Retention Of Resuscitation Skills Research Articles

Responding to the real problem of sustainable resuscitation skills with real assessment. Mixed-methods evaluation of an authentic assessment programme.

The retention of resuscitation skills is a widespread concern, with a rapid decay in competence frequently following training. Meanwhile, training programmes continue to be disconnected with real-world expectations and assessment designs remain in conflict with the evidence for sustainable learning. This study aimed to evaluate a programmatic assessment pedagogy which employed entrustment decision and the principles of authentic and sustainable assessment (SA). We conducted a prospective sequential explanatory mixed methods study to understand and address the sustainable learning challenges faced by final-year undergraduate paramedic students. We introduced a programme of five authentic assessments based on actual resuscitation cases, each integrating contextual elements that featured in these real-life events. The student-tutor consensus assessment (STCA) tool was configured to accommodate an entrustment scale framework. Each test produced dual student led and assessor scores. Students and assessors were surveyed about their experiences with the assessment methodologies and asked to evaluate the programme using the Ottawa Good Assessment Criteria. Eighty-four students participated in five assessments, generating dual assessor-only and student-led results. There was a reported mean score increase of 9% across the five tests and an 18% reduction in borderline or below scores. No statistical significance was observed among the scores from eight assessors across 420 unique tests. The mean student consensus remained above 91% in all 420 tests. Both student and assessor participant groups expressed broad agreement that the Ottawa criteria were well-represented in the design, and they shared their preference for the authentic methodology over traditional approaches. In addition to confirming local sustainability issues, this study has highlighted the validity concerns that exist with conventional resuscitation training designs. We have successfully demonstrated an alternative pedagogy which responds to these concerns, and which embodies the principles of SA, quality in assessment practice, and the real-world expectations of professionals.

Comparison Between Self-Deliberate Practice and Directed Learning Training Methods for Basic Life Support Knowledge and High-Quality Cardiopulmonary Resuscitation Skill Retention in Second-Year Medical Students 3 and 6 Months After Training.

Cardiopulmonary resuscitation (CPR) requires well-trained medical personnel. Multiple learning methods can be done for CPR skills training. This study aimed to compare self-deliberate practice (SDP) method and directed learning (DL) method to improve basic life support (BLS) knowledge and CPR skill performance in medical students. This is an experimental, single-blind, randomized controlled trial study of 40 medical students from February to July 2019. Forty subjects were randomly assigned into SDP and DL groups through a voluntary sampling method. Both groups attended a 1-day course and then practiced once a month for 3months. The DL group had practice sessions with assigned tutors, while the SDP group had to practice by themselves. Examination of BLS knowledge and CPR performance quality (compression depth, rate, and performance score) was collected before and after course lecture, after a skills training, 3 and 6months after training. Subject characteristics of both groups were comparable. Significant knowledge and skill improvement were found in the DL group and the SDP group when compared to their knowledge and skill before training. There were no significant differences between both groups in BLS knowledge and CPR performance quality in all examination periods. Both SDP and DL teaching methods show significant improvement and excellent retention in BLS knowledge and high-quality CPR performance. These two learning methods are both feasible and bring positive results for students. The online version contains supplementary material available at 10.1007/s40670-023-01746-7.

High-Frequency, Low-Dose Education to Improve Neonatal Outcomes in Low-Resource Settings: A Cluster Randomized Controlled Trial.

Annually 2.5 million infants die in the first 28 days of life, with a significant regional distribution disparity. An estimated 80% of those could be saved if neonatal resuscitation were correctly and promptly initiated. A barrier to achieving the target is the knowledge and skills of healthcare workers. The objective of this cluster randomized trial was to assess the improvement and retention of resuscitation skills of nurses, midwives, and birth attendants in 2 birth centers serving 60 villages in rural India using high-frequency, low-dose training. There was a significant difference ( P < .05) between the groups in the rate of resuscitation, with 18% needing resuscitation in the control group and 6% in the intervention group. The posttest scores for knowledge retention at the final 8-month evaluation were significantly better in the intervention group than in the control group (intervention group mean rank 19.4 vs control group mean rank 10.3; P < .05). The success rate of resuscitation was not significantly different among the groups. Improved knowledge retention at 8 months and the lower need for resuscitation in the intervention group support the efficacy of the high-frequency, low-dose education model of teaching in this setting. Replication of these findings in other settings with a larger population cohort is needed to study the impact of such intervention on birth outcomes in low-resource settings.

EHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings

ObjectiveTo assess the impact of mobile virtual reality (VR) simulations using electronic Helping Babies Breathe (eHBB) or video for the maintenance of neonatal resuscitation skills in healthcare workers in resource-scarce...

Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained: An observational study.

Neonatal resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Worldwide, four million neonate deaths happen annually, and birth asphyxia accounts for one million deaths. Improving providers' neonatal resuscitation skills is critical for delivering quality care and for morbidity and mortality reduction. However, retention of these skills has been challenging in developing countries, including Ethiopia. Hence, this study aimed to assess neonatal resuscitation skills retention and associated factors among midwives and nurses in Eastern Ethiopia. An institution-based cross-sectional study was conducted using a pre-tested, structured, observational checklist. A total of 427 midwives and nurses were included from 28 public health facilities by cluster sampling and simple random sampling methods. Data were collected on facility type, availability of essential resuscitation equipment, socio-demographic characteristics of participants, current working unit, years of professional experience, whether a nurse or midwife received refresher training, and skills and knowledge related to neonatal resuscitation. Binary logistic regression was used to analyse the association between neonatal resuscitation skill retention and independent variables. About 11.2% of nurses and midwives were found to have retention of neonatal resuscitation skills. Being a midwife (AOR, 7.39 [95% CI: 2.25, 24.24]), ever performing neonatal resuscitation (AOR, 3.33 [95% CI: 1.09, 10.15]), bachelor sciences degree or above (AOR, 4.21 [95% CI: 1.60, 11.00]), and good knowledge of neonatal resuscitation (AOR, 3.31 [95% CI: 1.41, 7.73]) were significantly associated with skill retention of midwives and nurses. Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained. This could increase the death of neonates due to asphyxia. Being a midwife, Bachelor Sciences degree or above educational status, ever performing neonatal resuscitation, and good knowledge were associated with skill retention. Providers should be encouraged to upgrade their educational level to build their skill retention and expose themselves to NR. Further, understanding factors affecting how midwives and nurses gain and retain skills using high-level methodology are essential.

Cohort study of neonatal resuscitation skill retention in frontline healthcare facilities in Bihar, India, after PRONTO simulation training

BackgroundUse of simulation in neonatal resuscitation (NR) training programmes has increased throughout low-income and middle-income countries. Many of such programmes have demonstrated a positive impact on NR knowledge and skill...

An audio-visual review model enhanced one-year retention of cardiopulmonary resuscitation skills and knowledge: A randomized controlled trial

BackgroundAs the majority of out-of-hospital cardiac arrest occur at patients’ homes, implementing high-quality cardiopulmonary resuscitation by family members is critical in improving patient outcomes. However, the survival rate remains low due to low bystander cardiopulmonary resuscitation rate and rapid skill deterioration in individuals who complete the training. ObjectivesTo evaluate the effectiveness of audio-visual review model and audio-visual-practice review model on cardiopulmonary resuscitation skill retention 12 months after training. DesignA randomized, double-blind, placebo controlled, and three-arm parallel study. ParticipantsA total of 641 family members of patients at high risk of out-of-hospital cardiac arrest enrolled in the study and 448 participants completed the follow-up. MethodsFamily members from Beijing, China were recruited. All families underwent initial cardiopulmonary resuscitation training. Their cardiopulmonary resuscitation skill and knowledge were assessed immediately after training. Trainees who were rated “adequate skill and knowledge” were assigned randomly into one of three groups. The control group was given a cardiopulmonary resuscitation instruction booklet and a placebo-DVD without any reminders. Both audio-visual and audio-visual-practice groups were reinforced by a telephone reminder every 3 months. The audio-visual-practice group was also asked to simultaneously practice the skills while watching the instructional-DVD. The trainees’ cardiopulmonary resuscitation skills and knowledge were re-assessed 12 months after training. ResultsThe retention rates of cardiopulmonary resuscitation skills in both audio-visual-practice (N = 177) and audio-visual (N = 157) groups were higher than that in control group (N = 114) 12 months after training (all P-values < 0.001). The cardiopulmonary resuscitation skill retention rate in audio-visual-practice group was higher than that in audio-visual group (49.7% vs 36.9%, P = 0.019), but no difference was found in intention-to-treat analysis (32.1% vs 27.1%, P = 0.230). Both audio-visual-practice and audio-visual groups had higher correct rates on all skill elements than that in control group (all P-values < 0.05). The cardiopulmonary resuscitation knowledge scores in both audio-visual-practice and audio-visual groups were higher than that in control group (all P-values < 0.001). However, no significant difference was found between audio-visual-practice and audio-visual groups (P = 0.243). ConclusionsBoth audio-visual-practice and audio-visual review models demonstrated better long-term retention of cardiopulmonary resuscitation skills for families of people at higher risk of out-of-hospital cardiac arrest. (Registration number: chiCTR-TRC-12002149)

