Randomized controlled trial comparing pit crew resuscitation model against standard advanced life support training

Objectives

Pit crew models are designed to improve teamwork in critical medical situations, like advanced life support (ALS). We investigated if a pit crew model training improves performance assessment and ALS skills retention when compared to standard ALS education.

Methods

This was a prospective, blinded, randomized, and controlled, parallel-group trial. We recruited students to 4-person resuscitation teams. We video recorded simulated ALS-situations after the ALS education and after 6-month follow-up. We analyzed technical skills (TS) and non-technical skills (NTS) demonstrated in them with an instrument measuring TS and NTS, and used a linear mixed model to model the difference between the groups in the TS and NTS. Another linear model was used to explore the difference between the groups in hands-on ratio and hands-free time. The difference in the total assessment score was analyzed with the Mann-Whitney U-test. The primary outcome was the difference in the total assessment score between the groups at follow-up. ALS skills were considered to be a secondary outcome.

Results

Twenty-six teams underwent randomization. Twenty-two teams received the allocated education. Fifteen teams were evaluated at 6-month follow-up: 7 in the intervention group and 8 in the control group. At 6-month follow-up, the median (Q1-Q3) total assessment score for the control group was 6.5 (6-8) and 7 (6.25-8) for the intervention group but the difference was not significant (U = 133, P = 0.373). The intervention group performed better in terms of chest compression quality (interaction term, β3 = 0.23; 95% confidence interval, 0.01-0.50; P = 0.043) at follow-up.

Conclusion

We found no difference in overall performance between the study arms. However, trends indicate that the pit crew model may help to retain ALS skills in different areas like chest compression quality.

[Research-based thinking of nurses at the end of their basic nursing education]

The purpose of this study was to find out the level of research-based thinking that students have internalized during their professional education. The research-based thinking of students has been investigated by analyzing the study reports, they have made at the end of their professional education. "The research-based thinking" is evaluated from the perspective of a research consumer. So, the purpose of this study was not to evaluate the level of studies, but the basis of them. The data consisted of 51 study reports. The data was analyzed by using the content analysis and descriptive statistics. The content analysis was based on the set of general rules for research using deductive methods of approach. The students' problems in research-based thinking fell mainly into the following parts: (1) the students did not use previous studies to build up the frame and the problems of their study, the students used scientific publications limitedly, it seems that the knowledge had the same value to the students regardless of the reference they have taken it from; (2) the students had difficulties in connecting the empirical part of their study with theoretical or conceptual frame. In this study the results indicated, that Finnish nursing students' research-based thinking is not mature in their study-reports at the end of education. It seems important to do further research to be able to analyze the reasons for these findings and how education could be improved in the future.