The effect of a national web course "Help-Brain-Heart" as a supplemental learning tool before CPR training: a cluster randomised trial

Kids Save Lives - The kids' and teachers' view: How school children and schoolteachers would alter a BLS course designed by specialists

Background

Training schoolchildren in basic life support ('Kids-Save-Lives' training) is widely believed to improve outcomes from out-of-hospital cardiac arrest. Numerous programmes have been launched, but to our knowledge, neither children nor schoolteachers have been directly involved in designing these courses. This is unfortunate, as it is well-known that children (as the target goup of training) learn differently from adults. We therefore sought to explore the view of schoolchildren and their teachers on the design of a 'Kids-Save-Lives' course.

Methods

We designed a state-of-the-art, 90-min BLS training and delivered it to all 13 classes of a secondary community school (children aged 12-16). Directly after each training, we performed Video-Stimulated Recall (VSR) with 2 children and 2 schoolteachers. For VSR, we presented video sequences from defined sections of the training and related semi-structured questions to these sections. The interviews were audio-recorded, transcribed, and analysed using qualitative content analysis.

Results

Twenty-four children and 24 teachers participated in the VSR. The overall satisfaction with the training was very high. Participants especially appreciated the brief theoretical introduction using a video, the high practical involvement, and the final scenario. Children suggested the program could be improved by better linking the video to the children's world, increasing excitement and action, and limiting the group size in the final scenario. Teachers suggested incorporating more theoretical background, using terms and language more consistently, and better integrating the program into the school curriculum.

Conclusions

Although very satisfied with a state-of-the-art 'Kids-Save-Lives' training, children and teachers made important suggestions for improvement.

Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis

Background

Worldwide, bystander CPR rates are low; one effective way to increase these rates is to train schoolchildren; however, the most effective way to train them is currently unknown.

Methods

This systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, evaluated whether CPR training for schoolchildren, using innovative teaching modalities (nonpractical, self, or peer-training) versus standard instructor-led training, resulted in higher quality CPR, self-confidence and short-term (≤3 months post-training) or long-term (>3 months post-training) retention of CPR skills.

Results

From 9793 citations, 96 studies published between 1975 and 2022 (44 RCTs and 52 before/after studies) were included. There were 43,754 students, average age of 11.5 ± 0.9 (range 5.9-17.6) and 49.2% male. Only 13 RCTs compared practical vs. nonpractical training (n = 5), self- vs. instructor-led training (n = 7) or peer- vs. instructor-led training (n = 5). The observed statistically significant differences in mean depth and rate of compressions between children with hands-on practical training and those without were not clinically relevant. Regardless of training modality, compression depth was consistently suboptimal. No differences were observed in CPR skills immediately or ≤ 3 months post-training, between children who were self- or peer-trained vs. instructor-led. Due to lack of data, we were unable to evaluate the impact of these novel training modalities on student self-confidence.

Conclusion

Although innovative training modalities are equally effective to instructor-led training when teaching schoolchildren CPR, compression depth was frequently suboptimal. Recommendations on standardized training and evaluation methods are necessary to understand the best ways to train children.

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

Effects of different cardiopulmonary resuscitation education interventions among university students: A randomized controlled trial

Cardiopulmonary resuscitation (CPR) education for the public may improve bystander intention to perform CPR on cardiac arrest patients. Studies have shown that different CPR education intervention methods can improve learning performance, with key indicators including attitude toward to CPR, intention to perform CPR, and degree of CPR knowledge and skills. The present study compared the traditional face-to-face method to hybrid and virtual reality (VR) methods to observe difference in learning performance and length of performance retention. This study adopted randomized controlled trial to compare CPR learning performance between traditional face-to-face, hybrid, and VR methods. Participants from each intervention group completed a pretest and 2 posttests. The measurement tools included an attitude and intention questionnaire, knowledge examination, and skill examination with a RESUSCI ANNE QCPR ® manikin. The performance among all participants in pretest showed no significant difference between the intervention groups, indicating no difference in their background attitude, knowledge, and skill level. Significant differences were observed in the average degree of intention to perform CPR between the hybrid and traditional groups in 1st and 2nd posttest. Compared to the pretest results, the posttests revealed significantly higher attitude toward CPR, intention to perform CPR, knowledge examination results, accuracy of overall chest compression, accuracy of CPR procedure, accuracy of AED usage, accuracy of chest compression rate, and accuracy of chest compression depth. The average time to reattending CPR learning and practice session was 11-12 weeks reported by participants. The hybrid and VR methods to CPR education resulted in the same level of improvement in learning performance as traditional face-to-face teaching. The suggested frequency for renewing CPR knowledge and skills is 12 weeks which may be considered in new strategies aimed at promoting CPR education and exposure to the public.