Simulation-Based Curricula for Enhanced Retention of Pediatric Resuscitation Skills: A Randomized Controlled Study.

Resuscitation skills decay as early as 4 months after course acquisition. Gaps in research remain regarding ideal educational modalities, timing, and frequency of curricula required to optimize skills retention. Our objective was to evaluate the impact on retention of resuscitation skills 8 months after the Pediatric Advanced Life Support (PALS) course when reinforced by an adjunct simulation-based curriculum 4 months after PALS certification. We hypothesized there would be improved retention in the intervention group. This is a partial, double-blind, randomized controlled study. First-year pediatric residents were randomized to an intervention or control group. The intervention group participated in a simulation-based curriculum grounded in principles of deliberate practice and debriefing. The control group received no intervention. T-tests were used to compare mean percent scores (M) from simulation-based assessments and multiple-choice tests immediately following the PALS course and after 8 months. Intervention group (n = 12) had overall improved retention of resuscitation skills at 8 months when compared with the control group (n = 12) (mean, 0.57 ± 0.05 vs 0.52 ± 0.06; P = 0.037). No significant difference existed between individual skills stations. The intervention group had greater retention of cognitive knowledge (mean, 0.78 ± 0.09 vs 0.68 ± 0.14; P = 0.049). Residents performed 61% of assessment items correctly immediately following the PALS course. Resuscitation skills acquisition from the PALS course and retention are suboptimal. These findings support the use of simulation-based curricula as course adjuncts to extend retention beyond 4 months.

Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania

BackgroundNewborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.MethodsAn initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4–6 weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches.ResultsEight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4–6 weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-value < 0.0001). Medical attendant cadre showed the greatest skills retention.ConclusionsA modified training approach consisting of structured OJT, guidance and tools improved newborn resuscitation skills retention among health care providers. The study results give evidence for including on-site training as part of efforts to improve provider performance and strengthen quality of care.

Short-Interval Self-Learning to Improve Retention of Resuscitation Skills: A Randomized Controlled Trial

The optimal interval and methods for cardiopulmonary resuscitation (CPR) retraining remain unclear. We evaluated the difference in CPR skills one year after a 45-minute chest compression-only CPR training among participants receiving short self-learning refresher training at 3-month intervals, those receiving this training at 6-month intervals, and those without the refresher training. Participants were randomly assigned to the 3-month group, 6-month group, or control group. Resuscitation skills were assessed immediately after the initial training, and at 1 year after the training. The primary endpoint was the number of chest compressions performed with appropriate depth one year after the training. Among 129 participants that were selected, 112 were fully evaluated. Although no significant differences were found in the baseline characteristics among the three groups, the self-training groups demonstrated a tendency to perform fewer chest compressions with appropriate depth (p = .122). No significant differences were observed between the three groups in terms of the number of chest compressions with appropriate depth one year after the training (p = .895). However, the appropriate number of chest compressions, the number of chest compressions with appropriate depth, and chest compression depth in the short-interval self-retraining groups one year later were better than those observed immediately after training. Short self-retraining every 3 or 6 months after the chest compression-only CPR training could not be attributed to the retention of chest compression skills with appropriate depth. However, short, frequent self-retraining in persons with poor skills might be useful in acquiring chest compression skills.

