Resuscitation training in developing countries: Importance of a stable program of formation of instructors

Abstract

We have read with interest the article of Meaney et al. about Resuscitation training in developing countries.1Meaney P.A. Topjian A.A. Chandler H.K. et al.Resuscitation training in developing countries: a systematic review.Resuscitation. 2010; 81: 1462-1472Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar This excellent revision shows that it is possible to organize educational training programs concerning Resuscitation in developing countries. However, no studies have demonstrated that training in resuscitation improves mortality secondary to cardiac arrest, regardless the development degree of the country. In our experience, the results of resuscitation courses in developing countries such as Honduras are similar to those launched in developed countries as in Europe, despite student previous knowledge could be lower.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google ScholarConversely, in our opinion the precise results obtained after diverse resuscitation training programs are not the most important issue. We believe that the solution to the lack of expertise in resuscitation is not that health care professionals of developed countries perform resuscitation courses in the developing countries.“Give a man a fish; feed him for a day. Teach a man to fish; feed him for a lifetime”. This Chinese proverb is also applicable to education in resuscitation. In resuscitation, this idea should prompt to teach instructors in resuscitation in developing countries. The expansion of a stable educational program able to achieve self efficacy, were the developing countries can teach themselves in an autonomous way, is the unique intervention capable to improve on a long term basis the education in resuscitation. The major role of the instructors of the developed countries should be not only to travel to the developing countries to teach CPR courses, but essentially to teach local health care instructors, to establish the structured programs and to contribute to the foundation of stable training centers. Education in resuscitation must be adapted in each country to the characteristics of the population. Each country knows what it needs and the best way to carry out an educational project. The collaboration between groups can be stable, but must aim at economic, scientific, and educational independence.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google ScholarIt is therefore essential to create a group of instructors, selected from CPR course students, who are able to maintain the training chain in order for them to reproduce and extend the courses rapidly and independently.The Spanish-Latin American Network for the Study of Cardiopulmonary Arrest in Childhood (RIBECPI) belonging to the Science and Technology Program for Development (CYTED) was set up and one of its main objectives is to stimulate and support the creation of pediatric CPR training groups in Latin American countries.3López-Herce J. Latin American network study of cardiopulmonary arrest in childhood.Ann Pediatr (Barc). 2009; 71: 177-178Crossref Scopus (4) Google ScholarThe aim of this project is to establish a progressive, long-term training programme managed by a local group able to develop pediatric CPR training in its own country, and to contribute to the spread of similar programmes to neighbouring countries. We begun the experience in Honduras in 2008 and it continued in Guatemala and Dominican Republic.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google Scholar The Honduras Resuscitation Group has taught 191 providers in advanced pediatric life support, 97 in pediatric basic life support and it has performed the first independent pediatric instructor course.In our opinion the training of independent CPR training groups through scientific collaboration and assessment by countries with experience is the most effective model for developing CPR education in developing countries.Conflicts of interestAll authors declare no conflict of interest. We have read with interest the article of Meaney et al. about Resuscitation training in developing countries.1Meaney P.A. Topjian A.A. Chandler H.K. et al.Resuscitation training in developing countries: a systematic review.Resuscitation. 2010; 81: 1462-1472Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar This excellent revision shows that it is possible to organize educational training programs concerning Resuscitation in developing countries. However, no studies have demonstrated that training in resuscitation improves mortality secondary to cardiac arrest, regardless the development degree of the country. In our experience, the results of resuscitation courses in developing countries such as Honduras are similar to those launched in developed countries as in Europe, despite student previous knowledge could be lower.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google Scholar Conversely, in our opinion the precise results obtained after diverse resuscitation training programs are not the most important issue. We believe that the solution to the lack of expertise in resuscitation is not that health care professionals of developed countries perform resuscitation courses in the developing countries. “Give a man a fish; feed him for a day. Teach a man to fish; feed him for a lifetime”. This Chinese proverb is also applicable to education in resuscitation. In resuscitation, this idea should prompt to teach instructors in resuscitation in developing countries. The expansion of a stable educational program able to achieve self efficacy, were the developing countries can teach themselves in an autonomous way, is the unique intervention capable to improve on a long term basis the education in resuscitation. The major role of the instructors of the developed countries should be not only to travel to the developing countries to teach CPR courses, but essentially to teach local health care instructors, to establish the structured programs and to contribute to the foundation of stable training centers. Education in resuscitation must be adapted in each country to the characteristics of the population. Each country knows what it needs and the best way to carry out an educational project. The collaboration between groups can be stable, but must aim at economic, scientific, and educational independence.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google Scholar It is therefore essential to create a group of instructors, selected from CPR course students, who are able to maintain the training chain in order for them to reproduce and extend the courses rapidly and independently. The Spanish-Latin American Network for the Study of Cardiopulmonary Arrest in Childhood (RIBECPI) belonging to the Science and Technology Program for Development (CYTED) was set up and one of its main objectives is to stimulate and support the creation of pediatric CPR training groups in Latin American countries.3López-Herce J. Latin American network study of cardiopulmonary arrest in childhood.Ann Pediatr (Barc). 2009; 71: 177-178Crossref Scopus (4) Google Scholar The aim of this project is to establish a progressive, long-term training programme managed by a local group able to develop pediatric CPR training in its own country, and to contribute to the spread of similar programmes to neighbouring countries. We begun the experience in Honduras in 2008 and it continued in Guatemala and Dominican Republic.2Urbano J. Matamoros M.M. López-Herce J. et al.A paediatric cardiopulmonary resuscitation training project in Honduras.Resuscitation. 2010; 81: 472-476Abstract Full Text Full Text PDF Scopus (15) Google Scholar The Honduras Resuscitation Group has taught 191 providers in advanced pediatric life support, 97 in pediatric basic life support and it has performed the first independent pediatric instructor course. In our opinion the training of independent CPR training groups through scientific collaboration and assessment by countries with experience is the most effective model for developing CPR education in developing countries. Conflicts of interestAll authors declare no conflict of interest. All authors declare no conflict of interest.