The timing of testing influences skill retention after basic life support training: a prospective quasi-experimental study

Abstract

BackgroundProper basic life support (BLS) is key in improving the survival of out-of-hospital cardiac arrest. BLS skills deteriorate in three to 6 months after training. One method to improve skill retention may be using the “testing effect” to test skills at the end of a BLS course. The aim of our study was to investigate whether either testing or the timing of such testing after BLS training have any influence on skill retention.MethodsThis was a post-test only, partial coverage, prospective quasi-experimental study designed to evaluate a BLS training course among 464 fifth year medical students at Semmelweis University in the first semester of 2013/2014. Groups were systematically but non-randomly assigned to either a control group that took no exam or one of two experimental groups that took an exam (N = 179, NoExam group; N = 165, EndExam group – exam at the end of the BLS training; N = 120, 3mExam group – exam 3 months after the BLS training). The ability to perform ten prescribed essential BLS steps was evaluated during a skill retention assessment 2 months after the course in the NoExam, 2 months after the course (and the exam) in the EndExam and 5 months after the course (2 months after the exam) in the 3mExam group to measure skill retention and the effect of our intervention. Scores were calculated for each BLS step, and also summed up as a total score. We used Kruskal-Wallis test to assess differences in skill retention.ResultsOverall, NoExam and EndExam groups showed similar skill retention. The mean total score (and many of the sub-scores) of students was significantly higher in the 3mExam group compared to both the NoExam and the EndExam groups, and there was no difference in the total score (and many of the sub-scores) of the latter two groups. The 3mExam group had less variability in total scores (and many of the sub-scores) than the other two groups.ConclusionOur study provides evidence that testing these skills 3 months after BLS training may be more effective than either testing immediately at the end of the course or no testing at all.

Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study

“…Other means for successful skills retention include watching training videos, e.g., for cardiopulmonary resuscitation (CPR) [ 13 ], or watching a video of one’s own CPR performance during a previous training [ 14 ]. Repeated assessments of CPR skills, e.g., in an OSCE, also increased retention [ 30 ], presumably because of the testing effect [ 31 ]. Feedback during CPR trainings also led to longer skills retention, i.e., 1 year [ 15 ], while feedback during laparoscopy training only increased participants’ immediate performance but had no long-term effect [ 32 ].…”

Comparison of Long-Term Effects between Chest Compression-Only CPR Training and Conventional CPR Training on CPR Skills among Police Officers

“…After placing trained police on the site, on-set time of CPR performance and using AED were significantly faster, and survival rates were significantly increased. In this way, detailed legal standards for CPR training contents including AED education, training hours, and training methods should be prepared to get actual results [ 47 , 48 , 49 , 50 , 51 , 52 , 53 ].…”

Short-Term Learning Effects of a Cardiopulmonary Resuscitation Program with Focus on the Relationship between Learning Effect and Trainees’ Perceived Competence

“…Moreover, our results also suggest the limits feedback provided by instructors may have. Studies comparing conventional training by instructors and training using a feedback device reported that training using a feedback device was more effective than conventional training [ 12 , 13 , 36 , 41 ]. Spooner et al found the same results as above; however, their results showed this effectiveness not only immediately after training, but also after 6 weeks of training [ 41 ].…”

“…Therefore, there are numerous studies to identify better educational methods to improve basic life support (BLS) skill effectively and achieve long term retention. Kovács et al investigated the influences of timing of testing on skill retention, and found that testing skills 3 months after training may be more effective than either testing immediately after training or not testing at all [ 12 ]. Moreover, real-time visual feedback devices [ 13 , 14 , 15 ], audio–visual feedback devices [ 16 , 17 ], and smartwatch feedback devices [ 18 , 19 , 20 ] have shown to improve the quality of CPR training.…”