A nationwide investigation of CPR courses, books, and skill retention

Abstract

Introduction: Survival from Out-of-Hospital Cardiac Arrest is highly associated with bystander cardiopulmonary resuscitation. The quality of bystander CPR is influenced by citizens attending Basic Life Support (BLS) courses and the quality of these courses. The purpose of the study was to investigate content, quality and compliance with the European Resuscitation Council (ERC) guidelines in national Danish BLS courses and the skill retention. Methods: Books from 16 different course providers were analyzed for compliance with guidelines using the principle of mutually exclusive and collectively exhaustive questioning. Observation of 56 BLS courses were conducted using an evaluation sheet, with a five-point Likert scale including theoretical, technical, and non-technical skills. BLS skills of participants were assessed with a follow-up test 4-6 months after a course using a modified Cardiff Test. Results: Analysis of the books, showed compliance with ERC guidelines of 69% on the examined items. Courses using ERC educational structure and having maximum six participants per instructor were associated with high quality in the course observations and a better follow-up test. Especially, the use of automated external defibrillator showed significant odds ratio (OR) of 21.8 (95% CI 4.1-114.7) to 31.3 (95% CI 3.7-265.1) of achieving high quality on courses with similar results in the follow-up test. Conclusion: National BLS courses had significant variation in the content of books, and compliance to ERC guidelines during courses and in skills retention 4-6 months after the courses. This study can be used to further improve and standardize BLS courses.

Effectiveness of web-based education in addition to basic life support learning activities: A cluster randomised controlled trial

“…This study may be considered for further web-based education in addition to international science and practice and new perspectives [1, 32, 38–40]. E-learning prior to the advanced life support (ALS) course for medical professionals resulted in equal overall scores for practical skills when compared with traditional training in ALS.…”

The effective group size for teaching cardiopulmonary resuscitation skills – A randomized controlled simulation trial

“…18 In 2019, Jensen et al showed that BLS courses with a maximum of six participants per instructor were associated with higher CPR quality. 19 To the best of our knowledge there is no study systematically evaluating effectiveness of CPR teaching with varying group sizes. Our results show that an instructor is unable to effectively detect 80% of errors made by BLS course participants if the instructor-toparticipant ratio is greater than one to six.…”

“…18 Jensen et al found significantly higher AED use (odds ratio 21.78) and increased chest compression depth and rate (ORs of 7.47 and 15.47, respectively) while evaluating BLS courses if there were six or fewer participants per instructor. 19 Detecting errors during teaching and providing corrective feedback is a string enabler of learning. 20 However, the optimal group size for group CPR teaching, which would enable instructors to oversee all participants and support all learners optimally during the course, is unknown while it may have strong implications on quality and resources needed.…”

Quality improvement for self-confidence, critical-thinking, and psychomotor skills in basic life support of nursing health professionals through case-scenario simulation training

“…For future sessions, individuals who need or want more handson practice for bag-valve-mask use will need to be more effectively identified or allowed more time for everyone to practice on the mannequin with directed feedback. [26] Using a case scenario with simulation helped learners apply knowledge and skills in context and learn a systematic approach, so reasoning and logic are engaged rather than trying to recall rote memorization. One study found learners improved and retained CPR skills using a problem based learning (PBL) style while using a high-fidelity simulation compared to a group that only received a lecture.…”

“…During a three-day period, the staff were divided into groups of five or six learners, an ideal group size for effective simulation learning. [26] Each group was assigned a one-hour time slot to participate in a team-based case scenario using a high-fidelity mannequin and staggered in a manner that did not compromise patient care. Each of the sessions consisted of a ten-minute pre-briefing to orient learners to the simulation environment and state the "simulation contract", which is the necessity for learners to suspend disbelief and act as one would in a real patient situation.…”