Resuscitation Training Research Articles

Cardiopulmonary Resuscitation Training and Its Impact on Health Care Students' Knowledge and Anxiety Levels

Purpose: This study examines the impact of cardiopulmonary resuscitation (CPR) training on the knowledge and anxiety levels of healthcare students in the Home Patient Care Program. Cardiac arrest, a life-threatening condition requiring immediate intervention, underscores the critical importance of proper CPR application. Methodology: The research utilized an experimental design with pre-test and post-test evaluations, involving 77 first-year students from Kastamonu University's Tosya Vocational School of Health Services. Participants were divided into experimental (n=34) and control (n=43) groups. The experimental group received five weeks of CPR and stress-anxiety management training based on the European Resuscitation Council's 2015 guidelines. Data were collected using a CPR knowledge questionnaire and the State-Trait Anxiety Inventory (STAI). Findings: Results revealed significant improvements in the CPR knowledge scores of the experimental group, increasing from 3.47 (±1.73) to 10.09 (±1.68) (p < 0.001). Concurrently, their state anxiety levels decreased from 45.09 (±10.54) to 38.50 (±9.08) (p < 0.001), and trait anxiety scores showed a moderate reduction. No significant changes were observed in the control group. Unique Contribution to Theory, Practice and Policy: The findings highlight the necessity of integrating CPR training with stress and anxiety management programs in healthcare education. Such training enhances students' ability to perform CPR effectively and reduces psychological barriers, ultimately improving patient outcomes. Further research with broader samples is recommended to validate these results.

Immersive Virtual Reality Versus Mannequin-based Simulation Training for Trauma Resuscitation: A Randomized Controlled Noninferiority Trial.

Despite its high potential, the effect of immersive virtual reality simulation (VRS) in trauma resuscitation training has not been studied. The aim of this study was to test the hypothesis that VRS is non-inferior to mannequin-based simulation (MBS) in trauma resuscitation training. In a single-center, randomized controlled noninferiority trial, we compared individual training with an immersive virtual reality Trauma Simulator to live MBS training in a facilitated group. The primary outcome was the Trauma Score (ranging from 55 to 177) during the MBS assessment. The secondary outcomes were the Trauma Score VRS assessment, System Usability Scale (SUS) (ranging from 0 to 100), and Simulation Sickness Questionnaire (SSQ) (ranging from 0 to 235.62). A total of 38 participants were enrolled in the study. The mean Trauma Score in MBS assessment was 163.2 (SD 7.9) for the control group and 163.1 (SD 13.8) for the intervention group; the difference of means 0.1 (95% confidence interval: -7.3, 7.5; P = .977). The mean Trauma Score in VRS assessment was 134.2 (SD 24.4) for control group and 158.4 (SD 17.6) for intervention group; the difference of means 24.2 (95% confidence interval: 10.1, 38.3; P = .001). The mean SUS of Trauma Simulator was 74.4 (SD 10.5). The median SSQ Total Severity score was 3.7 (IQR 0-18.7). This study showed that VRS led to noninferior effects on trauma resuscitation skills to MBS. Trauma Simulator had good usability, was well received by the participants, and had minimal adverse effects.

CPR training as a gender and rights-based healthcare issue.

It is not understood how cardiopulmonary resuscitation (CPR) training, specifically the representation of sex in CPR manikins, contributes to inequitable outcomes in cardiac arrest survival. The aim of this study was to identify the sex and chest wall secondary sexual characteristics of CPR manikins on the global market. The secondary aim was to identify if manikin manufacturing companies had a publicly available sustainability policy or equivalent, and if these covered products were manufactured. We conducted an observational descriptive study of the secondary sex characteristics and named sex of CPR training manikins available on the global market, and equity, diversity and inclusion (EDI), human rights and sustainability policies of the companies that manufacture them. Nine CPR manikin manufacturers were identified. Twenty CPR manikins were included for analysis. Of the 20 manikins, 75% were identified as male (n = 8, 40%) or no gender specified (n = 7, 35%) and all these had flat torsos-one had a breast overlay available. One company had a 2020 sustainability report that addressed EDI for the workforce only, and a 2023 report addresses this for products manufactured. Adult CPR manikins available globally are largely homogenous, flat-chested and do not have secondary sex characteristics or a named sex. One company had a sustainability report that referenced workforce only and has since committed to EDI for products manufactured. We urge CPR training providers and manufacturers to collectively promote a rights-based approach to healthcare aligned with the commercial determinants of health by committing to improving the diversity of CPR training manikins.

