Basic Life Support Instructors Research Articles

Effectiveness of basic life support training course intervention among dental practitioners and students - An experimental study.

To determine the level of knowledge and skill of basic life support (BLS) among undergraduate, postgraduate students, and general practitioners with and without regular attendance of the BLS Healthcare Provider course. The study was carried out at two intervals with two groups. A random sample involving undergraduate students, postgraduate students, and dental professionals was selected for both study groups. Group 1 with 440 participants had not attended BLS for Healthcare Providers Course in the last two years. Group 2 with 410 participants had attended the BLS for Healthcare Providers course regularly once a year. First, participants in Group 1 were evaluated using an MCQ test with 30 questions about their knowledge and skills in BLS. Then, a well-trained BLS instructor team from Dental College & Hospital offered BLS healthcare provider courses to students and dentists. Subsequently, Group 2 participants who had completed a BLS course for healthcare providers last year were also assessed for their knowledge and skills in BLS using another MCQ test. The marks obtained in the tests were tabulated and analyzed. To determine the association between variables with respect to mean knowledge score, t-test was employed. Multiple group comparison was made using analysis of variance and P < 0.05 was considered statistically significant. The group 1 participants score a mean of 5.7 marks against the Group 2 with a mean score of 27.4 marks out of 30 marks. Knowledge and skill in BLS skills among those in Group 1 without prior BLS training was mainly low. Dental practitioners performed marginally better than students in both groups. Based on the results, we make the following observations. With the introduction of BLS training into the academic curriculum and routine BLS hands-on workshops, all healthcare providers will be familiar with the BLS skills to effectively manage the life-threatening emergencies.

KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren: A Narrative Review and Scientific Statement From the International Liaison Committee on Resuscitation.

Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren. After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included. Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages. Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.

KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren: A Narrative Review and Scientific Statement From the International Liaison Committee on Resuscitation

BACKGROUNDBasic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren. METHODSAfter topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included. RESULTSSchoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages. CONCLUSIONSSchoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.

The role of specialised content knowledge in teaching basic life support

Objective: To investigate the role of specialised content knowledge in instructor training on the teaching and learning of basic life support (BLS) in secondary schools. Design: Cluster randomised controlled trial. Setting: Data were collected in three Flemish secondary schools during physical education classes. Method: Three secondary schools were randomly assigned to a 60-minute BLS instructor training without (one school, three teachers) or with (two schools, five teachers) a focus on recognising and addressing common errors. Knowledge of common errors in the performance of BLS and how to correct these is referred to as specialised content knowledge. Following instructor training, all teachers taught BLS lessons to different students. Teachers’ use of time and interactions were assessed by means of systematic observation. BLS performance was assessed individually and unannounced to students ( n = 294) one week following their training using a validated protocol. Results: On average, specialised content knowledge teachers interacted more with their students compared to common content knowledge teachers (8 vs 3 teacher interactions per lesson to the class as a whole, 43 vs 31 teacher interactions per lesson to students individually). In addition, students taught by specialised content knowledge teachers achieved significantly higher BLS scores (66% vs 61%; p &lt; .05). Overall, average BLS performance of students correlated positively with the amount of time reserved for hands-on practice, r(21) = .51; p &lt; .05. Conclusion: Specialised content knowledge (i.e. recognising and addressing common errors) should be part of BLS instructor training courses.

