Objectives: Successful implementation of any new technology requires extensive engagement with front-line staff. We explored the perceptions of emergency department and trauma staff about a trauma video review program (TVR) prior to implementation of the first such program in Canada at our level I trauma center. Methods:We conducted semi-structured individual interviews and in situ small group interviews with 35 multidisciplinary ED and trauma staff members of a teaching and research hospital in Toronto, Canada. We sought maximum variation in the sample of purposively selected participants. Interviews were recorded with audiotapes or detailed field notes, transcribed verbatim, coded, and analyzed using standard thematic analysis techniques.Results: Participants expressed overall support for the concept of TVR, but there is a core sense of unease that influenced overall staff perceptions. Despite several departmental presentations, very few participants actually had a solid understanding of how the TVR worked. Many were apprehensive about their own professional privacy, deeply concerned about vulnerable patients being filmed without consent, and questioned how video data would be used. Despite significant hesitancy, ED and trauma staff identified positive opportunities that TVR could bring, including providing an evidence base for quality improvement. Conclusions:TVR is an evolving approach to evaluate quality and patient safety in the trauma bay. As such it brings with it natural concerns and apprehension from staff regarding privacy, confidentiality, and how data will be captured and used. There is opportunity for these types of concerns to be addressed with a robust knowledge translation plan and engagement of staff throughout the implementation process.

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Method We performed a cluster randomised trial of community CPR training classes at Nowon District Health Community Centre in Seoul. CPR training classes were randomised into either intervention (instructor's objective real-time feedback based on the QCPR Classroom device or control (conventional, instructor's judgement-based feedback) group. Laerdal QCPR Classroom software is a real-time feedback device, which monitors quality of real-time CPR performances of multiple trainees simultaneously. During each training session, trainees practiced CPR five times. The primary outcome was the total CPR score, which is an overall measure of chest compression quality. Secondary outcomes were individual CPR performance parameters, including average number of compressions, average compression depth, percent adequate depth and percent acceptable release. Generalised linear mixed models were used to analyse the outcome data, accounting for both cluster-(random effect) and individual-(fixed effect) level factors. : A total of 149 training sessions (2613 trainees) were randomised into 70 intervention (1262 trainees) and 79 control (1351 trainees) groups. During the training, trainees in the QCPR feedback group significantly increased overall CPR score performance compared with those in the conventional feedback group (model-based mean D increment from baseline to session 5: 11.2 (95% CI: 9.2 to 13.2) and 8.0 (6.0-9.9), respectively) with statistically significant between group difference (p=0.02). Individual parameters of compression depth and release also showed higher improvement among trainees in QCPR group with marginal significance (p<0.08 for both). Results In this randomised trial, QCPR-Classroom based feedback during the CPR training session resulted in improved overall CPR quality. In this randomised trial, QCPR-Classroom based feedback during the CPR training session resulted in improved overall CPR quality. This suggests beneficial effect of instructor's real-time objective feedback on the quality of layperson's CPR performance. ConclusionThe training equipment used in this study (QCPR Classroom) was supported by the Laerdal Medical, but had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data.