What is the impact of structured resuscitation training on healthcare practitioners, their clients and the wider service? A BEME systematic review: BEME Guide No. 20

Abstract

A large number of resuscitation training courses (structured resuscitation training programmes (SRT)) take place in many countries in the world on a regular basis. This review aimed to determine whether after attending SRT programmes, the participants have a sustained retention of resuscitation knowledge and skills after their initial acquisition and whether there is an improvement in outcome for patients and/or their healthcare organisation after the institution of an SRT programme. All research designs were included, and the reported resuscitation training had to have been delivered in a predefined structured manner over a finite period of time. Data was extracted from the 105 eligible articles and research outcomes were assimilated in tabular form with qualitative synthesis of the findings to produce a narrative summary. Findings of the review were: SRTs result in an improvement in knowledge and skills in those who attend them, deterioration in skills and, to a lesser extent, knowledge is highly likely as early as three months following SRTs, booster or refresher sessions may improve an individual's ability to retain resuscitation skills after initial training and the instigation of resuscitation training in a healthcare institution significantly improves clinical management of resuscitations and patient outcome (including survival) after resuscitation attempts.

A longitudinal cohort study to investigate the retention of knowledge and skills following attendance on the Newborn Life support course

“…This is the first time that this phenomenon has been demonstrated after the NLS course and confirms the findings of studies on other resuscitation courses 6. Loss of skills occurred despite recruitment taking place at a regional neonatal centre where candidates have more experience than others from smaller units.…”

“…The testing of practical skills is crucial to assess if someone is a competent practitioner. We have shown in a recent systematic review that knowledge, and particularly skills, may deteriorate as early as 3 months after a resuscitation course 6. This issue has not been studied with respect to the neonatal life support (NLS) course.…”

Can I (still) resuscitate a baby?

“…They found, upon reassessing at 3–5 months and again at 12–14 months, that the skills of candidates had deteriorated, particularly if there had been little clinical exposure to neonatal resuscitation. This is not an unknown phenomenon: the same author has published similar findings about other resuscitation courses 3. The majority tested failed on simple important measures such as assessing the heart rate, changing the wet towel and asking the assessor about mannequin chest movement rather than more complex manoeuvres.…”

Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study

“…However, in our opinion, training is necessary but not sufficient: knowledge and skills begin to deteriorate within as little as three months after training (18,19), and the translation of skills from training environments to the setting of an actual cardiac arrest is another issue (8). There were therefore good reasons for evaluating the usefulness of real-time video communication between an intensivist at a remote location and the resident dealing with the pCPA.…”