Piloting a Basic Life Support instructor course: A short report

AimThe aim was to describe a new shortened pilot of the European Resuscitation Council’s standard Basic Instructor Course. MethodsThe four-hour pilot followed a blended learning strategy (pre-course preparation, on-site small-group sessions). Each participant taught a short Basic Life Support competency to the group (micro-teaching) and received the group's feedback. A feedback “drill” session followed. Primary quantitative outcome was the proportion of Basic Instructor Course participants subsequently teaching Basic Life Support. Post-course teachings were recorded and compared to standard eight-hour Basic Instructor Courses. Participants’ open feedback question answers were qualitatively analyzed and presented descriptively. ResultsThis pilot Basic Instructor Course taught 31 healthcare providers in 4 courses in 2019–2021 (aged 31.5 ± 12.9 years; 61 % women; 29 % physicians; 71 % medical students; 21 % no teaching experience). Participants reported that they gained most from micro-teaching (64 %), and advice on their teaching (50 %). Some judged the course as being too long (29 %). Twenty-seven pilot course participants (87 %) (including three instructor candidates) started teaching, whereas only nine of 37 participants of the 3 courses (24 %, including three instructor candidates) from the standard eight-hour course did. ConclusionParticipants of the pilot shortened Basic Instructor Course in a healthcare setting were successfully trained to teach European Resuscitation Council’s Basic Life Support provider courses in a short four-hour format. The pilot course seems to enable future instructors to teach Basic Life Support provider courses. Higher motivation to teach resulted in four times as many instructors who taught courses after the pilot course compared to the standard course.

Can kids save lives program improve knowledge, skills and attitude of greek students. Preliminary results from three years of implementation

Abstract Background Out of hospital cardiac arrest remains a big issue worldwide, with more than 700.000 deaths annually. Many lives could have been saved if more people had been trained in cardiopulmonary resuscitation. The World Health Organization endorsed the “Kids Save Lives” project in 2015 in order to reduce mortality, while countries, where children were taught cardiopulmonary resuscitation (CPR) in schools, have higher rates of bystander CPR and higher survival rates. Purpose To evaluate the level of theoretical knowledge, willingness to perform Cardiopulmonary resuscitation (CPR) and active skills of Greek secondary school students on the subject of Basic life Support before and after a “Kids Save Lives” program. Moreover to evaluate the potential benefits of training for 3 consecutive years Material and method Data collection took place on the academic periods of 2017–2018, 2018–2019 and 2019–2020 and was performed in secondary schools of Thessaly's region. A total of 5823 students (51,9% female, mean age 14.2 years) participated on the “Kids save Lives” program according to the European Resuscitation Council (ERC) and World Health Organization (WHO) statement. The program was under the approval of Greek Ministry of Education. 709 students followed the program for two consecutive years and 202 for three consecutive years. A 12-question questionnaire was answered by the students before and after the “kid saves lives” program, while practical skills were evaluated on manikins by experienced Basic Life Support Instructors. Results The training improves significantly the theoretical knowledge regarding CPR, with the percentage of correct answers being 48,65%, 63,88%, 75,70% before the first, second and third years respectively (p&amp;lt;0.001). After the course the percentages of correct answers went up to 83,26%, 87,95% and 92,67% after the first, second and third years of the course respectively (p&amp;lt;0.001). The participants willingness to perform bystander CPR significantly increased after the completion of the first year of course (93,8% before to 97,4% after, p&amp;lt;0.001) and remains highly for the next 2 years. Almost all of the participants (98.9%) could recognize the correct position near the victim and 91% performed chin lift maneuver and recognized cardiac arrest. More than 90% of the students performed chest compressions with the correct rate and placing their hands on the center of the chest (90,1% and 93.4%, respectively), whereas only 76.4% of the participants achieved the desired compression depth of 5 to 6 cm. One year later there was improvement to their skills and especially to the desired depth of chest compression (87,6%, p&amp;lt;0,001) Conclusions The overall results strongly depict the benefits of “Kids Save Lives” program by improving the theoretical knowledge, the practical skills and the attitude of Greek students towards CPR and indicate the need for its implementation for 3 consecutive years for every student. Funding Acknowledgement Type of funding sources: None.

A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study.

BackgroundPrompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students.ObjectiveOur objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders.MethodsA short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders.ResultsOut of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9%) initially agreed to participate. Moreover, 102 (19.3%) attended the practice sessions, and 48 (9.1%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56).ConclusionsThis study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders.International Registered Report Identifier (IRRID)RR2-10.2196/24664

Lean Six Sigma Redesign of a Process for Healthcare Mandatory Education in Basic Life Support-A Pilot Study.