Acquisition and Retention of Resuscitation Knowledge and Skills: What's Practice Have to Do With It?

Acquisition and Retention of Resuscitation Knowledge and Skills: What's Practice Have to Do With It?

Retention of knowledge and skills in pediatric basic life support amongst pediatricians

Retention of resuscitation skills is usually assessed at a predefined moment, which enables participants to prepare themselves, possibly introducing bias. In this multicenter study, we evaluated the retention of knowledge and skills in pediatric basic life support (PBLS) amongst 58 pediatricians and pediatric residents with an unannounced examination. Practical PBLS skills were assessed with a validated scoring instrument, theoretical knowledge with a 10-item multiple-choice test (MCQ). Participants self-assessed their PBLS capabilities using five-point Likert scales. Background data were collected with a questionnaire. Of our participants, 21% passed the practical PBLS exam: 29% failed on compressions/ventilations, 31% on other parts of the algorithm, 19% on both. Sixty-nine percent passed the theoretical test. Participants who more recently completed a PBLS course performed significantly better on the MCQ (p = 0.03). This association was less clear-cut for performance on the practical exam (p = 0.11). Older, attending pediatricians with more years of experience in pediatrics performed less well than their younger colleagues (p < 0.05). Fifty-one percent of the participants considered themselves competent in PBLS. No correlation was found between self-assessed PBLS capabilities and actual performance on the practical exam (p = 0.25).Conclusion: Retention of PBLS skills appears to be poor amongst pediatricians and residents, whereas PBLS knowledge is retained somewhat better.What is Known:• Pediatricians and pediatric residents are not always competent in pediatric basic life support (PBLS) in daily practice. Poor retention of skills supposedly accounts for this incompetence. Without regular exposure, resuscitation skills usually deteriorate within 3 to 6 months after training.• Examination of resuscitation skills usually takes place after training. Also, in most studies evaluating retention of skills, participants are tested at a predefined moment. Inasmuch as participants are able to prepare themselves, these assessments do not reflect the ad hoc resuscitation capabilities of pediatricians and residents.What is New:• In this study, pediatricians and pediatric residents had to complete an unannounced PBLS exam at variable time intervals from last certification. Retention of PBLS skills was rather poor (pass rate 21%).• The PBLS skills of older, attending pediatricians with many working years in pediatrics appeared to be inferior to those of their younger colleagues.

Resuscitation skills after Helping Babies Breathe training: a comparison of varying practice frequency and impact on retention of skills in different types of providers.

Helping Babies Breathe (HBB), a basic neonatal resuscitation curriculum, improves early neonatal mortality in low-resource settings. Our goal was to determine retention of resuscitation skills by different cadres of providers using the approved HBB Spanish translation in a rural clinic and community hospital in Honduras. Twelve clinic and 37 hospital providers were trained in 1 d HBB workshops and followed from July 2012 to February 2014. Resuscitation skills were evaluated by objective structured clinical evaluations (OSCEs) at regular intervals. Clinic providers practiced monthly, whereas hospital providers were randomized to monthly practice for 6 months vs three consecutive practices at 3, 5 and 6 months. In the rural clinic, follow-up OSCE assessment showed rapid loss of skills by 1 month after HBB training. For all providers, repeated monthly testing resulted in improvements and maintenance of OSCE performance. In the community hospital, over all time points, the group with monthly OSCEs had 2.9 greater odds of passing compared with the group who practiced less frequently. Physicians were found to have 4.3 times greater odds of passing compared with nurses. Rapid loss of resuscitation skills occurs after an initial training. Repeated practice leads to retention of skills in all types of providers. Further investigation is warranted to determine the clinical correlation of neonatal outcomes after HBB training.

Impact of Training Frequency on Nurses' Pediatric Resuscitation Skills.

The ideal time frame for frequency of resuscitation skills training has yet to be determined. Results obtained from this performance improvement project using hands-on practice sessions suggest that 6 months may be an adequate time frame for retention of resuscitation skills. Professional development educators may want to consider 6-month retraining intervals for low-volume/high-risk skills such as cardiopulmonary resuscitation to optimize nurses' proficiency in these life-saving competencies.

Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?

