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Breckwoldt J, Cheng A, Lauridsen KG, Lockey A, Yeung J, Greif R. Stepwise approach to skills teaching in resuscitation: A systematic review. Resusc Plus 2023; 16:100457. [PMID: 37674547 PMCID: PMC10477803 DOI: 10.1016/j.resplu.2023.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Aim To compare the effectiveness of Peyton's four-step approach for teaching resuscitation skills with alternative approaches. Methods For this systematic review, we followed the PICOST format (population, intervention, comparison, outcome, study design, timeframe) using Peyton's four-step approach as the standard. We included all studies analyzing skills training related to resuscitation and First Aid in any educational setting. Eligible were randomized controlled trials (RCTs) and non-randomized studies (non-randomized controlled trials, interrupted time series, controlled before-and-after studies, cohort studies, published conference abstracts, and case series where n ≥ 5). We excluded unpublished results (e.g. trial protocols), commentaries, editorials, reviews. Medline, Embase, PsycINFO, ERIC, CINAHL, and Cochrane were searched from inception until November 10, 2020 (updated November 25, 2022) for publications in all languages as long as there was an English abstract. Titles and abstracts of the papers retrieved were screened, and eligible publications were analysed in full text. From the final set of papers, data were extracted into a spreadsheet, subsequently risk of bias assessment was performed (using RoB2 and ROBINS-I), and the certainty of evidence (using GRADE) for each paper was assessed. Screening of studies, data extraction, risk-of-bias assessment, and assessment of certainty of evidence were all performed by two independent researchers. This review was conducted in adherence with PRISMA standards and was registered with PROSPERO (CRD42023377398). Results Overall, the search identified 2,574 studies from which 17 were included in the final analysis (14 RCTs, and 3 non-RCTs). The studies involved a total of 2,906 participants from various populations (from lay persons to health care professionals) and analysed nine different resuscitation skills being taught (ranging from chest compressions to needle cricotomy). The alternative teaching approaches ranged from two-steps to five-steps with various modifications of single steps. High methodological and clinical heterogeneity precluded a meta-analysis from being conducted. The risk of bias assessment showed considerable variation between the studies ranging from 'low' to 'serious'. Across all studies, certainty of evidence was rated as very low due to imprecision and inconsistency. Overall, 14 out of 17 studies showed no difference in skill acquisition or retention when comparing Peyton's four steps to other stepwise approaches. Conclusions Very low certainty evidence suggest that Peyton's four-step approach was not more effective in resuscitation skills training compared to alternative approaches. Funding None.
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Affiliation(s)
- Jan Breckwoldt
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
| | - Adam Cheng
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
| | - Kasper G. Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
| | - Andrew Lockey
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Education Implementation Team Task Force of the International Liaison Committee on Resuscitation ILCOR1
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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2
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Feng Q, Luo H, Li W, Chen T, Song N. Effects of gender diversity on college students' collaborative learning: From individual gender to gender pairing. Heliyon 2023; 9:e16237. [PMID: 37265618 PMCID: PMC10230217 DOI: 10.1016/j.heliyon.2023.e16237] [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: 11/21/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/03/2023] Open
Abstract
This study investigated the effects of gender and gender pairing on behaviors and social interaction during collaborative learning in a blended learning environment. Three types of pairing (all-female, all-male, and mixed) were considered in an empirical study with 44 undergraduate students. The results revealed that, first, female students were more likely to perform well in listening, talking, and integrating during class, and in the quality of posts after class, whereas male students tended to engage more in irrelevant behavior in collaboration. Second, same-gender groups were more active in collaborative discussion, but all-male groups performed worst in quality of posts after class. Third, both male and female students were more active in same-gender groups than in mixed groups. Finally, same-gender groups tended to have greater interpersonal connectedness than mixed-gender groups. The paper ends with a list of practical implications for facilitating effective collaborative learning in co-educational college classrooms.
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Affiliation(s)
| | - Heng Luo
- Corresponding author. 152 Luoyu Street, Central China Normal University, Wuhan, 430079, China.