Kids save lives: Who should train schoolchildren in resuscitation? A systematic review

AimCPR training for schoolchildren to increase bystander CPR-rates is widely applied. HCPs are regarded as the instructor gold standard, but using non-HCP instructors (e.g., peer-tutors, schoolteachers, medical students) challenges that. This systematic review assesses whether cardiopulmonary resuscitation (CPR) training for children led by peer-tutors, schoolteachers, or medical students results in different learning outcomes to training by health-care professionals (HCPs). MethodsWe searched studies that compared CPR training for schoolchildren (population) delivered by peer-tutors, schoolteachers, or medical students (intervention), with training led by HCPs (comparison), assessing student knowledge, skills, willingness and/or confidence to perform CPR (outcome). We included randomized and non-randomized controlled trials (study design). Medline, Embase, Psychinfo, Cinahl, Cochrane, Scopus, Web of Science, and Eric were searched from inception until December 23rd, 2023 (timeframe). Two independent reviewers performed title, abstract, full text screening, bias assessment, and grading of certainty of evidence. We followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines, and registered the review with PROSPERO. ResultsOf 9′092 studies identified, 14 were included. Comparison of intervention groups to HCP-led training showed similar overall results (knowledge, skills, self-confidence). Superior results for HCP training were only reported for ‘ventilation volume’, while schoolteachers and medical students achieved superior knowledge transfer. A meta-analysis was possible for ‘compression depth’ between peer-tutors and HCPs showing no significant differences. Certainty of evidence was ‘low’ to ‘very low’. ConclusionThis systematic review of CPR training for school children revealed that peer-tutors, schoolteachers and medical students achieve similar educational outcomes compared to those of HCPs. Non-HCPs training schoolchildren is an appropriate cost-efficient alternative and easy to implement in school curricula.

Comparative effectiveness of self-learning and instructor-assisted pediatric cardiopulmonary resuscitation training: A prospective randomized study

Comparative effectiveness of self-learning and instructor-assisted pediatric cardiopulmonary resuscitation training: A prospective randomized study

Comparison of virtual and in-person simulations for sepsis and trauma resuscitation training in Singapore: a randomized controlled trial.

This study aimed to compare cognitive, non-cognitive, and overall learning outcomes for sepsis and trauma resuscitation skills in novices with virtual patient simulation (VPS) versus in-person simulation (IPS). A randomized controlled trial was conducted on junior doctors in emergency departments from January to December 2022, comparing 70 minutes of VPS (n=19) versus IPS (n=21) in sepsis and trauma resuscitation. Using the nominal group technique, we created skills assessment checklists and determined Bloom's taxonomy domains for each checklist item. Two blinded raters observed participants leading 1 sepsis and 1 trauma resuscitation simulation. Satisfaction was measured using the Student Satisfaction with Learning Scale (SSLS). The SSLS and checklist scores were analyzed using the 2-tailed t-test. For sepsis, there was no significant difference between VPS and IPS in overall scores (2.0; 95% confidence interval [CI], -1.4 to 5.4; Cohen's d=0.38), as well as in items that were cognitive (1.1; 95% CI, -1.5 to 3.7) and not only cognitive (0.9; 95% CI, -0.4 to 2.2). Likewise, for trauma, there was no significant difference in overall scores (-0.9; 95% CI, -4.1 to 2.3; Cohen's d=0.19), as well as in items that were cognitive (-0.3; 95% CI, -2.8 to 2.1) and not only cognitive (-0.6; 95% CI, -2.4 to 1.3). The median SSLS scores were lower with VPS than with IPS (-3.0; 95% CI, -1.0 to -5.0). For novices, there were no major differences in overall and non-cognitive learning outcomes for sepsis and trauma resuscitation between VPS and IPS. Learners were more satisfied with IPS than with VPS (clinicaltrials.gov identifier: NCT05201950).