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

The Effectiveness of Technology-Based Cardiopulmonary Resuscitation Training on the Skills and Knowledge of Adolescents: Systematic Review and Meta-analysis

BACKGROUND

Cardiopulmonary resuscitation (CPR) training for adolescents is a prominent strategy to increase the number of community first responders who can recognize cardiac arrest and initiate CPR. More schools are adopting technology-based CPR training modalities to reduce class time and reliance on instructor availability and increase their capacity for wider training dissemination. However, it remains unclear whether these technology-based modalities are comparable with standard training.

OBJECTIVE

This study aimed to systematically review and perform meta-analyses to evaluate the effectiveness of technology-based CPR training on adolescents' CPR skills and knowledge.

METHODS

Searches were conducted in PubMed, Embase, Cochrane Library, Ovid MEDLINE, CINAHL, PsycINFO, Education Resources Information Center, ProQuest Dissertations and Theses Global, and Scopus from inception to June 25, 2021. Eligible randomized controlled trials (RCTs) compared technology-based training with standard training for adolescents aged 12 to 18 years. Studies were appraised using the Cochrane risk-of-bias tool. Random-effects meta-analyses were performed using Review Manager (The Cochrane Collaboration). Subgroup analyses were conducted to explore sources of heterogeneity. Overall certainty of evidence was appraised using the Grading of Recommendations Assessment, Development, and Evaluation approach.

RESULTS

Seventeen RCTs involving 5578 adolescents were included. Most of the studies had unclear risks of selection bias (9/17, 53%) and high risks of performance bias (16/17, 94%). Interventions that included instructor guidance increased the likelihood of adolescents checking the responsiveness of the person experiencing cardiac arrest (risk ratio 1.39, 95% CI 1.19-1.63) and calling the emergency medical services (risk ratio 1.11, 95% CI 1.00-1.24). Self-directed technology-based CPR training without instructor guidance was associated with poorer overall skill performance (Cohen d=-0.74, 95% CI -1.02 to -0.45). Training without hands-on practice increased mean compression rates (mean difference 9.38, 95% CI 5.75-13.01), whereas real-time feedback potentially yielded slower compression rates. Instructor-guided training with hands-on practice (Cohen d=0.45, 95% CI 0.13-0.78) and the use of computer programs or mobile apps (Cohen d=0.62, 95% CI 0.37-0.86) improved knowledge scores. However, certainty of evidence was very low.

CONCLUSIONS

Instructor-guided technology-based CPR training that includes hands-on practice and real-time feedback is noninferior to standard training in CPR skills and knowledge among adolescents. Our findings supported the use of technology-based components such as videos, computer programs, or mobile apps for self-directed theoretical instruction. However, instructor guidance, hands-on practice, and real-time feedback are still necessary components of training to achieve better learning outcomes for adolescents. Such a blended learning approach may reduce class time and reliance on instructor availability. Because of the high heterogeneity of the studies reviewed, the findings from this study should be interpreted with caution. More high-quality RCTs with large sample sizes and follow-up data are needed. Finally, technology-based training can be considered a routine refresher training modality in schools for future research.

How to evaluate first aid skills after training: a systematic review

Background

To be able to help and save lives, laypersons are recommended to undergo first aid trainings. The aim of this review was to explore the variety of the elements of the measuring systems to assess the effects of first aid trainings on different aspects of first aid skills including practical skills, knowledge, and emotional perspectives.

Methods

This systematic literature review used Scopus and PubMed databases and searched for studies published between January, 2000, and December, 2020. Out of 2,162 studies meeting the search criteria, 15 studies with quantitative and repeatable evaluation methods to assess first aid skills after first aid training for adults were included in the final analysis.

