Transitioning to Web-Based Learning in Basic Life Support Training During the COVID-19 Pandemic to Battle the Fear of Out-of-Hospital Cardiac Arrest: Presentation of Novel Methods

The Effects of Serious Games on Cardiopulmonary Resuscitation Training and Education: Systematic Review With Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Serious games have emerged as an innovative educational strategy with the potential to significantly enhance the quality and effectiveness of cardiopulmonary resuscitation (CPR) training. Despite their promise, there remains a degree of controversy when comparing the advantages of serious games with traditional CPR training methods. This study seeks to provide a comprehensive assessment of the impact of serious games on CPR training and education by systematically analyzing the results of previous research.

OBJECTIVE

This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies.

METHODS

We conducted a thorough and systematic search across 9 prominent web-based databases, encompassing the period from the inception of these databases until April 1, 2023. The databases included in our search were PubMed, Cochrane Library, Wiley Online Library, EBSCO (PsycInfo), SpringerLink, Chinese Biology Medicine Disc, Vip Journal Integration Platform, Wanfang Database, and Chinese National Knowledge Infrastructure. The studies selected adhered to the following criteria: (1) being a randomized controlled trial comparing serious games and traditional methods for CPR training; (2) having participants aged 12 years or older in CPR; (3) having an experimental group using serious games and a control group using nongame methods for CPR instruction; and (4) having outcomes including theoretical and skill assessments, compression depth, and rate. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Data analysis was performed using RevMan (version 5.3; Cochrane Training), and mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables.

RESULTS

A total of 9 articles were included, involving 791 study participants, of whom 395 in the experimental group taught CPR training using serious games and 396 in the control group taught CPR training using traditional methods. The results of our meta-analysis indicate that the use of serious games in CPR training yields outcomes that are comparable in effectiveness to traditional training methods across several key areas. Specifically, serious games demonstrated equivalence to traditional formats in theory assessment (SMD -0.22, 95% CI - 0.96 to 0.51; P=.55), skill assessment (SMD -0.49, 95% CI -1.52 to 0.55; P=.36), compression depth (MD -3.17, 95% CI -0.18 to 6.53; P=.06), and compression rate (MD -0.20, 95% CI -7.29 to 6.89; P=.96).

CONCLUSIONS

In summary, serious games offer a viable and effective CPR education approach, yielding results comparable to traditional formats. This modality is a valuable addition to CPR training methodologies. However, caution is warranted in interpreting these findings due to limited controlled trials, small sample sizes, and low-quality meta-analyzed evidence.

Effectiveness of an "online + in-person" hybrid model for an undergraduate molecular biology lab during COVID-19

The COVID-19 outbreak has created turbulence and uncertainty into multiple aspects of life in countries around the world. In China, the pandemic continues to pose a great challenge to the nature of traditional in-class education in schools. Chinese education has faced the difficult decision of whether to resume in-person teaching in an unprecedented and time-pressured manner. To ensure the quality of teaching and learning during this time, this study aims to explore the effectiveness of an "online + in-person" hybrid teaching model with a new three-part approach to the hybrid teaching lab, where students prepare for the in-person lab using virtual simulated experiments and learning modules and debrief their learning afterwards online as well. This approach not only enhances the efficiency during the in-person lab but also strongly reinforces concepts and laboratory skills by providing a "practice run" before physically attending the lab. A total of 400 medical undergraduates from Dalian Medical University in China were recruited for this study. In an undergraduate molecular biology laboratory course, we observed 200 students in a hybrid teaching model. We evaluated the learning outcomes from the "online + in-person" hybrid teaching model with a questionnaire survey and assessed the quality of experiment execution, report writing, and group collaboration. Moreover, the 200 students from the hybrid group were evaluated during an annual science competition at the university and compared to 200 students from the competition cohort who had no experience with a hybrid learning model. The comparison data were analyzed using a student's t-test statistical analysis. The students in the hybrid learning group demonstrated a strong enthusiasm for the model, high amount of time utilizing the online system, and high scores on laboratory evaluation assignments. Approximately 98% of the hybrid learning students reported that they preferred mixed teaching to the traditional teaching mode, and all students scored above 96% on the online laboratory report. Teachers of the course observed that the hybrid group had a noticeably higher level of proficiency in lab skills compared to the previous students. At the Dalian Medical University annual science competition, where we compared our hybrid group to a traditional learning group, scores for both the objective and subjective items showed that the students instructed with the hybrid lab model had superior performance (p < 0.05). In the context of the COVID-19 pandemic, we developed a new three-part molecular biology laboratory course that strongly improved students' laboratory skills, knowledge retention, and enthusiasm for the course using online learning to improve their learning efficiency and expedite the in-person laboratory experience. We found that these students performed at a higher level in a combined theoretical/practical science competition compared to the students in traditional in-person lab courses. Additionally, our model subjectively fostered enthusiasm and excellence in both teachers and students. Further, cultivation of the students' independent learning and creative problem solving skills were emphasized. The exploration of an effective teaching model, such as the one described here, not only provides students with a solid foundation for their future medical studies and career development but also promotes more efficient in-person laboratory time.

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.

Importance of Immediate Electronic-Based Feedback to Enhance Feedback for First-Time CPR Trainees

Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the participants expressed their subjective opinion on how the feedback provided during the classes, basic vs. detailed, motivated them to improve the quality of their CPR performance. Additionally, during the classes, the instructor conducted an extended observation of students’ work and behavior. In the students’ opinion, the CPR training with detailed feedback devices provided motivation for learning and improving CPR proficiency than that with a basic control panel. Furthermore, the comments given from devices seemed to be more acceptable to the students, who did not see any bias in the device’s evaluation compared to that of the instructor. Detailed device feedback motivates student health practitioners to learn and improve the overall quality of CPR. The use of mannequins that provide detailed feedback during BLS courses can improve survival in out-of-hospital cardiac arrest.