Knowledge and Attitude on Neonatal Resuscitation Among Nursing Students: A Cross-Sectional Study.

This study assesses nursing students' knowledge and attitudes toward neonatal resuscitation. This cross-sectional study was conducted at a nursing college in June 2024. Participants were selected through purposive sampling. Data on knowledge and attitudes toward neonatal resuscitation were collected using self-administered web-based questionnaires. Statistical analyses were used to examine the comparisons, correlations, and predictors, including t-tests, ANOVA, Pearson correlation tests, and binomial logistic regression. Statistical analyses showed that 45.2% of nursing students had moderate knowledge, 39% had good knowledge, and all exhibited positive attitudes. BSc nursing students, those with prior neonatal resuscitation training, and those who had witnessed or performed resuscitation had significantly higher knowledge (p ≤.001). III-year Diploma students, those aged 22-23, and students with 6-10 days of NICU/labor room posting also had higher knowledge (p ≤ .001, p ≤ .005). Additionally, BSc students and those with prior training displayed significantly more positive attitudes (p ≤ .001). A moderate positive correlation was found between knowledge and attitude, with key predictors being labor room posting duration for knowledge and exam marks for attitude. This study highlights the need for improved neonatal resuscitation education and training of nursing students to improve outcomes and reduce mortality rates among newborns. To ensure effective newborn care, educational programs can be designed to target specific areas such as clinical exposure and resuscitation training. Comprehensive training initiatives aligned with international guidelines are vital for developing proficient neonatal resuscitation practices. Such proactive approaches can help build a cohort of competent healthcare professionals who can deliver timely and effective interventions, thereby ensuring the well-being of newborns.

Abstract Su1106: Evaluating Culturally Competent Cardiopulmonary Resuscitation (CPR) Training in Urban Minority Communities

Introduction: Timely resuscitation can triple the chance of survival for out-of-hospital cardiac arrest (OHCA) patients. Differences in bystander CPR rates between white and minority communities lead to significant racial and ethnic disparities in OHCA survival rates. Immigrant populations, in particular, face several educational barriers and are often excluded in community CPR trainings. Previous efforts have increased the inclusivity of CPR education for female and disabled citizens through targeted interventions. Significant opportunities exist to apply similar strategies and tackle community-level disparities. Aim: To examine the impact of culturally competent CPR instruction on confidence levels and acceptability of CPR skills among minority citizen groups. Methods: CPR cohorts were taught using a local emergency services syllabus. Through discussion with course site leaders, the syllabus was adapted in three categories: language variations, cultural adaptations, and/or consideration of cultural learning styles. A pre-post design was utilized to assess impact of culturally-tailored CPR training. Confidence and acceptability levels in performing CPR were measured using a digital survey. An unpaired t-test was used to analyze pre/post-course data. Trainings were held from November 2023 to May 2024. Results: All participants were 18 years or older (n=217). The response rate was 36.7% (n=80). Confidence levels increased by 121% for checking for breathing and responsiveness (p<0.0001), 63.9% for communicating with 911 (p<0.0001), 137% for administering chest compressions (p<0.0001), and 172% for connecting an AED (p<0.0001). CPR acceptability improved, with participants reporting a 47.8% reduction in perceived difficulty post-course (p<0.0001). Conclusions: Implementing culturally tailored CPR training significantly improved confidence in CPR skills and acceptability of CPR. Future experiments may compare outcomes between intervention and control CPR cohorts at more course sites.