Healthcare staff are required to undertake mandatory training programs to ensure they maintain key clinical competencies. This study was conducted in a private hospital in Ireland, where the processes for accessing mandatory training were found to be highly complex and non-user friendly, resulting in missed training opportunities, specific training license expiration, and underutilized training slots which resulted in lost time for both the trainers and trainees. A pilot study was undertaken to review the process for accessing mandatory training with a focus on the mandatory training program of Basic Life Support (BLS). This was chosen due to its importance in patient resuscitation and its requirement in the hospital achieving Joint Commission International (JCI) accreditation. A pre- and post-team-based intervention design was used with Lean Six Sigma (LSS) methodology employed to redesign the process of booking, scheduling, and delivery of BLS training leading to staff individual BLS certification for a period of two years. The redesign of the BLS training program resulted in a new blended delivery method, and the initiation of a pilot project led to a 50% increase in the volume of BLS classes and a time saving of 154 h 30 min for staff and 48 h 14 min for BLS instructors. The success of the BLS process access pilot has functioned as a platform for the redesign of other mandatory education programs and will be of interest to hospitals with mandatory training requirements that are already facing healthcare challenges and demands on staff time.

The effect of content knowledge and repeated teaching on teaching and learning basic life support: a cluster randomised controlled trial

Background Experimental research on the training of BLS instructors and how their performance evolves is scarce. This study investigated the role of content knowledge and repeated teaching trials for improving teaching and learning Basic Life Support (BLS). Methods A cluster randomised controlled trial. Six secondary school teachers were assigned to either a common content knowledge (CCK) or specialised content knowledge (SCK) training. In the CCK group, teachers were taught to perform BLS technically correct. In the SCK group, teachers were additionally taught to detect and correct common errors students would make. Following the training, teachers taught two BLS lessons to two different classes of secondary school students (n = 216, age 12–14). Teachers’ lesson organisation in terms of cognitive (e.g. task presentations), motor (e.g. practice time), and general (e.g. getting organised) activities was assessed. Students’ BLS and CPR performance was assessed as the primary outcomes. Results BLS performance was significantly higher in the second lesson for students taught by SCK versus CCK teachers (73% vs 63%). No significant difference was detected between lesson one and two across conditions and teachers. For cardiopulmonary resuscitation (CPR) variables, significant differences in favour of the SCK condition were found for chest compression depth after lesson one, and the amount and volume of ventilations after lesson two. Conclusion Students’ BLS and CPR performance was positively impacted by the SCK training. BLS performance varied greatly by teachers with averages ranging from 53% to 83% across conditions. Results suggest teaching experience alone is not sufficient to improve teaching effectiveness.

Peer Education Model for Basic Life Support Training among High School Children: A Randomized Trial.

The aim of the study was to test the effectiveness of the peer education method on the learning and application of Basic Life Support (BLS) in high school students and to test the effectiveness of the peer education model on the BLS instructor training. High school grade one students were included in the study. Students were divided in two groups (Group A and Group B). Peer instructors who were trained by health professionals trained students in Group A. Peer instructors who were trained by their peers trained students in Group B. Pre- and post-training awareness and knowledge tests were applied to measure the awareness and knowledge of all students. Students' success in applying BLS steps was evaluated by a practical exam that was coordinated by physicians using a checklist. Result of the pre-post training awareness questionnaire, pre-post training knowledge tests, and practical exam indicated that instructors trained by their peers were as effective as the instructors trained by medical physicians in terms of giving BLS training to high school students. In the 16-step BLS application competence evaluation, the students in Group A applied BLS with a success rate of 90.2% and in Group B with a success rate of 93.4%. In the current study, it was shown that the peer education model is effective in BLS training and BLS instructor training in high school students. This novel method of peer education gives an opportunity to overcome the stated shortage in the budget and in trained instructors.