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3
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Schauwinhold MT, Schmidt M, Rudolph JW, Klasen M, Lambert SI, Krusch A, Vogt L, Sopka S. Innovative Tele-Instruction Approach Impacts Basic Life Support Performance: A Non-inferiority Trial. Front Med (Lausanne) 2022; 9:825823. [PMID: 35646961 PMCID: PMC9134732 DOI: 10.3389/fmed.2022.825823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Sustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk. Methods In a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard Instructor Feedback (SIF) BLS training (Historical control group of 2019) with arm (2) a Tele-Instructor Supported Peer-Feedback (TPF) BLS training (Intervention group of 2020). Both study arms were based on Peyton's 4-step approach. Before and after each training session, objective data for BLS performance (compression depth and rate) were recorded using a resuscitation manikin. We also assessed overall BLS performance via standardized instructor evaluation and student self-reports of confidence via questionnaire. Non-inferiority margins for the outcome parameters and sample size calculation were based on previous studies with SIF. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority. Results The results confirmed non-inferiority of TPF to SIF for all tested outcome parameters. A follow-up after 2 weeks found no confirmed COVID-19 infections among the participants. Conclusion Tele-instructor supported peer feedback is a powerful alternative to in-person instructor feedback on BLS skills during a pandemic, where infection risk needs to be minimized while maximizing the quality of BLS skill learning. Trial registration https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025199, Trial ID: DRKS00025199.
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Affiliation(s)
- Michael Tobias Schauwinhold
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Michelle Schmidt
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, MA, United States.,Department of Anaesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Martin Klasen
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Sophie Isabelle Lambert
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Alexander Krusch
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Lina Vogt
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Saša Sopka
- AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Sopka S, Hahn F, Vogt L, Pears KH, Rossaint R, Rudolph J, Klasen M. Peer video feedback builds basic life support skills: A randomized controlled non-inferiority trial. PLoS One 2021; 16:e0254923. [PMID: 34293034 PMCID: PMC8297748 DOI: 10.1371/journal.pone.0254923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/06/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction Training Basic Life Support saves lives. However, current BLS training approaches are time-consuming and costly. Alternative cost-efficient and effective training methods are highly needed. The present study evaluated whether a video-feedback supported peer-guided Basic Life Support training approach achieves similar practical performance as a standard instructor-guided training in laypersons. Methods In a randomized controlled non-inferiority trial, 288 first-year medical students were randomized to two study arms with different Basic Life Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer Video Feedback (PVF). Outcome parameters were objective data for Basic Life Support performance (compression depth and rate) from a resuscitation manikin with recording software as well as overall Basic Life Support performance and subjective confidence. Non-inferiority margins (Δ) for these outcome parameters and sample size calculation were based on previous studies with Standard Instructor Feedback. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority. Results Results confirmed non-inferiority of Peer Video Feedback to Standard Instructor Feedback for compression depth (proportion difference PVF–SIF = 2.9%; 95% CI: -8.2% to 14.1%; Δ = -19%), overall Basic Life Support performance (proportion difference PVF–SIF = 6.7%; 95% CI: 0.0% to 14.3%; Δ = -27%) and subjective confidence for CPR performance (proportion difference PVF–SIF = -0.01; 95% CI: -0.18–0.17; Δ = -0.5) and emergency situations (proportion difference PVF–SIF = -0.02; 95% CI: -0.21–0.18; Δ = -0.5). Results for compression rate were inconclusive. Discussion Peer Video Feedback achieves comparable results as standard instructor-based training methods. It is an easy-to-apply and cost-efficient alternative to standard Basic Life Support training methods. To improve performance with respect to compression rate, additional implementation of a metronome is recommended.