CURRENT LEVEL OF KNOWLEDGE AND AWARENESS OF HEALTHCARE PERSONNEL IN BASIC AND ADVANCED LIFE SUPPORT IN ARREST CASES WITH AND WITHOUT COVID-19 INFECTION

Objective: The knowledge of healthcare professionals about life support is crucial for saving lives. It was aimed to evaluate the knowledge and awareness level of healthcare professionals about advanced life support. Materials and methods: Our study was conducted between 15.02.2021 and 15.03.2021 with healthcare personnel working in our hospital. Data were collected by the questionnaire method. The researcher prepared the survey questions according to the European Resuscitation Council COVID-19 guidelines and American Heart Association Advanced Cardiac Life Support algorithms updated in 2020. 265 healthcare personnel (physicians, physician assistants, family physicians, nurses, health officers, and anesthesia technicians) participated in the study. Demographic characteristics of the participants (gender, age, duration of service, duties, duty stations), training and practice status, and level of knowledge were evaluated. Results: 67.2% of the participants were female, and 32.8% were male. The majority of the participants were nurses working in the inpatient clinics. 49.9% had a tenure of 1-5 years. 52.0% had received advanced cardiac life support training, and 19.6% had obtained and used automatic external defibrillators. 63.8% had performed advanced cardiac life support on a patient. In our study, the general level of advanced cardiac life support knowledge of the participants was found to be low. There was no significant difference in advanced cardiac life support scores in terms of gender, age, occupation, workplace, and tenure (p=0.604; p=0.986; p=0.927; p=0.982; p=0.295, respectively). Conclusion: Providing in-service resuscitation training to healthcare workers in line with current guidelines and supporting them with practical applications can provide quality knowledge and skills and increase their awareness of their responsibilities.

Enhancing cardiopulmonary resuscitation training for the community with foam pillows: A promising approach.

This study evaluates the efficacy of foam pillows as instructional aides to achieve accurate compression depth and chest recoil during CPR training. A descriptive study design was employed. The study involved 30 respondents with no experience with CPR. We enrolled 30 respondents aged 17 to 25 through open recruitment via WhatsApp and Instagram. Foam pillows (45 cm x 60 cm) with compression markers served as instructional tools. The study utilized Laerdal's Little Anne QCPR CPR mannequins and the QCPR application on an iPad Air 2 . After 1 minute of hands-only CPR on a foam pillow, all respondents continue to perform in Little Anne QCPR mannequin. The findings of this study show that the correct compression depth was performed by 28 respondents (93%) and the correct chest recoil by 30 respondents (100%). Foam pillows promise to enhance community-based CPR training by promoting precision in compression depth and chest recoil.

Impact of Simulation on the Development of Nursing Students' Competence in Adult Cardiopulmonary Resuscitation.

Cardiopulmonary resuscitation (CPR) training is crucial for nursing students as future nurses are the first responders in the ambulatory and hospital care chain. Simulation-based learning has been shown to be more effective in acquiring the knowledge and technical and non-technical skills required for CPR. The present study aims to evaluate the impact of high-fidelity simulation-based adult CPR training on the acquisition and retention of knowledge and the development of technical and non-technical skills of nursing students at the Higher Institute of Nursing Professions and Health Techniques in Fez, Morocco. We conducted an interventional study with 49 nursing students. Twenty-five students (51.02%) in the simulation group received both traditional CPR training (theoretical lecture and demonstration of procedures) and simulation CPR training, while 24 students (48.97%) in the control group received only traditional training. Data were obtained using a questionnaire on theoretical knowledge of CPR, a technical skills assessment grid, and the Team Emergency Assessment Measure (TEAM) for non-technical skills. The post-test scores for theoretical knowledge immediately after simulation were significantly higher for the simulation group (16.41±1.73 out of 20) than for the control group (13.15±1.96 out of 20). Mean CPR knowledge retention scores 30 days after training were significantly higher in the simulation group (15.60±1.71) compared with the control group (11.38±1.93). Assessment of technical skills on a high-fidelity mannequin showed a considerable advantage for the simulation group (30.88±1.64 out of 34) over the control group (18.00±0.78 out of 34). In addition, the results demonstrated a significant difference between the TEAM score of the simulation group (37.84±2.67 out of 44) and the control group (22.33±0.96 out of 44) and a significant difference between the Global Team Performance of the simulation group (8.16±0.68) out of 10 and the control group (4.83±0.38). The findings demonstrated that adult CPR training using high-fidelity simulation was superior to the traditional method with regard to knowledge acquisition and retention and the development of technical and non-technical skills in undergraduate nursing students.