The effective group size for teaching cardiopulmonary resuscitation skills – A randomized controlled simulation trial

Aim of the studyThe ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants’ errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching. MethodsMedical students acting as simulated Basic Life Support course participants were instructed to make three different pre-defined Basic Life Support quality errors (e.g., chest compression too fast) in 7 min. Basic Life Support instructors were randomized to groups of 3–10 participants. Instructors were asked to observe the Basic Life Support skills and to correct performance errors. Primary outcome was the maximum group size at which the percentage of correctly identified participants’ errors drops below 80%. ResultsSixty-four instructors participated, eight for each group size. Their average age was 41 ± 9 years and 33% were female, with a median [25th percentile; 75th percentile] teaching experience of 6 [2;11] years. Instructors had taught 3 [1;5] cardiopulmonary resuscitation courses in the year before the study. A logistic binominal regression model showed that the predicted mean percentage of correctly identified participants’ errors dropped below 80% for group sizes larger than six. ConclusionThis randomized controlled simulation trial reveals decreased ability of instructors to detect Basic Life Support performance errors with increased group size. The maximum group size enabling Basic Life Support instructors to correct more than 80% of errors is six. We therefore recommend a maximum instructor-to-participant ratio of 1:6 for cardiopulmonary resuscitation courses.

Basic life support skills can be improved among certified basic life support instructors

BackgroundA correct visual skill demonstration is important when learning cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED). Basic life support (BLS) instructors are expected to master and demonstrate CPR/AED skills correctly. The aim of this study was to evaluate certified BLS instructors’ competencies in demonstrating CPR and the use of an AED. MethodsCertified BLS instructors demonstrated CPR and the use of an AED on a resuscitation manikin. Skills were evaluated using data collected from the manikin and video recordings and compared to resuscitation guidelines. Further, instructors completed questionnaires on resuscitation guidelines and rating of their own CPR/AED skills. ResultsOverall, we analyzed data from 125 instructors. Of all chest compressions, only 22% were within guideline recommendations regarding depth. Instructors performed chest compressions with excessive depth (mean depth 64mm (7.3)) and a mean rate of 115min−1 (10.8). Only 25% of instructors placed the left AED electrode correctly (median distance 7.6cm (5.0;10.5)), while the right AED electrode usually was placed correctly (median distance 2.9cm (1.5;4.0), 85% placed correctly). Nearly half of the instructors failed to state correct answers regarding how to diagnose a cardiac arrest and where to place the AED electrodes. Despite their performance, instructors rated their BLS skills as good. ConclusionCertified BLS instructors’ have poor CPR/AED skills and several important knowledge gaps on CPR/AED guidelines in contrast to instructors’ self-reported skills. This highlights a need for improving BLS instructor education, including continuous faculty development to ensure optimal learning conditions for BLS course participants.

Learning Effectiveness Assessment between Primary School Students and Adults in Basic Life Support Education.

Background Out-of-hospital cardiac arrest (OHCA) remains a big issue of critical care. It is well known that bystander cardiopulmonary resuscitation (CPR) with an automated external defibrillator (AED) used did improve the survival rate. Therefore, CPR education including basic life support (BLS) and AED has been advocated for years. It showed significant improvement of knowledge and willingness to perform CPR through adolescents after the course. However, little is known regarding the ability and learning effectiveness of school students who attend such courses. Therefore, this study aimed to evaluate the CPR effectiveness of both adolescents (12 years old) and adults who undergo the same course of BLS and AED. Methods This is a retrospective study. Sixth-grade elementary school students in Northern Taiwan were selected to compare with the adult group. Both took 90 minutes of the BLS and AED course by the doctor with BLS instructor qualification. The primary outcomes were CPR quality and passing or failing the skill examination parameters. The secondary outcome was the posttraining written test and questionnaire of CPR willingness. Results In the written test, there was a statistical difference in the pretest score except AED knowledge, but no difference was revealed in the posttest score. No statistical difference in CPR quality was noted. In the skill examination, only checking breathing status had statistical difference (elementary group (71%) vs. adult group (86%) (p=0.003)). Conclusion We revealed that sixth-grade elementary students' performance in CPR and AED was similar to that of adults after completing the current 90-minute course. Therefore, we strongly advocate offering CPR and AED courses to 12-year-old children, and these courses should emphasize checking the victim's breathing status.

