The effects of flipped learning for bystander cardiopulmonary resuscitation on undergraduate medical students

Abstract

ObjectivesTo compare bystander cardiopulmonary resuscitation skills retention between conventional learning and flipped learning for first-year medical students. MethodsA post-test only control group design. A total of 108 participants were randomly assigned to either the conventional learning or flipped learning. The primary outcome measures of time to the first chest compression and the number of total chest compressions during a 2-minute test period 6 month after the training were assessed with the Mann-Whitney U test. ResultsFifty participants (92.6%) in the conventional learning group and 45 participants (83.3%) in the flipped learning group completed the study. There were no statistically significant differences 6 months after the training in the time to the first chest compression of 33.0 seconds (interquartile range, 24.0-42.0) for the conventional learning group and 31.0 seconds (interquartile range, 25.0-41.0) for the flipped learning group (U=1171.0, p=0.73) or in the number of total chest compressions of 101.5 (interquartile range, 90.8-124.0) for the conventional learning group and 104.0 (interquartile range, 91.0-121.0) for the flipped learning group (U=1083.0, p=0.75). The 95% confidence interval of the difference between means of the number of total chest compressions 6 months after the training did not exceed a clinically important difference defined a priori. ConclusionsThere were no significant differences between the conventional learning group and the flipped learning group in our main outcomes. Flipped learning might be comparable to conventional learning, and seems a promising approach which requires fewer resources and enables student-centered learning without compromising the acquisition of CPR skills.

Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: a systematic literature review comparing different training methodologies

“… Korea 2015 [ 24 ] Peer-assisted learning vs. professional instructor training Prospective Case-Control Study 187 High-school Students No CPR performance and knowledge No difference in willingness to perform CPR (64.7% vs. 55.2%, p = 0.202) and knowledge retention (61.76 ± 17.80 vs. 60.78 ± 39.77, p = 0.848) between peer-assisted and professional instructor groups. Standard versus Hybrid CPR Training Japan 2017 [ 25 ] Coventional vs. flipped learning Interventional Study 108 Medical Students No CPR quality No difference in time to first chest compression (33 s vs. 31 s, p = 0.73) or number of chest compressions (101.5 vs. 104, p = 0.75). USA 2019 [ 26 ] Traditional vs. video-only vs. video + hands-on session at a Kiosk Randomized Controlled Trial 738 layperson No CPR performance and quality After the initial education session, the video-only group had a lower total score (compressions correct on hand placement, rate, and depth) (−9.7; 95% confidence interval [CI] -16.5 to −3.0) than the classroom group.…”

“…Moreover, variability was also noted in the standard of content taught between different training methods and within each training method as well. Although “Einlebenretten” (“save one life”) educational framework [ 20 ] and European Resuscitation Council (ERC) 2010 guidelines [ 21 , 34 ] were the two contents similar between standard and non-standard face to face CPR training, the standard training group also used contents from ERC 2005 guidelines [ 34 ], American Heart Association (AHA) Heartsaver Citizen CPR course [ 27 , 28 , 31 , 38 ], AHA 2010 guidelines [ 25 ], National Safety Council Adult CPR training program [ 29 ], HeartCode BLS course [ 33 ], Dutch Resuscitation Council course [ 37 ], and Danish Red Cross course [ 36 ]. Although the computer-based HeartCode BLS course [ 33 ] and National Center for Early Defibrillation course [ 27 ] were similar between hybrid and online CPR training methodology, the standard of content was also adopted from other sources in these instructional methods.…”

“…Although the computer-based HeartCode BLS course [ 33 ] and National Center for Early Defibrillation course [ 27 ] were similar between hybrid and online CPR training methodology, the standard of content was also adopted from other sources in these instructional methods. The hybrid teaching methodology had contents from Japanese Red Cross Society [ 25 ] and AHA 2010 guidelines [ 25 ], while online training method adopted content from National Safety Council Adult CPR training program [ 29 ] and TrygFonden foundation [ 36 ]. The content (CPR, ventilation, and breathing) and outcomes measured (CPR performance, quality, knowledge, attitude, self-confidence, and willingness to perform CPR) were similar between the training methodologies.…”

“… CPR Quality 1. No statistically significant difference in time to first chest compression (33 s vs. 31 s, U = 1171, p = 0.73) and number of total chest compressions (101.5 vs. 104, U = 1083, p = 0.75) between the instructor-led and flipped learning group, respectively [ 25 ]. 2.…”

“…In terms of CPR quality, no significant difference was noted in time to first chest compression (33 s vs. 31 s, U = 1171, p = 0.73) and number of total chest compressions (101.5 vs. 104, U = 1083, p = 0.75) between the instructor-led group and flipped learning group [ 25 ]. Furthermore, the kiosk group and the instructor-led group had similar total scores after training [ 26 ].…”