BackgroundThe first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities.MethodsWe conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT). Because of staff turnover, some birth attendants (BA) were trained as they joined the delivery room staff, after the initial training was completed (catch-up initial training). We compared pass rates for skills and knowledge pre- and post- initial HBB training and following refresher training among active BAs. An Objective Structured Clinical Examination (OSCE) B tested resuscitation skill retention by comparing post-initial training performance with pre-refresher training performance. We identified factors associated with loss of skills in pre-refresher training performance using multivariable logistic regression analysis. Daily bag and mask ventilation practice, equipment checks and supportive supervision were stressed as part of training.ResultsOne hundred five MT (1.6 MT per facility) conducted initial and refresher HBB trainings for 835 BAs; 76% had no prior resuscitation training. Initial training improved knowledge and skills: the pass percentage for knowledge tests improved from 74 to 99% (p < 0.001). Only 5% could ventilate a newborn mannequin correctly before initial training but 97% passed the post-initial ventilation training test (p < 0.0001) and 99% passed the OSCE B resuscitation evaluation. During pre-refresher training evaluation, a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for the OSCE B resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training).ConclusionsHBB training significantly improved neonatal resuscitation knowledge and skills. However, skills declined more than knowledge over time. Ongoing skills practice and monitoring, more frequent retesting, and refresher trainings are needed to maintain neonatal resuscitation skills.Trial registrationClinicalTrials.gov Identifier: NCT01681017; 04 September 2012, retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1141-3) contains supplementary material, which is available to authorized users.

Inside the Debriefing Room: Multidisciplinary Rapid Response Team Training Findings Revealed

BackgroundResearch indicates that, despite the intent to save lives through rapid response teams (RRTs), mortality and morbidity outcome data are variable. A reason for that may be a lack of proficient and consistent training and education. ObjectivesTo determine whether high-fidelity simulation is an effective instructional method for interdisciplinary RRT training. MethodsMultidisciplinary health care team members participated in high-fidelity simulation scenarios, were evaluated by the instructors during the simulation, and then were given the opportunity to give informal and formal feedback. ResultsThe results of an anonymous survey sent to all participants showed that a majority who completed the online survey (91.4%) found this instructional method to be either very effective or somewhat effective for teaching in the hospital setting. The majority of participants (63.6%) indicated that high-fidelity simulation was their preferred method of learning when compared with case studies, online learning modules, or classroom/lecture. Major themes and opportunities identified for additional training were communication, assessment skills, teamwork, critical thinking, cardiopulmonary resuscitation skill retention, and timely initiation of RRT calls. ConclusionsThis pilot study supports the current literature detailing the effectiveness of high-fidelity simulation and perceived learner outcomes. During crisis situations, there are significant communication barriers that can derail care providers from providing the most optimal care to the patient. As a result of debriefing, it was found that derogatory comments made by the RRT members during previous rapid response calls significantly impacted how early subsequent rapid responses were called by some participants.

Education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council CPR/AED course

ObjectivesTo examine whether education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council (ERC) CPR/AED course. BackgroundBecause of the importance of bystander CPR/AED skills in the setting of cardiac arrest, acquisition and retention of resuscitation skills has gained a great amount of interest. MethodsThe ERC CPR/AED course format for written and practical evaluation was used. Eighty lay people were trained and evaluated at the end of the course, as well as at one, three, and six months. ResultsRetention of CPR/AED skills improved over time, recording the lowest practical scores at one month after initial training and the lowest written scores at initial training. In practical evaluation scores, when examined longitudinally, age presented a significant adverse effect and higher background education presented a non-significant positive effect. Moreover, regarding written evaluation scores, when examined longitudinally, education presented a significant positive effect while age did not significantly correlate with written scores. ConclusionsEducation and age affected retention of CPR/AED skills in lay rescuers. Also, our results suggest that the ERC CPR/AED course format may be poorly designed to discriminate between participants with different levels of practical and written resuscitation skills and merit a thorough investigation in future studies.