Development controller and feedback of Chiang Mai automated external defibrillation trainer and manikin for basic life support training

Objectives Basic Life Support (BLS) should be taught to everyone; however, there is a lack of Automated External Defibrillation (AED) trainers in Thailand due to the cost of the imported equipment. An AED trainer, manikin, and manikin controller system was locally developed which can display training results to help reduce the cost. Methods This is a descriptive study of a locally developed controller and feedback system, the Chiang Mai AED trainer and manikin. The controller was examined by 5 BLS instructors using a 10-point scale questionnaire consisting of 3 questions to evaluate the efficacy of the device. Correlation among BLS instructors was also calculated. Results The controller and feedback system for the Chiang Mai AED trainer and manikin worked appropriately as intended. The instructor set up either a ‘shock advised’ or a ‘no shock advised’ scenario for 2 two-minute chest compressions. The AED trainer responded promptly when the electrode pads were attached to the manikin. The controller was also able to display compression depth, compression speed, chest recoils, rescue breaths, and time to first defibrillation. Evaluation of the controller using a 10-point scale resulted in a median of 27 (interquartile range 26-29) out of 30. Intraclass correlation was 0.97 (95% confidence interval 0.90-0.99, p &lt; 0.001). Conclusions The controller for the Chiang Mai AED trainer and manikin is effective for use in BLS training. Chiang Mai Medical Journal 2021;60(1):87-98. doi 10.12982/CMUMEDJ.2021.08

Implementation of basic life support training for school children: Online education for potential instructors? Results of a cluster randomised, controlled, non-inferiority trial

Aim of the studyComprehensive training of the population in basic life support (BLS) increases the chance of survival in cardiac arrest. To implement BLS trainings at schools a high number of instructors will be needed. This non-inferiority study investigated, if online education is effective to prepare instructors to teach BLS compared to face-to-face education. MethodsA cluster randomised, controlled, single blinded study was performed in 2018 in Hamburg, Germany. A mixed group of potential instructors were allocated alternately to either the intervention or control group and participated in a four-hour instructor training. The instructor training of the control group was realised by trained educators. The intervention group participated in a self-regulated online training with hands-on training supported by peers. Instructors provided BLS training for high school students. The primary endpoint was a mean score in the BLS skills assessment of the students. The secondary endpoint was teaching effectiveness of the instructors. ResultsBLS assessments of 808 students of 46 classes, who were taught by 74 instructors could be analysed. The students trained by interventional instructors achieved 0.14 points less (95% CI: −0.27 to 0.56) compared to students trained by control instructors (9.34 vs. 9.48). The non-inferiority could not be confirmed. The teaching performance in the intervention group was better in some aspects compared to the control group. ConclusionIntegrating all results of this study, online education may be an effective alternative to prepare potential BLS instructors. Using free online courses, motivated persons can independently acquire necessary skills to become instructors and autonomously realise low cost BLS trainings at schools.

Medical Students Can be Trained to be Life-Saving First Aid Instructors for Laypeople: A Feasibility Study from Gaza, Occupied Palestinian Territory.