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Affiliation(s)
- Saša Sopka
- Medical Faculty, AIXTRA–Competency Center for Training and Patient Safety, RWTH Aachen University, Aachen, Germany
- Medical Faculty, Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
- * E-mail:
| | - Fabian Hahn
- Medical Faculty, AIXTRA–Competency Center for Training and Patient Safety, RWTH Aachen University, Aachen, Germany
| | - Lina Vogt
- Medical Faculty, AIXTRA–Competency Center for Training and Patient Safety, RWTH Aachen University, Aachen, Germany
- Medical Faculty, Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Kim Hannah Pears
- Medical Faculty, AIXTRA–Competency Center for Training and Patient Safety, RWTH Aachen University, Aachen, Germany
| | - Rolf Rossaint
- Medical Faculty, Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jenny Rudolph
- Center for Medical Simulation, Boston, MA, United States of America
| | - Martin Klasen
- Medical Faculty, AIXTRA–Competency Center for Training and Patient Safety, RWTH Aachen University, Aachen, Germany
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Abstract
Worldwide, organizations and small and medium-sized enterprises have already disruptively changed in many ways their physiological inner mechanisms, because of information and communication technologies (ICT) revolution. Nevertheless, the still ongoing COVID-19 worldwide emergency definitely promoted a wide adoption of teleworking modalities for many people around the world, making it more relevant than before to understand the real impact of virtual environments (VEs) on teamwork dynamics. From a psychological point of view, a critical question about teleworking modalities is how the social and cognitive dynamics of collaborative facilitation and collaborative inhibition would affect teamwork within VEs. This study analyzed the impact of a virtual environment (VE) on the recall of individuals and members of nominal and collaborative groups. The research assessed costs and benefits for collaborative retrieval by testing the effect of experimental conditions, stimulus materials, group size, experimental conditions order, anxiety state, personality traits, gender group composition and social interactions. A total of 144 participants were engaged in a virtual Deese-Roediger-McDermott (DRM) classical paradigm, which involved remembering word lists across two successive sessions, in one of four protocols: I-individual/nominal, I I -nominal/individual, I I I -nominal/collaborative, I V -collaborative/nominal. Results suggested, in general, a reduced collaborative inhibition effect in the collaborative condition than the nominal and individual condition. A combined effect between experimental condition and difficulty of the task appears to explain the presence of collaborative inhibition or facilitation. Nominal groups appeared to enhance the collaborative groups’ performance when virtual nominal groups come before collaborative groups. Variables such as personality traits, gender and social interactions may have a contribution to collaborative retrieval. In conclusion, this study indicated how VEs could maintain those peculiar social dynamics characterizing the participants’ engagement in a task, both working together and individually, and could affect their intrinsic motivation as well as performances. These results could be exploited in order to design brand new and evidenced-based practices, to improve teleworking procedures and workers well-being, as well as teleworking teamwork effectiveness.
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Süss-Havemann C, Kosan J, Seibold T, Dibbern NM, Daubmann A, Kubitz JC, Beck S. Implementation of Basic Life Support training in schools: a randomised controlled trial evaluating self-regulated learning as alternative training concept. BMC Public Health 2020; 20:50. [PMID: 31931770 PMCID: PMC6958621 DOI: 10.1186/s12889-020-8161-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 01/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background The Kids save lives statement recommends annual Basic Life Support (BLS) training for school children but the implementation is challenging. Trainings should be easy to realise and every BLS training should be as effective as possible to prepare learners for lifesaving actions. Preparedness implies skills and positive beliefs in the own capability (high self-efficacy). Methods This randomized controlled cluster study investigates, if self-regulated learning promotes self-efficacy and long-term retention of practical BLS skills. Students in the age of 12 years participated in a practical training in BLS and a scenario testing of skills. In the control group the practical training was instructor-led. In the intervention group the students self-regulated their learning processes and feedback was provided by the peer-group. The primary outcome self-efficacy for helping in cardiac arrest after the training and 9 months later was analysed using a multilevel mixed model. Means and pass-rates for BLS skills were secondary outcomes. Results Contrary to the assumptions, this study could not measure a higher self-efficacy for helping in cardiac arrest of the students participating in the intervention (n = 307 students) compared to the control group (n = 293 students) after training and at the follow-up (mean difference: 0.11 points, 95% CI: − 0.26 to 0.04, P = 0.135). The odds to pass all items of the BLS exam was not significantly different between the groups (OR 1.11, 95% CI: 0.81 to 1.52, p = 0.533). Self-regulated learning was associated with a higher performance of male students in the BLS exam (mean score: 7.35) compared to females of the intervention (female: 7.05) and compared to males of the control (7.06). Conclusion This study could not resolve the question, if self-regulated learning in peer-groups improves self-efficacy for helping in cardiac arrest. Self-regulated learning is an effective alternative to instructor-led training in BLS skills training and may be feasible to realise for lay-persons. For male students self-regulated learning seems to be beneficial to support long-term retention of skills. Trial registration ISRCTN17334920, retrospectively registered 07.03.2019.