Results

Practical skills, especially on the ability to perform cardiopulmonary resuscitation (CPR) and to use an automated external defibrillator, were the most studied first aid skills after first aid training. This evaluation was based on several standardized measurements and assessed often with the help of a combination of resuscitation manikin and observer. Evaluation methods of performance in other emergency situations are not well standardized. Questionnaires used to assess knowledge of first aid, though seemingly based on guidelines, were also not standardized, either. Emotional aspects of first aid (willingness or self-confidence) were evaluated by highly simplified questionnaires, and answers were graded by five-point Likert scale.

Conclusion

According to our review, the focus of evaluation methods after first aid training has been on practical skills and especially on CPR. Though the evaluation of first-aid knowledge seems to be straightforward, it is not performed systematically. Evaluation methods for emotional aspects are highly simplified. Overall, standardized measurements and evaluation methods to assess all aspects of first aid skills are needed.

Blended learning for accredited life support courses - A systematic review

Aim

To evaluate the effectiveness on educational and resource outcomes of blended compared to non-blended learning approaches for participants undertaking accredited life support courses.

Methods

This review was conducted in adherence with PRISMA standards. We searched EMBASE.com (including all journals listed in Medline), CINAHL and Cochrane from 1 January 2000 to 6 August 2021. Randomised and non-randomised studies were eligible for inclusion. Study screening, data extraction, risk of bias assessment (using RoB2 and ROBINS-I tools), and certainty of evidence evaluation (using GRADE) were all independently performed in duplicate. The systematic review was registered with PROSPERO (CRD42022274392).

Results

From 2,420 studies, we included data from 23 studies covering fourteen basic life support (BLS) with 2,745 participants, eight advanced cardiac life support (ALS) with 33,579 participants, and one Advanced Trauma Life Support (ATLS) with 92 participants. Blended learning is at least as effective as non-blended learning for participant satisfaction, knowledge, skills, and attitudes. There is potential for cost reduction and eventual net profit in using blended learning despite high set up costs. The certainty of evidence was very low due to a high risk of bias and inconsistency. Heterogeneity across studies precluded any meta-analysis.

Conclusion

Blended learning is at least as effective as non-blended learning for accredited BLS, ALS, and ATLS courses. Blended learning is associated with significant long term cost savings and thus provides a more efficient method of teaching. Further research is needed to investigate specific delivery methods and the effect of blended learning on other accredited life support courses.

Efficacy and knowledge of conducting CPR through online learning during the COVID-19 pandemic: A literature review

The COVID-19 pandemic has made it difficult to carry out face-to-face training activities in various higher institutions. This has led to a negative impact on the skills and abilities of nursing students in performing cardiopulmonary resuscitation (CPR) and the cessation of their clinical practice programs in hospitals. Therefore, the aim of this study is to determine the efficacy and knowledge of nursing students in performing CPR by implementing a blended learning program, through online learning platforms. The search for full-text articles was carried out in May 2020 and were reviewed to know whether they fit the theme using the ProQuest, ScienceDirect and PubMed databases with the keywords "BLS", "CPR", "Blended learning", "Knowledge" and "Self-efficacy". In addition, there were 15 articles that matched the criteria. The application of a blended learning program that integrates video and face-to-face lectures through online learning platforms in conducting effective CPR, increases the efficacy and knowledge of nursing students. The effectiveness of online learning greatly affects the efficacy and knowledge of nursing students in conducting CPR. Therefore, it was highly recommended during the COVID-19 pandemic.

National coverage of out-of-hospital cardiac arrests using automated external defibrillator-equipped drones - A geographical information system analysis

BACKGROUND

Early defibrillation is essential for increasing the chance of survival in out-of-hospital-cardiac-arrest (OHCA). Automated external defibrillator (AED)-equipped drones have a substantial potential to shorten times to defibrillation in OHCA patients. However, optimal locations for drone deployment are unknown. Our aims were to find areas of high incidence of OHCA on a national level for placement of AED-drones, and to quantify the number of drones needed to reach 50, 80, 90 and 100% of the target population within eight minutes.

METHODS

This is a retrospective observational study of OHCAs reported to the Swedish Registry for Cardiopulmonary Resuscitation between 2010-2018. Spatial analyses of optimal drone placement were performed using geographical information system (GIS)-analyses covering high-incidence areas (>100 OHCAs in 2010-2018) and response times.

RESULTS

39,246 OHCAs were included. To reach all OHCAs in high-incidence areas with AEDs delivered by drone or ambulance within eight minutes, 61 drone systems would be needed, resulting in overall OHCA coverage of 58.2%, and median timesaving of 05:01 (min:sec) [IQR 03:22-06:19]. To reach 50% of the historically reported OHCAs in <8 min, 21 drone systems would be needed; for 80%, 366; for 90%, 784, and for 100%, 2408.