Bystanders can improve the outcome in emergencies by activating the "chain of survival." Gaza's (Palestine) population has little, if any, access to training in Basic Life Support (BLS) and cardiopulmonary resuscitation (CPR). The goal was to recruit local medical students to be life-saving first aid instructors, and have them train 3,000 laypeople in BLS and CPR. One hundred and seventeen medical students from Al Azhar University-Gaza (Gaza City, Palestine) were trained as BLS and CPR instructors. Twelve training hours were delivered in practical BLS and CPR skills, plus four in communication and didactical skills, to enable training of laypeople. Students answered a questionnaire exploring demographics, prior training experience, expectations, and motivation to join the training. Teaching material were developed after the European Resuscitation Council (ERC; Niel, Belgium) guidelines and similar training at The Arctic University of Norway (Tromsø, Norway). A total of 117 medical students (52.1% female; 47.9% male), from third through sixth year, completed training, and all were in their early twenties. Ninety-five (81.2%) agreed to answer the questionnaire. Of those, five students lost family members during Israeli military operations. Eighty-two (70.1%) never had hands-on first aid training. Seventy-six (80.0%) hoped the training would improve their community's response to emergencies. With 58 training sessions completed, 1,312 laypeople (596 males; 716 females) were trained: 5.52 lay trainees per student instructor. The majority (n = 1,012; 77.1%) were school students aged 13-20 years. It is feasible to recruit local medical students for practical BLS and CPR trainings targeting laypeople in communities under stress. The training impact on local resilience and patients' outcomes need further studies.

Certified Basic Life Support Instructors Identify Improper Cardiopulmonary Resuscitation Skills Poorly: Instructor Assessments Versus Resuscitation Manikin Data.

During basic life support (BLS) training, instructors assess learners' cardiopulmonary resuscitation (CPR) skills and correct errors to ensure high-quality performance. This study aimed to investigate certified BLS instructors' assessments of CPR skills. Data were collected at BLS courses for medical students at Aarhus University, Aarhus, Denmark. Two certified BLS instructors evaluated each learner with a cardiac arrest test scenario, where learners demonstrated CPR on a resuscitation manikin for 3.5 minutes. Instructors' assessments were compared with manikin data as reference for correct performance. The first 3 CPR cycles were analyzed. Correct chest compressions were defined as 2 or more of 3 CPR cycles with 30 ± 2 chest compressions, 50 to 60 mm depth, and 100 to 120 min rate. Correct rescue breaths were defined as 50% or more efficient breaths with visible, but not excessive manikin chest inflation (for instructors) or 500 to 600mL air (manikin data). Overall, 90 CPR assessments were performed by 16 instructor pairs. Instructors passed 81 (90%) learners, whereas manikin pass rate was 2%. Instructors identified correct chest compressions with a sensitivity of 0.96 [95% confidence interval (CI) = 0.79-1) and a specificity of 0.05 (95% CI = 0.01-0.14), as well as correct rescue breaths with a sensitivity of 1 (95% CI = 0.40-1) and a specificity of 0.07 (95% CI = 0.03-0.15). Instructors mistakenly failed 1 learner with adequate chest compression depth, while passing 53 (59%) learners with improper depth. Moreover, 80 (89%) improper rescue breath performances were not identified. Certified BLS instructors assess CPR skills poorly. Particularly, improper chest compression depth and rescue breaths are not identified.

Local medical students can be instructors for life-saving first-aid courses for lay people: a descriptive study from Gaza