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Affiliation(s)
- Christoph Süss-Havemann
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany
| | - Janina Kosan
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany
| | - Thomas Seibold
- Department of Anaesthesiology, Intensiv Care and Pain Management, Kath. Marienkrankenhaus, Alfredstraße 9, 22087, Hamburg, Germany
| | - Nils Martin Dibbern
- Specialist Center for Anaesthesia and Pain Medicine, Schoen Clinic Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Germany
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany
| | - Jens Christian Kubitz
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany
| | - Stefanie Beck
- Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany.
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van Dawen J, Vogt L, Schröder H, Rossaint R, Henze L, Beckers SK, Sopka S. The role of a checklist for assessing the quality of basic life support performance: an observational cohort study. Scand J Trauma Resusc Emerg Med 2018; 26:96. [PMID: 30445986 PMCID: PMC6240285 DOI: 10.1186/s13049-018-0564-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Training lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. This study evaluated whether a simple observational checklist can be used by BLS instructors to adequately measure the quality of BLS performance as an alternative to other feedback devices. METHODS The BLS performances of 152 first-year medical students (aged 21.4 ± 3.9 years) were recorded on video, and objective data regarding the quality of the BLS were documented using Laerdal PC SkillReporting software. The performances were categorized according to quality. Ten BLS instructors observed the videos and completed a ten-point checklist based on the Cardiff Test of BLS (version 3.1) to assess the performances. The validity of the checklist was reviewed using interrater reliability as well as by comparing the checklist-based results with objective performance data. RESULTS Matching the checklist-based evaluation with the objective performance data revealed high levels of agreement for very good (82%) and overall insufficient (75%) performances. Regarding the checklist-based evaluation, interrater reliability depended on the checklist item; thus, some items were more easily identified correctly than others. The highest and lowest levels of agreement were observed for the items "undressed torso" and "complete release between compressions" (mean joint-probability 95 and 67%, respectively). CONCLUSIONS The observational checklist adequately distinguished sufficient from insufficient BLS performances and offered an assessment of items not incorporated by SkillReporting software such as the initial assessment or undressing the chest. Although its usefulness was reduced for scaling intermediate performance groups, the checklist may be overall a useful rating tool in BLS-training if objective feedback devices are not available, for example, due to large groups of participants or limited training time.
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Affiliation(s)
- Johanna van Dawen
- Department of Orthopaedics and Trauma Surgery, Düren Hospital, Roonstraße 30, 52351 Düren, Germany
| | - Lina Vogt
- Department of Anaesthesiology, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
- Interdisciplinary Training Centre for Medical Education and Patient Safety – AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Hanna Schröder
- Department of Anaesthesiology, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
- Interdisciplinary Training Centre for Medical Education and Patient Safety – AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Lina Henze
- Interdisciplinary Training Centre for Medical Education and Patient Safety – AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Stefan K. Beckers
- Department of Anaesthesiology, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
- Emergency Medical Service, Fire Department Aachen, Stolberger Str. 155, 52060 Aachen, Germany
| | - Saša Sopka
- Department of Anaesthesiology, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
- Interdisciplinary Training Centre for Medical Education and Patient Safety – AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
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Rajeswaran L, Cox M, Moeng S, Tsima BM. Assessment of nurses' cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana. Afr J Prim Health Care Fam Med 2018; 10:e1-e6. [PMID: 29781687 PMCID: PMC5913783 DOI: 10.4102/phcfm.v10i1.1633] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/02/2017] [Accepted: 11/09/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals. AIM We aimed to investigate nurses' retention of CPR knowledge and skills at district hospitals in Botswana. METHODS A quantitative, quasi-experimental study was conducted at three hospitals in Botswana. A pre-test, intervention, post-test, and a re-test after 6 months were utilised to determine the retention of CPR knowledge and skills. Non-probability, convenience sampling technique was used to select 154 nurses.The sequences of the test were consistent with the American Heart Association's 2010 basic life support (BLS) guidelines for health care providers. Data were analysed to compare performance over time. RESULTS This study showed markedly deficient CPR knowledge and skills among registered nurses in the three district hospitals. The pre-test knowledge average score (48%) indicated that the nurses did not know the majority of the BLS steps. Only 85 nurses participated in the re-evaluation test at 6 months. While a 26.4% increase was observed in the immediate post-test score compared with the pre-test, the performance of the available participants dropped by 14.5% in the re-test 6 months after the post-test. CONCLUSION Poor CPR knowledge and skills among registered nurses may impede the survival and management of cardiac arrest victims. Employers and nursing professional bodies in Botswana should encourage and monitor regular CPR refresher courses.
