 4-step approach” for BLS training leads to equal practical performance compared to the standard 4-step approach. Materials and methods After baseline testing, 220 laypersons were either trained using the widely accepted method for resuscitation training (4-step approach) or using a newly created “media-supported 4-step approach”, both of equal duration. In this approach, steps 1 and 2 were ensured via a standardised self-produced podcast, which included all of the information regarding the BLS algorithm and resuscitation skills. Participants were tested on manikins in the same mock cardiac arrest single-rescuer scenario prior to intervention, after one week and after six months with respect to ECC-performance, and participants were surveyed about the approach. Results Participants (age 23 ± 11, 69% female) reached comparable practical ECC performances in both groups, with no statistical difference. Even after six months, there was no difference detected in the quality of the initial assessment algorithm or delay concerning initiation of CPR. Overall, at least 99% of the intervention group (n = 99; mean 1.5 ± 0.8; 6-point Likert scale: 1 = completely agree, 6 = completely disagree) agreed that the video provided an adequate introduction to BLS skills. Conclusions The “media-supported 4-step approach” leads to comparable practical ECC-performance compared to standard teaching, even with respect to retention of skills. Therefore, this approach could be useful in special educational settings where, for example, instructors’ resources are sparse or large-group sessions have to be prepared.
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Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial*. Crit Care Med 2012; 40:787-92. [PMID: 22080629 DOI: 10.1097/ccm.0b013e318236f2ca] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths). DESIGN Prospective, multicenter randomized study. SETTING Three academic medical center inpatient wards. SUBJECTS Adult family members or friends (≥ 18 yrs old) of inpatients admitted with cardiac-related diagnoses. INTERVENTIONS In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes. MEASUREMENTS Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments. MAIN RESULTS Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or "secondary training." Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves "very comfortable" with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08). CONCLUSIONS Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov. Unique identifier: NCT01260441.
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Shayne P, Coates WC, Farrell SE, Kuhn GJ, Lin M, Maggio LA, Fisher J. Critical appraisal of emergency medicine educational research: the best publications of 2010. Acad Emerg Med 2011; 18:1081-9. [PMID: 21996074 DOI: 10.1111/j.1553-2712.2011.01191.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research studies published in 2010 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2010 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified 41 EM studies that used hypothesis-testing or observational investigations of educational interventions. Five reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008 and 2009. RESULTS Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Comparing the literature of 2010 to 2008 and 2009, the number of published educational research papers increased from 30 to 36 and then to 41. The number of funded studies remained fairly stable over the past 3 years at 13 (2008), 16 (2009), and 9 (2010). As in past years, research involving the use of technology accounted for a significant number of publications (34%), including three of the five highlighted studies. CONCLUSIONS Forty-one EM educational studies published in 2010 were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2010 papers are noted.
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Affiliation(s)
- Philip Shayne
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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