BackgroundBystanders can initiate a chain of survival in emergency situations by recognising the situation, calling for help, and initiating basic life support (BLS) and first aid. The lay population of Gaza has had little if any access to systematic BLS and CPR training. This study aimed to find out whether medical students could act as instructors to train 3000 lay people in BLS and CPR. MethodsWe selected 82 medical students from Al Azhar University to train as BLS and CPR instructors. Student volunteers who were in their third, fifth, and sixth year of medical school were chosen based on sex (to achieve equal numbers of males and females) and geography (for approximately even geographical distribution). Their training included 12 hours of BLS and CPR skills and 4 hours of didactic instruction, with a view to delivering 1–2 hours of basic training for lay people. Students responded to a written questionnaire with details of their demographics, training experience, motivation, and expectations. Teaching materials and methods were based on the European Resuscitation Council guidelines and followed a similar training model as that at The Arctic University of Norway (UiT). The board of the Faculty of Medicine at Al Azhar University approved the training and the study. Findings82 medical students completed training (mean age 21·7 years [SD 1·25]; 54% [44 of 82] female, 46% [38 of 82] male). Following training, 87% of students (71 of 82) responded to the questionnaire and 76% (62 of 82) took part in training lay people. Of those who completed the questionnaire, five reported having lost family members during Israeli military operations in Gaza (the questionnaire section on demographics included the impact of warfare on the students' lives). Almost two-thirds (54 of 71) had no previous practical first aid training. 49 of 71 (69%) described a sense of belonging and duty to the community as their most important motivation, and 56 of 71 (79%) hoped that their training would contribute to increased capacity and skills in the community's response to emergencies, especially during attacks. 55 training sessions have been completed so far, involving 1222 lay participants, mostly school students (including students at vocational schools) aged 13–20 years (75%; 922 of 1222). 62 student instructors have been active, with a ratio of 5·4 lay trainees to each student instructor. Of the trainees, 45% were male (546 of 1222) and 55 % female (676 of 1222). InterpretationWe have shown that local medical students are willing and capable of being trained as volunteer instructors to teach BLS and CPR, targeting lay people in serious conditions. The effects of such training on local resilience and patient outcomes need further study. FundingThe Palestine Children Relief (PCRF) funded the travel expenses of the trainers and provided medical students with first aid kits.

The role of a checklist for assessing the quality of basic life support performance: an observational cohort study

BackgroundTraining lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. This study evaluated whether a simple observational checklist can be used by BLS instructors to adequately measure the quality of BLS performance as an alternative to other feedback devices.MethodsThe BLS performances of 152 first-year medical students (aged 21.4 ± 3.9 years) were recorded on video, and objective data regarding the quality of the BLS were documented using Laerdal PC SkillReporting software. The performances were categorized according to quality. Ten BLS instructors observed the videos and completed a ten-point checklist based on the Cardiff Test of BLS (version 3.1) to assess the performances. The validity of the checklist was reviewed using interrater reliability as well as by comparing the checklist-based results with objective performance data.ResultsMatching the checklist-based evaluation with the objective performance data revealed high levels of agreement for very good (82%) and overall insufficient (75%) performances. Regarding the checklist-based evaluation, interrater reliability depended on the checklist item; thus, some items were more easily identified correctly than others. The highest and lowest levels of agreement were observed for the items “undressed torso” and “complete release between compressions” (mean joint-probability 95 and 67%, respectively).ConclusionsThe observational checklist adequately distinguished sufficient from insufficient BLS performances and offered an assessment of items not incorporated by SkillReporting software such as the initial assessment or undressing the chest. Although its usefulness was reduced for scaling intermediate performance groups, the checklist may be overall a useful rating tool in BLS-training if objective feedback devices are not available, for example, due to large groups of participants or limited training time.

Competence-based training needs assessment for basic life support instructors.

Basic life support instructors play an important role in the planning, implementation, and evaluation of basic life support education. However, little is known about basic life support instructors' competence. The aim of the present study was to identify basic life support instructors' competence attributes and assess their competence-based training needs according to their expertise. This was a descriptive survey study to identify the educational needs of basic life support instructors using importance and performance analysis. A Web-based survey with a 29 item Competence Importance-Performance scale was undertaken with a convenience sample of 213 Korean instructors. Factor analysis identified several important factors for the competence of instructors: assessment, professional foundations, planning and preparation, educational method and strategies and evaluation. The importance and performance analysis matrix showed that training priorities for novice instructors were communication with learners and instructors, learner motivation, educational design, and qualifications of instructors, whereas checking equipment status and educational environment had the highest training priority for experienced instructors. Assessment was the most important factor in basic life support instructor's competence. A competence-based training program is needed according to basic life support instructors' expertise.