OP14 Understanding the experiences of pre-registration nurses, after using a mental simulation audio script for learning CPR

Abstract

Aim: To understand the experiences of pre-registration nurses who have used a mental simulation audio script for learning cardio-pulmonary resuscitation (CPR) skills Objectives: To co–construct a mental simulation audio script using the real–life cardiac arrest experiences of pre–registration nurses For 12 pre–registration nurses to use the CPR mental simulation audio script for 4 weeks To interview pre–registration nurses about their experiences of using the CPR mental simulation script To evaluate the data with a view to assessing the feasibility of undertaking larger scale trial using experimental methods to test the effectiveness of the CPR audio script as a learning tool Summary of work undertaken: Mental simulation can be defined as the cognitive visualisation of a task with a distinct absence of any overt physical movement.1 As part of an Education in Doctorate (EdD), I am currently studying the experiences of pre-registration nurses after using a mental simulation script for learning CPR skills. The mental simulation scenario script describes the imagined scenario. Mental simulation has been used to enhance the learning of many different skills in many disciplines, including (but not exclusive to) nursing, medicine, aviation, music and sport. The scenario script aids the learner in creating the mentally simulated images required for the task being learned. To add authenticity the script was co-constructed using the self-described experiences of pre-registration nurses who had been personally involved in performing CPR in a clinical setting. The student participants were interviewed about their experiences (reactions, memories, feelings etc) of undertaking CPR in clinical practice. An audio-script was then created based on these interviews. Over a four-week period, twelve pre-registration nurse participants used the newly created mental simulation audio-script so they could visualise themselves undertaking CPR. The participants were then interviewed, using a semi-structured interview technique, about their experiences of using the mental simulation audio-script. Overall, this study is an evaluation and feasibility study as a prelude to more experimental methods that will test the audio-script efficacy as learning tool. Impact on practice: Each element of high-quality CPR must be carried out precisely to increase the patient’s chances of survival to hospital to discharge. Failure to carry out just one of the elements inaccurately will result in a reduction in the patient’s chances of survival.2 Despite this, there are multiple examples of research findings showing that each one of these elements is often inadequately performed by healthcare practitioners,3 including pre-registration nursing.4 For this reason, CPR skill acquisition and retention remain a challenge to healthcare professional educators. Skill retention is seen to be more problematic where individuals receive initial training that they may not be required to use for extended periods of time5 and this certainly applies to CPR training. Using a mental simulation audio-script to learn CPR skills is potentially a cost-effective and sustainable way of self-directed learning of CPR skills for all healthcare professionals, including pre-registration nurses. Using mental simulation could potentially take CPR skill acquisition from declarative to procedural state of skill acquisition, meaning that it is immune to skill decay. This would allow the practitioner to perform CPR accurately and proficiently when required to do so. References Arora S, Aggarwal R, Hull L, Miskovic D, Kneedone R, Darzi A, Sevdalis N. Mental practice enhances technical skills and teamwork in crisis simulations - a double blind, randomised controlled study. Journal of the American College of Surgeons 2011;213(3):S126–S134. Zuercher M, Hilwig RW, Ranger-Moore J, Nysaether J, Nadkarni VM, Berg M, Berg RA. Leaning during chest compressions impairs cardiac output and left ventricular myocardial blood flow in piglet cardiac arrest. Critical Care Medicine 2010;38(4):1141–1146. Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J, Berg R. Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation 2009;120(13):1241–1247. Kardong-Edgren S, Adamson KA. BSN Medical-Surgical Student Ability to Perform CPR in a Simulation: Recommendations and Implications. Clinical Simulation in Nursing 2009;5:e79–e83. Kim JW, Ritter FE, Koubek RJ. An integrated theory for improved skill acquisition and retention in the three stages of learning. Theoretical Issues in Ergonomics Science 2013;14(1):22–37.