An Exploratory Study of Factors Influencing Resuscitation Skills Retention and Performance Among Health Providers

Resuscitation and life support skills training comprises a significant proportion of continuing education programming for health professionals. The purpose of this study was to explore the perceptions and attitudes of certified resuscitation providers toward the retention of resuscitation skills, regular skills updating, and methods for enhancing retention. A mixed-methods, explanatory study design was undertaken utilizing focus groups and an online survey-questionnaire of rural and urban health care providers. Rural providers reported less experience with real codes and lower abilities across a variety of resuscitation areas. Mock codes, practice with an instructor and a team, self-practice with a mannequin, and e-learning were popular methods for skills updating. Aspects of team performance that were felt to influence resuscitation performance included: discrepancies in skill levels, lack of communication, and team leaders not up to date on their skills. Confidence in resuscitation abilities was greatest after one had recently practiced or participated in an update or an effective debriefing session. Lowest confidence was reported when team members did not work well together, there was no clear leader of the resuscitation code, or if team members did not communicate. The study findings highlight the importance of access to update methods for improving providers' confidence and abilities, and the need for emphasis on teamwork training in resuscitation. An eclectic approach combining methods may be the best strategy for addressing the needs of health professionals across various clinical departments and geographic locales.

Retention into internship of resuscitation skills learned in a medical student resuscitation program incorporating an Immediate Life Support course

AimsThis study describes the acquisition and retention of resuscitation skills by medical students during and following a vertically integrated training program incorporating an Immediate Life Support course (ILS): and the skills demonstrated by interns on entry to clinical practice. MethodsYearly resuscitation workshops were held in the final 3 years of a 6-year undergraduate medical curriculum. These consisted of a basic life support course in year 4; a resuscitation workshop including shock-advisory defibrillation in year 5; and an ILS course in year 6. A medical student cohort was tested during the course and at the beginning of internship. ResultsBefore year 5 training, an average of 36.6% of students passed each criterion and this increased to 72.3% 10 weeks after training. Prior to the ILS course (approximately 6–18 months following year 5 training), this proportion had decreased to 35.2%; and on retesting as interns the proportion was 64.1%, with delay between ILS training and testing of between 3 and 9 months. The proportion of interns correctly performing airway opening, initial rescue breathing and ventilation technique was lower than other measured skills. Those with ILS training performed better in initial rescue breaths (p=0.03), ventilation technique (p=0.04), and recommencement of CPR without delay following defibrillation (p=0.02). ConclusionsA vertically integrated undergraduate resuscitation course appears to reinforce the maintenance of resuscitation skills until internship. Skills are maintained for at least 6–9 months following an ILS course. This may be due to the ILS course embedding the skills more thoroughly.

Pediatric Resuscitation Mock Code Practice Impacts Selected Skills

Objectives: Determine the utility of a computer‐controlled mannequin in training and assessment of resident pediatric resuscitation skills. Determine if mock code practice is beneficial in maintaining mastery of critical pediatric resuscitation skills.Methods: A prospective randomized study of 22 interns (12 pediatric, 10 emergency medicine) randomized to: Group 1 (cases who participated in 3 mock codes over a 6 month period) and Group 2 (controls who did not receive mock code practice). Each intern was randomly paired in teams of two who participated at baseline in two code scenarios using the Laerdal Simbaby. The interns alternated airway and circulatory management responsibility. At 6 months all interns returned to the simulator in pairs to participate in another two pediatric code scenarios. All sessions were videotaped and time of computer initiation of scenario events recorded. Videos were examined by a pediatric emergency physician (blinded to Group participation) using a structured recording form. A general linear model was used to assess differences in response times and Fisher's exact tests for categorical data.Results: Whether in charge of airway or circulatory management, at post test interns who had completed mock codes required less time to: recognize the need for bag mask ventilation (Diff 5.6 seconds, p &lt; 0.005), initiate BVM (Diff 2.7 seconds, p &lt; 0.006), intubate (Diff 22 seconds, p &lt; 0.03), and recognizing the need for chest compressions (Diff 24 seconds, p &lt; 0.03). There were no differences in times for recognizing the need for fluid resuscitation or for factors such as appropriate mask size, rate of ventilation, intubation success (including number of attempts), compression techniques, or IO placement.Conclusions: Computer controlled mannequins provide reproducible measurable experiences. This study demonstrates that mock code practice may impact some, but not all, aspects of pediatric resuscitation skill retention.