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Maár C, Zima E, Nagy B, Pál-Jakab Á, Szvath P, Kiss B, Fritúz G, Gál J, Merkely B, Kovács E. The investigation of the efficiency of basic life support education among high school students: Protocol, design and implementation of an interventional, prospective longitudinal, individually randomised, parallel 1:1 grouped trial. Resusc Plus 2024; 18:100585. [PMID: 38439933 PMCID: PMC10909624 DOI: 10.1016/j.resplu.2024.100585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
Background Basic life support (BLS) skills are crucial not only for healthcare workers but for all lay people as well. Timely recognition of out-of-hospital cardiac arrest (OHCA) and the initiation of BLS by bystanders before the arrival of healthcare personnel may improve survival. There are several methods of spreading BLS skills and improve BLS skill retention among lay people. One of these methods can be the education of adolescent school children. The introduction of mandatory BLS education in schools was very effective in some European countries to increase the rate of bystander BLS. Methods/design The current study aims to investigate the efficacy of a BLS training and BLS curriculum among high school children in Hungary. Moreover, the investigators would like to optimise factors influencing skill retention in this first responder group and aim to compare two types of teaching methods: feedback given by the instructor or software-based feedback on the efficacy of chest compressions during the course. This study will be an interventional, assessor blinded, individually randomised parallel group trial recruiting 360 students. BLS skill retention will be assessed at the end of the course, two months after the training and six months after training. Discussion The current study will increase our knowledge on the methods educating BLS among high school children. The results will help us to create an effective BLS curriculum at schools.Trial registration: ClinicalTrials.gov: NCT06016153. Prospectively registered on 08/2023.
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Affiliation(s)
- Csaba Maár
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Department of Anesthesiology and Perioperative Care, Semmelweis University, Üllői út 78, 1082 Budapest, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
| | - Endre Zima
- Department of Anesthesiology and Perioperative Care, Semmelweis University, Üllői út 78, 1082 Budapest, Hungary
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary
| | - Bettina Nagy
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Ádám Pál-Jakab
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Petra Szvath
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
| | - Boldizsár Kiss
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Gábor Fritúz
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
| | - János Gál
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
| | - Béla Merkely
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Enikő Kovács
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
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CPR Quality Assessment in Schoolchildren Training. J Cardiovasc Dev Dis 2022; 9:jcdd9110398. [DOI: 10.3390/jcdd9110398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Abstract
Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in schoolchildren, compared with a real-time software. This observational study (March 2019–2020) included 104 schoolchildren with no previous CPR training (11–17 years old, 66 girls, 84 primary schoolchildren, 20 high schoolchildren). Simultaneous evaluations of CPR quality were performed using an observational checklist and real-time software. High-quality CPR was determined as a combination of 70% correct maneuvers in compression rate (100–120/min), depth (5–6 cm), and complete release, using a real-time software and three positive performance in skills using a checklist. We adjusted a multivariate logistic regression model for age, sex, and BMI. We found moderate to high agreement percentages in quality of CPR performance (rate: 68.3%, depth: 79.8%, and complete release: 91.3%) between a checklist and real-time software. Only 38.5% of schoolchildren (~14 years-old, ~54.4 kg, and ~22.1 kg/m2) showed high-quality CPR. High-quality CPR was more often performed by older schoolchildren (OR = 1.43, 95% IC:1.09–1.86), and sex was not an independent factor (OR = 1.26, 95%IC:0.52–3.07). For high-quality CPR in schoolchildren, a checklist showed moderate to high agreement with real-time software. Better performance was associated with age regardless of sex and BMI.
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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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Jensen TW, Lockey A, Perkins GD, Granholm A, Eberhard KE, Hasselager A, Møller TP, Ersbøll AK, Folke F, Lippert A, Østergaard D, Handley AJ, Chamberlain D, Lippert F. The Copenhagen Tool a research tool for evaluation of basic life support educational interventions. Resuscitation 2020; 156:125-136. [PMID: 32889023 DOI: 10.1016/j.resuscitation.2020.08.120] [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: 04/24/2020] [Revised: 07/21/2020] [Accepted: 08/21/2020] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Theo Walther Jensen
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Copenhagen, Denmark; Danish Resuscitation Council, c/o Emergency Medical Services, Telegrafvej 5, 2750 Copenhagen, Denmark.
| | - Andrew Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, United Kingdom
| | - Gavin D Perkins
- Warwick Trials Unit, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Anders Granholm
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kristine E Eberhard
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Asbjørn Hasselager
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Thea Palsgaard Møller
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Copenhagen, Denmark
| | - Anne Lippert
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | | | - Douglas Chamberlain
- Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex, United Kingdom
| | - Freddy Lippert
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, 2750 Copenhagen, Denmark; Danish Resuscitation Council, c/o Emergency Medical Services, Telegrafvej 5, 2750 Copenhagen, Denmark
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Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation 2019; 138:259-272. [PMID: 30928504 DOI: 10.1016/j.resuscitation.2019.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. METHODS Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts. RESULTS Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills. CONCLUSION All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.
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