Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.

Introduction: The ability of laypersons to perform BLS/AED increases immediately after resuscitation training. Studies indicate that resuscitation skills rapidly decay after initial training, however it is unknown whether teaching technique influence retention of skill. Aim: To study the retention of BLS/AED skills three months after training when teaching laypersons using a four-stage and two-stage teaching technique. Methods: Laypersons (exclusion: health care professionals/students) were randomized to a standardized ERC BLS/AED courses using the four-stage teaching technique or to courses with the same content but modified to a two-stage teaching technique. Participants were tested in a simulated cardiac arrest scenario three months (±five days) after their course to assess retention of BLS/AED. Tests were video recorded and reviewed by two independent assessors blinded to training technique. Skills were assessed using the ERC BLS/AED assessment form. The primary endpoint was passing the test (17 out of 17 skills adequately performed). Results: A total of 160 participants were included in the study. No difference was found in pass rate immediately after training (diff. -1.6%; 95%CI -17.9%; 14.6%). There was no statistical difference in retention of BLS/AED skills (pass rate: both 11%, diff. -0.4%; 95%CI -28%-27%) three months after training . Total average skills adequately performed (of 17) were 13.7 versus 13.3 among laypersons trained with the four-stage (n=64) and the two-stage technique (n=64). No difference was found in number of chest compressions delivered per compression cycle (29±2.8 vs 30±3.1), chest compression rate (107±17 vs 108±19 minute-1), chest compression depth (46±11 vs 43±12 mm), number of effective rescue breaths between compression cycles (1.6±0.7 vs 1.6±0.5) and tidal volume (0.6±0.4 0.7±0.4 L). Conclusion: We found no difference in retention of BLS/AED skills among laypersons taught using a four-stage teaching technique compared to a two-stage teaching technique.

Introduction: Resuscitation guidelines recommend that unconscious and spontaneously breathing persons are placed in the recovery position to secure airway patency. Techniques for teaching the recovery position require evaluation. Aim: To evaluate acquisition and retention of recovery position skills among laypersons taught using a four-stage and two-stage teaching technique. Methods: Laypersons were randomized to a standardized European Resuscitation Council (ERC) courses in BLS/AED including training in recovery position using a four-stage teaching technique compared to modified course with the same content using a two-stage teaching technique. Participants were tested immediately after training and three months (±five days) later to assess acquisition and retention of recovery position skills. Tests were video recorded and reviewed by two assessors blinded to teaching technique. A skill checklist in accordance with the ERC guidelines representing the eight steps of the recovery position was used. The primary endpoint was passing the test (8 out of 8 skills). Result: In total, 160 participants were included. Total average number of steps of eight performed correctly was 7.3±1.0 (n=70) vs 7.1±1.1 (n=72) (p=0.5) immediately after the course and 4.1 ±2.3 (n=64) vs 3.8 ±2.3 (n=64) (p=0.4) three month later when using the four-stage and the two-stage technique, respectively. Correct final recovery position was obtained by 91% vs 93% immediately after the course and 49% vs 42% three month later. Each separate step of the recovery position is shown in Table 1. Conclusion: There was no difference in skill acquisition and retention when teaching laypersons recovery position using the four-stage and two-stage teaching technique. There was a marked decrease in skill level three months after training, particularly keeping the airway patent by head tilt and checking breathing regularly in both groups.