Fire at Sea: A 70-year Review of Fire-Related Mass Casualty Events on U.S. Aircraft Carriers.

A major fire at sea is among the most devastating events that can occur while a U.S. Navy combatant vessel is underway. Since World War II, no attack on a large U.S. Navy capital ship has occurred during combat operations. However, increasing global tensions raise the threat of future peer adversary naval combat, and shipboard medical caregivers must be prepared for mass casualty events in the deployed maritime environment. To better prepare modern naval caregivers for this possibility, we reviewed mass casualty events from major fires aboard large U.S. Navy aircraft carriers from 1950 through 2020 to summarize available objective data and identify lessons learned. Underway fires from any cause aboard U.S. Navy aircraft carriers and large amphibious assault ships causing more than 10 casualties (injuries + deaths) were reviewed from 1950 through 2020 using available open access sources including literature review, the Naval Safety Command mishap database, and U.S. Navy Judge Advocate Manual reports. Of 246 fires identified, 27 met inclusion criteria resulting in 1,634 casualties with a combined crew mortality of 23% of those injured. In the 16 events with at least 1 death, 2.0% of the total crew was injured with a combined mortality of 28%. All mishaps occurred while underway during routine training or combat operations; none were caused by an enemy combatant attack. Those events affecting more than 5% of the crew were particularly devastating resulting in a mortality rate of 29% of 1,056 total casualties. Given that main medical spaces may be damaged or destroyed during major fires from any cause, identified lessons learned included the need for (1) distributed medical supplies, (2) flexible medical treatment locations throughout the ship, (3) specific training to prepare non-physician caregivers and non-medical first responders to provide burn and hemorrhagic shock resuscitation, airway management, and prolonged care at or near the point of injury, and (4) the prolonged holding capability of critically ill burned and injured patients if evacuation off the ships is unavailable. Shipboard fires underway pose a significant threat to crew safety with a mortality of nearly a quarter of those injured. These fire mass casualty events immediately overwhelm shipboard medical capabilities requiring a complex response from all hands beginning with non-medical first responders. Notably, all events occurred outside of direct enemy combat, potentially underestimating the impact and number of casualties of a shipboard fire during naval combat. Advances in peer weaponry and the threat of future conflict emphasize the need for pre-deployment burn care training for all shipboard medical caregivers as well as advanced airway and resuscitation training for non-physician caregivers. This review underscores the profound impact of shipboard fires on crew safety, highlighting the critical need for enhanced preparedness and response strategies to prepare for fire-related mishaps during routine operations and naval combat.

A pilot study of a virtual reality-based simulation platform for Neonatal Resuscitation Program training.

This pilot implementation study introduces a novel, neonatal-specific virtual reality (VR) simulation platform for resuscitation training and assesses its initial feasibility and reception in a neonatal intensive care unit setting. We developed a custom VR model simulating a resuscitation scenario for a 30-week neonate. Neonatal providers completed individualized training sessions and post-training surveys. Thirty-eight neonatal providers participated in the study. The VR platform was well-received, with 97% willing to use it again and 95% recommending it. Most participants (70.3%) found VR more realistic than traditional methods, with an average usefulness rating of 4.5/5. However, 40.5% reported adverse effects like eye strain and motion sickness. Feedback led to three significant VR platform upgrades. This study demonstrates strong enthusiasm for VR among neonatal providers. While promising, further research with larger samples and comparisons to traditional methods is needed to fully evaluate VR's effectiveness in neonatal resuscitation training.