CONCLUSIONS

At a national level, GIS-analyses can identify high incidence areas of OHCA and serve as tools to quantify the need of AED-equipped drones. Use of only a small number of drone systems can increase national coverage of OHCA substantially. Prospective real-life studies are needed to evaluate theoretically optimized suggestions for drone placement.

The Copenhagen Tool a research tool for evaluation of basic life support educational interventions

INTRODUCTION

Over the past decades, major changes have been made in basic life support (BLS) guidelines and manikin technology. The aim of this study was to develop a BLS evaluation tool based on international expert consensus and contemporary validation to enable more valid comparison of research on BLS educational interventions.

METHODS

A modern method for collecting validation evidence based on Messick's framework was used. The framework consists of five domains of evidence: content, response process, internal structure, relations with other variables, and consequences. The research tool was developed by collecting content evidence based on international consensus from an expert panel; a modified Delphi process decided items essential for the tool. Agreement was defined as identical ratings by 70% of the experts.

RESULTS

The expert panel established consensus on a three-levelled score depending on expected response level: laypersons, first responders, and health care personnel. Three Delphi rounds with 13 experts resulted in 16 "essential" items for laypersons, 21 for first responders, and 22 for health care personnel. This, together with a checklist for planning and reporting educational interventional studies within BLS, serves as an example to be used for researchers.

CONCLUSIONS

An expert panel agreed on a three-levelled score to assess BLS skills and the included items. Expert panel consensus concluded that the tool serves its purpose and can act to guide improved research comparison on BLS educational interventions.

Nursing students' knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: a randomized controlled trial

BACKGROUND

Although various forms of online education are on the rise worldwide, effects of such innovative approach are yet to be validated. This study analyzes whether blended learning cardiopulmonary resuscitation (CPR) education that integrates e-learning and face-to-face education is effective in improving nursing students' knowledge, attitude, and self-efficacy.

METHODS

A randomized controlled design was used. The participants of this study were 120 nursing students randomly assigned to the intervention group (n = 60) or the control (n = 60). The intervention group was trained using a blended learning CPR education program. Self report questionnaires with knoweldge, attitude, and self-efficacy were all used in the pre and post intervention. Differences before and after the education of each group were analyzed with a paired t-test, and the differences between the two groups were analyzed with ANCOVA with knowledge as the covariate.

RESULTS

The findings indicated that the intervention group had significantly higher knowledge scores (intervention: 16.40 ± 1.56, control: 6.46 ± 2, p < .001), and emotional attitude (intervention: 40.85 ± 8.01, control: 36.05 ± 6.87, p = .002) about CPR than the control group, but other outcomes did not differ between groups.

CONCLUSIONS

In this monocentric study, a blended learning CPR program that integrated videos and face to face lecture was found effective in improving nursing students' knowledge and attitudes regarding CPR.

Supplementary dataset to self-learning training compared with instructor-led training in basic life support

In this article, we present supplementary data to the article entitled "Self-learning training versus instructor-led training in basic life support: a cluster randomised trial" [1]. In three supplementary files, we present the informed consent of the included participants, the modified instrument to calculate the total score for practical skills called "the Cardiff Test of basic life support and automated external defibrillation" and the questionnaire to obtain background factors, theoretical knowledge, self-assessed knowledge and confidence and willingness to act, distributed directly after training and six months after training. The results of comparisons between "directly after intervention" and "six months after intervention", for each training group separately, are presented in three tables. We also present two tables showing the reasons why the participants were not prepared to perform compressions and/or ventilations in the event of a sudden out-of-hospital cardiac arrest.

Effectiveness of web-based education in addition to basic life support learning activities: A cluster randomised controlled trial

BACKGROUND

Effective education in basic life support (BLS) may improve the early initiation of high-quality cardiopulmonary resuscitation and automated external defibrillation (CPR-AED).

AIM

To compare the learning outcome in terms of practical skills and knowledge of BLS after participating in learning activities related to BLS, with and without web-based education in cardiovascular diseases (CVD).

