Abstract Background The role of e-learning in contemporary healthcare education is quickly developing. The aim of this study was to examine the relationship between the use of an e-learning ...simulation programme (Microsim™, Laerdal, UK) prior to attending an Advanced Life Support (ALS) course and the subsequent relationship to candidate performance. Methods An open label, multi-centre randomised controlled study was conducted. The control group received a course manual and pre-course MCQ four weeks prior to the face to face course. The intervention group in addition received the Microsim programme on a CD. The primary outcome was performance during a simulated cardiac arrest at the end of the course. Secondary outcomes were performance during multiple choice exams, resuscitation skills assessments and feedback to Microsim programme. Results 572 participants were randomised (287 Microsim, 285 control). There were no significant differences in the primary outcome (performance during a standard cardiac arrest simulation) or secondary outcomes. User evaluations were favorable. 79% would recommend it to colleagues. 9% stated Microsim could replace the entire ALS course, 25% parts. Over 70% of participants’ perceived that Microsim improved their understanding of the key learning domains of the ALS course. Conclusion Distributing Microsim to healthcare providers prior to attending an ALS courses did not improve either cognitive or psychomotor skills performance during cardiac arrest simulation testing. The challenge that lies ahead is to identify the optimal way to use e-learning as part of a blended approach to learning for this type of training programme.
Abstract Background Studies have shown that blended approaches combining e-learning with face-to-face training reduces costs whilst maintaining similar learning outcomes. The preferences in learning ...approach for healthcare providers to this new style of learning have not been comprehensively studied. The aim of this study is to evaluate the acceptability of blended learning to advanced resuscitation training. Methods Participants taking part in the traditional and blended electronic advanced life support (e-ALS) courses were invited to complete a written evaluation of the course. Participants’ views were captured on a 6-point Likert scale and in free text written comments covering the content, delivery and organisation of the course. Proportional-odds cumulative logit models were used to compare quantitative responses. Thematic analysis was used to synthesise qualitative feedback. Results 2848 participants from 31 course centres took part in the study (2008–2010). Candidates consistently scored content delivered face-to-face over the same content delivered over the e-learning platform. Candidates valued practical hands on training which included simulation highly. Within the e-ALS group, a common theme was a feeling of “time pressure” and they “preferred the face-to-face teaching”. However, others felt that e-ALS “suited their learning style”, was “good for those recertifying”, and allowed candidates to “use the learning materials at their own pace”. Conclusions The e-ALS course was well received by most, but not all participants. The majority felt the e-learning module was beneficial. There was universal agreement that the face-to-face training was invaluable. Individual learning styles of the candidates affected their reaction to the course materials.
To compare the effectiveness of cognitive aid use during resuscitation with no use of cognitive aids on cardiopulmonary resuscitation quality and performance.
This systematic review followed the ...PICOST format. All randomised controlled trials and non-randomised studies evaluating cognitive aid use during (simulated) resuscitation were included in any setting. Unpublished studies were excluded. We did not include studies that reported cognitive aid use during training for resuscitation alone. Medline, Embase and Cochrane databases were searched from inception until July 2019 (updated August 2022, November 2023, and 23 April 2024). We did not search trial registries. Title and abstract screening, full-text screening, data extraction, risk of bias assessment (using RoB2 and ROBINS-I), and certainty of evidence (using GRADE) were performed by two researchers. PRISMA reporting standards were followed, and registration (PROSPERO CRD42020159162, version 19 July 2022) was performed. No funding has been obtained.
The literature search identified 5029 citations. After removing 512 duplicates, reviewing the titles and abstracts of the remaining articles yielded 103 articles for full-text review. Hand-searching identified 3 more studies for full-text review. Of these, 29 studies were included in the final analysis. No clinical studies involving patients were identified. The review was limited to indirect evidence from simulation studies only. The results are presented in five different populations: healthcare professionals managing simulated resuscitations in neonates, children, adult advanced life support, and other emergencies; as well as lay providers managing resuscitations. Main outcomes were adherence to protocol or process, adherence to protocol or process assessed by performance score, CPR performance and retention, and feasibility of chatbot guidance. The risk of bias assessment ranged from low to high. Studies in neonatal, paediatric and adult life support delivered by healthcare professionals showed benefits of using cognitive aids, however, some studies evaluating resuscitations by lay providers reported undesirable effects. The performance of a meta-analysis was not possible due to significant methodological heterogeneity. The certainty of evidence was rated as moderate to very low due to serious indirectness, (very) serious risk of bias, serious inconsistency and (very) serious imprecision.
Because of the very low certainty evidence from simulation studies, we suggest that cognitive aids should be used by healthcare professionals during resuscitation. In contrast, we do not suggest use of cognitive aids for lay providers, based on low certainty evidence.
