Comparing Real-Time Feedback Modalities to Support Optimal Cardiopulmonary Resuscitation for Undergraduate Nursing Students: A Quasi-Experimental Cross-Over Simulation Study

Abstract

AIM: Optimal Cardiopulmonary Resuscitation (CPR) is reliant on a chain of well performed interventions and skills. To investigate whether CPR feedback devices improve performance for nursing students, the effects of three feedback modalities -Visual: Laerdal SimPad®;Visual-embodied metaphoric: Innosonian Brayden Pro®; and Visual-audio: Physio-Control TrueCPR® -was tested. METHODS:A quasi-experimental cross over study compared performance metrics of participant exposure to three feedback modalities and standard adult Basic Life Support (BLS) without feedback in a simulated environment. Following baseline training, 64 participants performed adult single rescuer BLS on a manikin for each modality and without feedback for two minutes. Effective chest compressions (correct depth, thoracic recoil, pressure point, rate, no-flow fraction) and ventilation parameters were compared using Friedman and Wilcoxon tests. RESULTS:Superior technical accuracy in CPR skills performance was evident with all feedback modalities when compared to no feedback p=<0.05); visual-audio feedback (TrueCPR®) was most effective (p=0.005). Participants demonstrated higher technical accuracy in CPR performance (30:2 cycles; chest compression number/rate/depth; chest recoil; pressure point; correct number of ventilations) when compared to no feedback (p=0.0001), despite achieving national certification three weeks prior to data collection.CONCLUSION: This appears to be the first study to explore the use of feedback modalities during CPR performance in nursing students. These feedback devices can play a major role in improving measurable parameters of BLS and psychomotor skill capability. Modalities varied in their ability to improve performance; visual-audio feedback significantly improved chest compressions, ventilation and cycle performance, while visual-graph-based feedback improved flow fraction and ventilations.

Learning practical nursing skills in simulation centers – A narrative review

“… Quantitative descriptive Pre / post / post 25 Third and fourth year Peripheral Venous Catheter(PVC) Avstick + SP and Static manikin Self-efficacy Communication skills The Avstick and the standard manikin similarly provided self-efficacy. The Avstick increased interpersonal skills to nursing students learning PVC insertion Dick-Smith et al., 2020 Australia To investigate whether CPR feedback devices improve performance for nursing students. QE IG (3 groups) Post 64 64 Third year CPR All groups CPR without feedback, then CPR with feedback from Simpad, TrueCPR, or Brayden Skill perf.…”

Determinants factors on Public Health Centre nurses' confidence in performing cardiopulmonary resuscitation

“…Several strategies can be used to build and maintain PHC nurse confidence. The need for simulation with real-time feedback is one of the strategies that can be done (Barbosa, Bias, Agostinho, Oberg, Lopes, & Sousa, 2019;Demirtas, Basak, Sahin, & Sonkaya, 2022;Demirtas, Guvenc, Aslan, Unver, Basak, & Kaya, 2021;Dick-Smith, Elliott, Martinez-Maldonado, & Power, 2020;Mather, & McCarthy, 2021;Moon, & Hyun, 2019). Simulations that are carried out regularly in various settings in PHC situations can not only increase the retention of knowledge and skills but can also build confidence when the actual simulation occurs.…”

Keep Me in the Loop: Real-Time Feedback with Multimodal Data

“…It measures compression depth and provides metronome sounds for the correct compression rate. The study from Dick-Smith et al (Dick-Smith et al, 2020) compared the three commercial devices just described looking at which modality combination (among visual, audio and embodied) support best undergraduate nursing students to acquire CPR skills. The combination of visual and audio of the TrueCPR appeared to be the most effective.…”