METHODS

Laymen (n = 2,623) were cluster randomised to either BLS education or to web-based education in CVD before BLS training. The participants were assessed by a questionnaire for theoretical knowledge and then by a simulated scenario for practical skills. The total score for practical skills in BLS six months after training was the primary outcome. The total score for practical skills directly after training, separate variables and self-assessed knowledge, confidence and willingness, directly and six months after training, were the secondary outcomes.

RESULTS

BLS with web-based education was more effective than BLS without web-based education and obtained a statistically significant higher total score for practical skills at six months (mean 58.8, SD 5.0 vs mean 58.0, SD 5.0; p = 0.03) and directly after training (mean 59.6, SD 4.8 vs mean 58.7, SD 4.9; p = 0.004).

CONCLUSION

A web-based education in CVD in addition to BLS training enhanced the learning outcome with a statistically significant higher total score for performed practical skills in BLS as compared to BLS training alone. However, in terms of the outcomes, the differences were minor, and the clinical relevance of our findings has a limited practical impact.

Effects of native language on CPR skills and willingness to intervene in out-of-hospital cardiac arrest after film-based basic life support training: a subgroup analysis of a randomised trial

OBJECTIVES

The aim was to investigate whether the students' native language, Swedish as native language (SNL) versus other native language (ONL), affects cardiopulmonary resuscitation (CPR) skills or willingness to act after film-based training in Swedish.

SETTING

13-year-old students in two municipalities.

DESIGN

A subgroup from a previous randomised study was analysed. During 2013 to 2014, a film-based CPR method was evaluated. Practical skills and willingness to act were assessed directly after training and after 6 months. CPR skills were evaluated using a modified Cardiff test.

PARTICIPANTS

A total of 641 students were included in the analysis (SNL, n=499; ONL, n=142).

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary endpoint was the total score of the modified Cardiff test at 6 months. The secondary endpoints were total score directly after training, individual variables for the test and self-reported willingness to act.

RESULTS

At the practical test, SNL students scored better than ONL students; directly after training, 67% vs 61% of maximum score, respectively (p<0.001); at 6 months, 61% vs 56% of maximum score (p<0.001). Most students were willing to perform compressions and ventilation on a friend (SNL 85% vs ONL 84%). However, if the victim was a stranger, ONL students were more willing to perform both compressions and ventilation than SNL students (52% vs 38% after training, p<0.001; 42% vs 31% at 6 months, p=0.032). SNL students preferred to initiate chest compressions only.

CONCLUSIONS

SNL students scored slightly higher in the practical CPR skill test than ONL students. Willingness to act was generally high, however ONL students reported higher willingness to perform both compressions and ventilation if the victim was a stranger. Further research is needed to investigate how CPR educational material should be designed and simplified for optimal learning by students. Different language versions or including feedback in CPR training can be a way to increase learning.

ETHICS APPROVAL

The study was approved by the Regional Ethical Review Board of Linköping, Sweden (2013/358-31).

TRIAL REGISTRATION NUMBER

NCT03233490; Pre-results.

Self-learning training versus instructor-led training for basic life support: A cluster randomised trial

AIM

To compare the effectiveness of two basic life support (BLS) training interventions.

METHODS

This experimental trial enrolled 1301 lay people in BLS training. The participants were cluster randomised to either self-learning training or to traditional instructor-led training. Both groups used the Mini-Anne Kit (Laerdal Medical, Stavanger, Norway) and standardised film instructions. After training, the participants practical skills were measured on a Resusci Anne manikin and an AED trainer with the PC SkillReporting system (Laerdal Medical, Stavanger, Norway). The primary outcome was the total score from the modified Cardiff Test of basic life support with automated external defibrillation (19-70 points), six months after training. The secondary outcomes were total score directly after training and quality of individual variables, self-assessed knowledge, confidence and willingness to act, directly and six months after training.

RESULTS

For primary outcome six months after training there was no statistically significant difference (p = 0.44) between the total score for the self-learning group (n = 670; median 59, IQR 55-62) compared with the instructor-led group (n = 561; median 59, IQR 55-63). The instructor-led training resulted in a statistically significant higher total score (median 61 versus 59, p < 0.0001), self-assessed knowledge and willingness to act, directly after training (secondary outcomes) compared with the self-learning training.

CONCLUSIONS

There was no statistically significant difference in practical skills or willingness to act when comparing self-learning training with instructor-led training six months after training in BLS. However, directly after the intervention, practical skills were better when the training was led by an instructor.