Does increasing self-reliant learning in a cardiopulmonary resuscitation laboratory improve knowledge and confidence acquisition?

Abstract

This investigation determined if increasing the degree of self-reliant learning (allowing students to set goals, identify resources, and implement learning strategies) in an Anesthetic Emergencies/Cardiopulmonary Resuscitation laboratory learning exercise would increase surface knowledge and confidence acquisition. A total of 100 students enrolled in a surgical exercises course in the junior year of a DVM program participated. One month prior to the laboratory devoted to Anesthetic Emergencies/Cardiopulmonary Resuscitation, students in two of four laboratory sections were asked to submit a protocol designed for the laboratory that included cardiopulmonary arrest and resuscitation, jugular venous catheterization with central venous pressure measurement, and tracheotomy. The validity of the methodology included in the protocols was reviewed by the instructor prior to the laboratory. The remaining two laboratory sections were given a laboratory outline that included specific directions for the target procedures, as well as instructor-selected references. A 10-question multiple choice question test designed to test surface knowledge was given at the beginning of the laboratory and the same 10 questions were embedded in the final examination for the surgical exercises course. At the beginning and end of the laboratory, each student was asked to rate his/her confidence level associated with administering CPR (visual analogue scale). Group means were compared using a Wilcoxon's rank sum test (p < 0.05) and anova for repeated measures was used to test for differences in confidence levels and test scores over time (p < 0.05). There was no significant difference between the mean (±SEM) entry quiz test score for the Self-Reliant Learning (SRL) group (4.1 ± 0.26) and that for the Instructor-Directed Learning (IDL) group (4.6 ± 0.24). The exit quiz scores for the IDL group (5.2 ± 0.224) were significantly higher than those for the SRL group (3.9 ± 0.21) although the difference between entry and exit quiz scores for the two groups was not significant. There was no significant difference between entry or exit confidence levels for the two groups. Students in the SRL group reported investing a significantly greater number of hours in preparation for the laboratory than students in the IDL group (4.8 ± 0.4 versus 3.0 ± 0.23). There was no significant difference between how the two groups rated the quality of the learning experience (IDL = 7.3 ± 0.33; SRL = 7.2 ± 0.33). In comparison to IDL, an isolated SRL experience does not significantly increase surface knowledge acquisition or retention, confidence level associated with target skills, or estimation of the quality of learning experience.