The use of the objective structured clinical examination to evaluate paediatric cardiopulmonary resuscitation skills in medical students and measures to improve training

BackgroundThe main objectives of the study were to analyse the use of the Objective Structured Clinical Examination (OSCE) to evaluate the skills of medical students in paediatric basic life support (PBLS), to compare two resuscitation training models and to evaluate the measures to improve the teaching program.MethodsComparative, prospective, observation study with intervention in two hospitals, one undergoing a PILS course (Paediatric Immediate Life Support) and another PBLS. The study was performed over three phases. 1º. PBLS OSCE in 2022 three months after the resuscitation training 2. Measures to improve the training program in 2023 3. PBLS OSCE in 2023. Overall results were analysed and comparison between both sites and those for 2022 and 2023 were made.ResultsA total of 210 and 182 students took part in the OSCE in 2022 and 2023, respectively. The overall mean score out of 100 was 83.2 (19), 77.8 (19.8) in 2022 and 89.5 (15.9) and 2023, P < 0.001. Overall cardiopulmonary resuscitation (CPR) effectiveness was adequate in 79.4% and 84.6% of students in 2022 and 2023, respectively. The results of hospital students undergoing a PILS course were better (86.4 (16.6) than those undergoing a PBLS. 80.2 (20.6) p < 0.001. The results from both hospitals improved significantly in 2023.ConclusionsThe OSCE is a valid instrument to evaluate PBLS skills in medical students and to compare different training methods and program improvements. Medical students who receive a PILS attain better PBLS skills than those who undergo a PBLS course.

Interprofessional In Situ Simulation’s Impact on Healthcare Personnel’s Competence and Reported Need for Training in Cardiopulmonary Resuscitation—A Pilot Study in Norway

Background/objectives: International guidelines recommend cardiopulmonary resuscitation [CPR] training every sixth month. However, research indicates that more training is needed to maintain CPR competence. The objectives of this pilot study were (a) to assess health personnel’s self-reported competence and need for more training in CPR before and after interprofessional in situ CPR simulation and (b) to assess time since the last CPR course and respondent’s reported need for more training. Also, we wanted a pilot to assess areas of improvement in a future, larger study. Methods: A questionnaire was administered to healthcare personnel in hospital wards receiving CPR training using a purposeful sampling strategy. Results: In total, 311 respondents answered the pre-intervention and 45 respondents answered the post-intervention survey. The respondents believed they had good knowledge, skills, and training in CPR, and about 2/3 of the respondents reported a need for more knowledge, skills, and training. There was a weak positive correlation between the time since the last CPR course and the perceived need for more training [p &lt; 0.05]. There were no significant differences in self-reported competence or perceived need for more training pre- and post-intervention. The pilot detected several limitations that need improvement in a future study. Conclusions: The authors suggest that regular training is important for maintaining competence in CPR. Also, in a future study, comparisons at an individual level, as well as assessments by experts and of non-technical skills, should be included.

The Association of Time to Key Prehospital Interventions Recorded by EMT-Worn video Devices and Sustained Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest