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Chauvin A, Truchot J, Bafeta A, Pateron D, Plaisance P, Yordanov Y. Randomized controlled trials of simulation-based interventions in Emergency Medicine: a methodological review. Intern Emerg Med 2018; 13:433-444. [PMID: 29147942 DOI: 10.1007/s11739-017-1770-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/10/2017] [Indexed: 11/27/2022]
Abstract
The number of trials assessing Simulation-Based Medical Education (SBME) interventions has rapidly expanded. Many studies show that potential flaws in design, conduct and reporting of randomized controlled trials (RCTs) can bias their results. We conducted a methodological review of RCTs assessing a SBME in Emergency Medicine (EM) and examined their methodological characteristics. We searched MEDLINE via PubMed for RCT that assessed a simulation intervention in EM, published in 6 general and internal medicine and in the top 10 EM journals. The Cochrane Collaboration risk of Bias tool was used to assess risk of bias, intervention reporting was evaluated based on the "template for intervention description and replication" checklist, and methodological quality was evaluated by the Medical Education Research Study Quality Instrument. Reports selection and data extraction was done by 2 independents researchers. From 1394 RCTs screened, 68 trials assessed a SBME intervention. They represent one quarter of our sample. Cardiopulmonary resuscitation (CPR) is the most frequent topic (81%). Random sequence generation and allocation concealment were performed correctly in 66 and 49% of trials. Blinding of participants and assessors was performed correctly in 19 and 68%. Risk of attrition bias was low in three-quarters of the studies (n = 51). Risk of selective reporting bias was unclear in nearly all studies. The mean MERQSI score was of 13.4/18.4% of the reports provided a description allowing the intervention replication. Trials assessing simulation represent one quarter of RCTs in EM. Their quality remains unclear, and reproducing the interventions appears challenging due to reporting issues.
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Affiliation(s)
- Anthony Chauvin
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France.
- Faculté de Médecine, Université Diderot, Paris, France.
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France.
| | - Jennifer Truchot
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
- Ilumens Simulation Department, Paris Descartes University, 45 rue des Saint Pères, 75006, Paris, France
| | - Aida Bafeta
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
| | - Dominique Pateron
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Patrick Plaisance
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
| | - Youri Yordanov
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
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Finke SR, Schroeder DC, Ecker H, Wingen S, Hinkelbein J, Wetsch WA, Köhler D, Böttiger BW. Gender aspects in cardiopulmonary resuscitation by schoolchildren: A systematic review. Resuscitation 2018; 125:70-78. [PMID: 29408490 DOI: 10.1016/j.resuscitation.2018.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/23/2017] [Accepted: 01/17/2018] [Indexed: 02/07/2023]
Abstract
AIM Bystander CPR-rates are embarrassingly low in some European countries. To increase bystander CPR-rates, many different approaches are used; one of them is training of schoolchildren in CPR. Multiple authors investigated practical and theoretical CPR performance and demonstrated gender differences related to schoolchildren CPR. The objective was to elaborate gender aspects in practical and theoretical CPR-performance from the current literature to better address female and male students. METHODS A systematic search in PubMed-database with different search terms was performed for controlled and uncontrolled prospective investigations. Altogether, n = 2360 articles were identified and checked for aptitude. From n = 97 appropriated articles, n = 24 met the inclusion criteria and were finally included for full review and incorporated in the manuscript. RESULTS Female students demonstrated higher motivation to attend CPR-training (p < 0.001), to respond to cardiac arrest (CA) (p < 0.01), scored higher in a CPR-questionnaire (p < 0.025), revealed better remembrance of the national emergency phone-number (p < 0.05) and showed a higher multiplier effect (p < 0.0001). Male students showed higher confidence in CPR-proficiency (p < 0.05), revealed deeper chest compressions (CC) (p < 0.001; p < 0.0015; p < 0.01), a higher CC-fraction (p < 0.01) and a higher arbitrary cardiac output simulated equivalent index (p < 0.05). Male gender could not be detected to be a predictor for higher tidal volume (p = 0.70; p = 0.0212). CONCLUSION In context of schoolchildren CPR, gender aspects are underestimated. Female students seem to be more motivated to attend CPR-training, reach more people in the role of a multiplier and need to be individually addressed in intensified practical training. Male students achieve a more sufficient chest compression depth and -fraction and could benefit from individual motivation.