The objective of this study was to evaluate the impact of the prior participation of one or more members of the adult resuscitation team in an accredited advanced life support course on patient ...outcomes (return of spontaneous circulation, survival to discharge, survival to 30 days, and survival to 1 year).
A systematic search of Medline, CINAHL, Embase, ERIC, and Cochrane databases was conducted through 6 March 2018. We included randomised and observational studies in any language. Reviewers independently extracted data on study design and outcomes. The GRADE approach was used to evaluate the overall quality of evidence for each outcome.
Nine hundred and ninety-two articles were identified of which eight observational studies were included. No randomised controlled trials were identified. Meta-analysis showed an association between participation of healthcare personnel in an advanced life support course and return of spontaneous circulation odds ratio (OR) 1.64; 95% CI 1.12–2.41, risk difference (RD) 0.10 (95% CI 0.03–0.17). Life support training showed a significant absolute effect on patient survival to discharge RD 0.10, 95% CI 0.01–0.18, but non-significant relative effect OR 2.12; 95% CI 0.98–4.57. Data from one study showed an association with survival to 30 days OR 7.15; 95% CI 1.61–31.69, RD 0.18 (95% CI 0.08–0.27).
The inference of this review is that the advanced life support courses have a positive impact upon return of spontaneous circulation and survival to hospital discharge. The data also implies a positive impact upon survival to 30 days of adult cardiac arrest patients.
CPR Quality Assessment in Schoolchildren Training Oliveira, Katia M. G.; Carmona, Maria José C.; Mansur, Antonio P. ...
Journal of cardiovascular development and disease,
11/2022, Letnik:
9, Številka:
11
Journal Article
Recenzirano
Odprti dostop
Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in ...schoolchildren, compared with a real-time software. This observational study (March 2019–2020) included 104 schoolchildren with no previous CPR training (11–17 years old, 66 girls, 84 primary schoolchildren, 20 high schoolchildren). Simultaneous evaluations of CPR quality were performed using an observational checklist and real-time software. High-quality CPR was determined as a combination of 70% correct maneuvers in compression rate (100–120/min), depth (5–6 cm), and complete release, using a real-time software and three positive performance in skills using a checklist. We adjusted a multivariate logistic regression model for age, sex, and BMI. We found moderate to high agreement percentages in quality of CPR performance (rate: 68.3%, depth: 79.8%, and complete release: 91.3%) between a checklist and real-time software. Only 38.5% of schoolchildren (~14 years-old, ~54.4 kg, and ~22.1 kg/m2) showed high-quality CPR. High-quality CPR was more often performed by older schoolchildren (OR = 1.43, 95%IC:1.09–1.86), and sex was not an independent factor (OR = 1.26, 95%IC:0.52–3.07). For high-quality CPR in schoolchildren, a checklist showed moderate to high agreement with real-time software. Better performance was associated with age regardless of sex and BMI.
The rate of survival from out-of-hospital cardiac arrest in Europe remains unacceptably low and could be increased by better bystander cardiopulmonary resuscitation (CPR) rates. The European ...Resuscitation Council has announced that there will be a European Cardiac Arrest Awareness Day every year on the 16th of October. This is to coincide with the goals of the Written Declaration passed by the European Parliament in June 2012 that emphasised the importance of equal access to CPR and automated external defibrillator (AED) training. The topic of this year's Awareness Day is ‘Children Saving Lives’ and it is hoped that all national resuscitation councils will promote awareness of the benefits of training all children in CPR and AED use and lobby for legislative change to ensure that all children receive this training. Children are not just the adults of tomorrow – they are the lifesavers of today and tomorrow.
Abstract Aim The cardiac arrest simulation test (CASTest) assesses resuscitation knowledge and skills during a simulated cardiac arrest. The aim of this study is to validate an alternative scoring ...system for measuring individual candidate performance during research involving the CASTest. Methods The performance of 537 participants was measured using the new scoring system. Evidence of internal structure was sought by comparing the score with global rating of performance and pass/fail decision; identification of participants with instructor potential, skill tests and MCQ scores. Relationships between CASTest score, profession and seniority were also examined. Results Global assessment of performance identified 413 passes (76.9%) and 124 fails (23.1%). CASTest score was significantly higher in those that passed than in those that failed (median 77 vs 62.5, P < 0.0001). There were no differences between professions. Senior staff performed slightly better than junior staff (median 74 and 72 respectively, P = 0.01). Excellent participants (identified as having instructor potential) scored significantly higher than the other participants (median 94 and 72 respectively, P < 0.0001). A strong correlation was demonstrated between domains in the CASTest (rho 0.72–0.82, P < 0.01). Other assessment outcomes for the ALS course correlated poorly with CASTest scores (rho 0.27–0.37, P < 0.01). Conclusion This new simple scoring system can be used to better characterise performance on the ALS course CASTest than the current binary pass–fail outcome.
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