Objectives The quality of prehospital resuscitation provided by emergency medical technicians (EMTs) is essential to ensure better outcomes following out-of-hospital cardiac arrests (OHCA). We assessed the quality of prehospital resuscitation by recording time to key prehospital interventions using EMT-worn video devices and investigated its association with outcomes of patients with OHCA. Methods This retrospective, cross-sectional study included cases of non-traumatic OHCA in adults treated by emergency medical services (EMS) in Hsinchu City, Taiwan, during 2022 and 2023. We used data from high-resolution, chest-mounted wearable cameras to define and measure six quality indices (QIs) for prehospital resuscitation interventions (i.e., time spent recognizing OHCA). To evaluate the association between QI performance and sustained return of spontaneous circulation (ROSC), we used multivariable logistic regression. Results Of 745 patients eligible for this study, 187 (25.1%) achieved sustained ROSC. Six core QIs were analyzed: recognition of OHCA (median time: 9.0 s), time from recognizing OHCA to initiating cardiopulmonary resuscitation (cardiopulmonary resuscitation [CPR]; 9.0 s), automated external defibrillator setup (34.0 s), time from recognizing OHCA to beginning ventilation (160.0 s), advanced airway management (300 s), and deploying a mechanical CPR device (50 s). The performance of the six QIs were not associated with sustained ROSC (Adjusted odds ratio [95% confidence interval]: 1.00 [0.99–1.00], 0.99 [0.98–1.00], 1.00 [1.00–1.01], 1.00 [1.00–1.00], 1.00 [1.00–1.00], and 0.99 [0.99–1.00], respectively). Conclusions This study describes the rate of sustained ROSC and time to key interventions captured by EMT-worn video devices in non-traumatic OHCA patients. Although we found no direct link between QI performance and improved OHCA outcomes, this study highlights the potential of video-assisted QIs to enhance the documentation and understanding of prehospital resuscitation processes. These findings suggest that further refinement and application of these QIs could support more effective resuscitation strategies and training programs.

Empowering Medical Students by Facilitating Cardiopulmonary Resuscitation Training for Their Peer

Cardiopulmonary Resuscitation (CPR) training is an essential component of medical education, equipping students with life-saving skills to respond effectively in emergencies. Following a CPR training program, this study investigates the impact of medical students’ knowledge and confidence levels as they facilitate hands-on CPR sessions for their peers. Through a review of literature and empirical analysis, this research elucidates the benefits of peer-assisted learning in CPR education. Results indicate a significant improvement in both knowledge and confidence levels among facilitators following the CPR training program. Overall, the findings highlight the invaluable role of medical student facilitators in enhancing CPR training outcomes and fostering a culture of peer support and empowerment within the medical community. This study underscores the significance of integrating peer-assisted learning strategies into CPR education programs, providing medical students with opportunities for both personal and professional growth. By leveraging the expertise and enthusiasm of medical student facilitators, educators can enhance the effectiveness and sustainability of CPR training initiatives, ultimately contributing to improved patient outcomes and community resilience in emergencies.

Safety management within the scope of teaching practical clinical skills: framing errors for cardiopulmonary resuscitation training – a multi-arm randomized controlled equivalence trial

Introduction Cardiopulmonary resuscitation (CPR) is among the most important skills in clinical practice. Errors can happen here, just like everywhere, and potentially have severe consequences. Two common error handling strategies known from practice are Error Management (EM) and Error Avoidance (EA). However, its effects on medical performance outcomes remain unclear. This study aimed to examine the role of error framing in basic life support (BLS) training for future healthcare professionals. Materials and Methods In an equivalence trial (N = 430), first-year medical, dentistry, physiotherapy, and midwifery students underwent BLS training. In the three study arms, participants received either (1) instructions framing errors positively (EM), (2) instructions framing errors to be avoided (EA), or (3) no further instructions (Control). CPR performance was assessed using a resuscitation manikin measuring compression depth (CD) and compression rate (CR). The self-confidence ratings were assessed using a questionnaire. Equivalence margins for the outcome parameters and sample size calculations were based on previous standard BLS studies, using two-sided 95% confidence intervals to determine significance of equivalence. Results The results regarding CD revealed equivalence with a trend toward superiority of EM over EA (proportional difference 23.3%-points; 95% CI 11.4%–34.2%) and EM over control (proportional difference 23.4%-points; 95% CI 11.5%–34.2%.) and significant equivalence of EA and control (proportional difference 0.1%-points; 95% CI −11.6%–11.7%). Significant equivalence was determined for all study arms with respect to CR and self-confidence. Conclusion Our study revealed that EM was not detrimental to learners’ CPR performance. Given existing research on long-term beneficial effects of EM on patient safety, coupled with the proven equivalence of EM and EA concerning short-term performance, we argue that EM is a promising approach for future medical education purposes. Raising awareness of error framing and teaching error-handling strategies is expected to benefit ongoing safety management efforts in medical education and beyond.