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Affiliation(s)
- Simon-Richard Finke
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany.
| | - Daniel C Schroeder
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Hannes Ecker
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Sabine Wingen
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Jochen Hinkelbein
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Wolfgang A Wetsch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Daniela Köhler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Bernd W Böttiger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany; European Resuscitation Council (ERC), Niel, Belgium
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11
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Lou Z, Yan FH, Zhao ZQ, Zhang W, Shui XQ, Liu J, Zhuo DL, Li L, Yu ED. The Sex Difference in Basic Surgical Skills Learning: A Comparative Study. JOURNAL OF SURGICAL EDUCATION 2016; 73:902-905. [PMID: 27184180 DOI: 10.1016/j.jsurg.2016.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical skills education. METHODS A didactic description of 10 surgical skills was performed, including knot tying, basic suture I, basic suture II, sterile technique, preoperative preparation, phlebotomy, debridement, laparotomy, cecectomy, and small bowel resection with hand-sewn anastomosis. The students were rated on a 100-point scale for each basic surgical skill. Later during the same semester all the students took the final theoretical examination. RESULTS A total of 342 (male = 317 and female = 25) medical students participated in a single skills laboratory as part of their third-year medical student clerkship. The mean scores for each of the 10 surgical skills were higher in female group. The difference in sterile technique, preoperative preparation, cecectomy, and small bowel resection with hand-sewn anastomosis reached the significant level. Compared with male medical students, the mean theory examination score was significantly higher in female medical students. Approximately 76% of the (19 of 25) female students expressed their interest in pursuing a surgical career, whereas only 65.5% (207 of 317) male students wanted to be surgical professionals (p = 0.381). CONCLUSIONS Female medical students completed basic surgical skills training more efficiently and passed the theoretical examination with significantly higher scores than male medical students. In the future, studies should be done in other classes in our institution and perhaps other schools to see if these findings are reliable or valid or just a reflection of this 1 sample.
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Affiliation(s)
- Zheng Lou
- Department of Colorectal Surgery, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - Fei-Hu Yan
- Department of Colorectal Surgery, The First Affiliated Hospital, Second Military Medical University, Shanghai, China; Department of General Surgery, Naval 413 Hospital, Zhoushan, China
| | - Zhi-Qing Zhao
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China.
| | - Wei Zhang
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - Xian-Qi Shui
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - Jia Liu
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - Dong-Lan Zhuo
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - Li Li
- Department of Surgical Education, The First Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - En-da Yu
- Department of Colorectal Surgery, The First Affiliated Hospital, Second Military Medical University, Shanghai, China.
