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

Abstract

BackgroundOptimal 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. MethodA 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. After 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. ResultsSuperior technical accuracy in CPR skills performance was evident with all feedback modalities when compared with no feedback p = <.05); visual-audio feedback (TrueCPR®) was most effective (p = .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 with no feedback (p = .0001), despite achieving national certification three weeks before data collection. ConclusionThis 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, whereas visual-graph–based feedback improved flow fraction and ventilations.