Impact of the Neonatal Resuscitation Video Review program for neonatal staff: a qualitative analysis.

Neonatal resuscitation video review (NRVR) involves recording and reviewing resuscitations for education and quality assurance. Though NRVR has been shown to improve teamwork and skill retention, it is not widely used. We evaluated clinicians' experiences of NRVR to understand how NRVR impacts learning and can be improved. Neonatal Intensive Care Unit (NICU) clinicians with previous NRVR experience were recruited for individual semi-structured interviews. Using a social constructivist viewpoint, five researchers used thematic analysis to analyze participant responses. Twenty-two clinicians (11 nurses, 11 doctors) were interviewed. All participants expressed positive attitudes towards NRVR. Four themes were identified: (1) Learning from reality-exposure to real-life resuscitations was highly clinically relevant. (2) Immersive self-regulation-watching videos aided recall and reflection. (3) Complexities in learner psychological safety-all participants acknowledged viewing NRVR videos could be confronting. Some expressed fear of judgment from colleagues, though the educational benefit of NRVR superseded this. (4) Accessing and learning from diverse vantage points-NRVR promoted group discussion, which prompted participant learning from colleagues' viewpoints. Neonatal clinicians reported NRVR to be an effective and safe method for learning and refining skills required during neonatal resuscitation, such as situational awareness and communication. Neonatal resuscitation video review is not known to be widely used in neonatal resuscitation teaching, and published research in this area is limited. Our study examined clinician attitudes towards an established neonatal resuscitation video review program. We found strong support for teaching using neonatal resuscitation video review among neonatal doctors and nurses, with key benefits including increased situational awareness and increased clinical exposure to resuscitations, while maintaining psychological safety for participants. The results of this study add evidence to support the addition of video review to neonatal resuscitation training.

Impact of Video-Based Error Correction Learning for Cardiopulmonary Resuscitation Training: Quasi-Experimental Study.

Video-based error correction (VBEC) in medical education could offer immediate feedback, promote enhanced learning retention, and foster reflective practice. However, its application in cardiopulmonary resuscitation (CPR) training has not been investigated. The objective of this study is to assess whether the VBEC procedure could improve the training performance of CPR among anesthesiology residents. A quasi-experimental study was conducted among anesthesiology residents between December 2022 and April 2023. Primary outcomes included a posttraining knowledge test and practical assessment scores. Secondary outcomes included the number of residents who correctly conducted CPR at each step, the rate of common mistakes during the CPR process, and the self-assessment results. A total of 80 anesthesiology residents were divided into a VBEC group (n=40) and a control group (n=40). The VBEC group underwent a 15-minute VBEC CPR training, whereas the control group underwent a 15-minute video-prompting CPR training. The posttraining knowledge test score of the VBEC group was significantly higher than that of the control group (73, SD 10.5 vs 65.1, SD 11.4; P=.002). The residents in the VBEC group had lower error rates in "failure to anticipate the next move" (n=3, 7.5% vs n=13, 32.5%; P=.01) and "failure to debrief or problem solve after the code" (n=2, 5% vs n=11, 27.5%; P=.01), as well as better performance in the "secure own safety" step (n=34, 85% vs n=18, 45%; P<.001) than those in the control group. The VBEC group showed significantly higher confidence in CPR than the control group (n=?, 62.5% vs n=?, 35%; P=.03). VBEC may be a promising strategy compared to video prompting for CPR training among anesthesiology residents.