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Schoeb DS, Brennecke E, Andert A, Grommes J, von Trotha KT, Prescher A, Neumann UP, Binnebösel M. Assessment of a course of realistic surgical training during medical education as a tool for pre-residential surgical training. BMC MEDICAL EDUCATION 2016; 16:45. [PMID: 26842357 PMCID: PMC4739082 DOI: 10.1186/s12909-016-0568-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/28/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND In recent years the focus on practical skills in the German curriculum of medical school has increased greatly. In this study we evaluate the value of a practical surgery course for medical students as a tool for surgical education, as a way of enhancing interest in surgical fields, and as a method of influencing medical students to subsequently choose a surgical career. METHODS The "Feel like a surgeon"-course is an optional practical surgery course in which topographical anatomy and realistic surgical training using fresh human cadavers are combined for medical students of the RWTH Aachen University. Between 2010 and 2015 every student completed a survey before starting and after completing our course, and in 2015 a follow-up was performed. Using a standardized questionnaire, course quality, learning success and impact on post-instructional career and choice of profession was evaluated. RESULTS In total, 82 students attended our course between 2010 and 2015 and took part in the evaluation. Evaluation of the course was positive overall, with an average grade of 1.4° ± °0.50. Significant improvement of basic, as well as more complex surgical skills and theoretical knowledge was noted. Furthermore, self-confidence for patient related assignments improved as well. In the follow-up evaluation, a high level of recommendation for surgical residents was seen, as was a high influence of the course on our students' career choice, although no significant change in career plans before and after taking the course was noted. CONCLUSIONS Our results indicate that a practical surgical course can be a valuable tool to prepare students for a surgical residency and to improve their practical skills generally.
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Affiliation(s)
- Dominik S Schoeb
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Eva Brennecke
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Anne Andert
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Jochen Grommes
- Department of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Klaus T von Trotha
- Department of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany
| | - Ulf P Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Marcel Binnebösel
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany.
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13
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Smart JR, Kranz K, Carmona F, Lindner TW, Newton A. Does real-time objective feedback and competition improve performance and quality in manikin CPR training--a prospective observational study from several European EMS. Scand J Trauma Resusc Emerg Med 2015; 23:79. [PMID: 26471882 PMCID: PMC4608309 DOI: 10.1186/s13049-015-0160-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/30/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is important for patient survival. Real time objective feedback during manikin training has been shown to improve CPR performance. Objective measurement could facilitate competition and help motivate participants to improve their CPR performance. The aims of this study were to investigate whether real time objective feedback on manikins helps improve CPR performance and whether competition between separate European Emergency Medical Services (EMS) and between participants at each EMS helps motivation to train. METHODS Ten European EMS took part in the study and was carried out in two stages. At Stage 1, each EMS provided 20 pre-hospital professionals. A questionnaire was completed and standardised assessment scenarios were performed for adult and infant out of hospital cardiac arrest (OHCA). CPR performance was objectively measured and recorded but no feedback given. Between Stage 1 and 2, each EMS was given access to manikins for 6 months and instructed on how to use with objective real-time CPR feedback available. Stage 2 was undertaken and was a repeat of Stage 1 with a questionnaire with additional questions relating to usefulness of feedback and the competition nature of the study (using a 10 point Likert score). The EMS that improved the most from Stage 1 to Stage 2 was declared the winner. An independent samples Student t-test was used to analyse the objective CPR metrics with the significance level taken as p < 0.05. RESULTS Overall mean Improvement of CPR performance from Stage 1 to Stage 2 was significant. The improvement was greater for the infant assessment. The participants thought the real-time feedback very useful (mean score of 8.5) and very easy to use (mean score of 8.2). Competition between EMS organisations recorded a mean score of 5.8 and competition between participants recorded a mean score of 6.0. CONCLUSIONS The results suggest that the use of real time objective feedback can significantly help improve CPR performance. Competition, especially between participants, appeared to encourage staff to practice and this study suggests that competition might have a useful role to help motivate staff to perform CPR training.
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Affiliation(s)
- J R Smart
- Research Consultant for South East Coast Ambulance NHS Trust (SECAmb), Banstead, UK.
| | - K Kranz
- Swiss Institute of Emergency Medicine (SIRMED), Nottwil, Switzerland
| | - F Carmona
- Sistema Emergencias Mediques (SEM), Barcelona, Spain
| | - T W Lindner
- Norwegian Air Ambulance Foundation, Drøbak, Norway
- SAFER (Stavanger Acute medicine Foundation for Education and Research) and Stavanger University Hospital, Stavanger, Norway
| | - A Newton
- South East Coast Ambulance NHS Trust (SECAmb), Banstead, UK
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14
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Effects of gender grouping on students’ group performance, individual achievements and attitudes in computer-supported collaborative learning. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2015.02.038] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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