Deliberate practice in resuscitation training using a feedback device, and the effects of the physical characteristics of the rescuer on the acquisition and retention of cardiopulmonary resuscitation skills: Randomized clinical trial.

BACKGROUND: Cardiopulmonary resuscitation (CPR) skills decline rapidly and rescuers' physical characteristics could impact on their performance. Our aim was to analyse the effects of deliberate practice using a feedback device (FD) on the CPR performance of nursing students prior to, immediately after, and three months after training, considering their physical characteristics. METHOD: Sixty nursing students participated in this randomized clinical trial (control group n = 28; training group n = 32). Their physical characteristics (weight, height, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)% index, handgrip strength, and CPR position strength) were measured before starting the trial. The training group followed a CPR training programme based on deliberate practice, providing feedback on their performance using an FD. All participants were evaluated during two-minute CPR compression/ventilation cycles. RESULTS: The training group showed an improved ability to perform chest compressions (F(2, 115.2) = 13.3; p < .001; ω2p = 0.17) and ventilations (F(2, 115.3) = 102.1; p < .001; ω2p = 0.63), improving their overall quality of CPR (F(2, 115.2) = 40.1; p < .001; ω2p = 0.40). The physical characteristics of the participants did not affect CPR performance in any study phase. CONCLUSIONS: A structured training programme based on deliberate practice using an FD had a positive effect on the acquisition of CPR skills by participants, while their physical characteristics had no impact on performance.

Quality of cardiopulmonary resuscitation: Degree of agreement between instructor and a feedback device during a simulation exercise.

BACKGROUND: High-quality cardiopulmonary resuscitation (CPR) saves lives after a cardiorespiratory arrest. Currently used feedback devices (FD) provide accurate information on CPR quality during training. However, there is no consensus in previous studies that have compared FD to the feedback provided by an instructor and most show methodological limitations. This study aimed to analyse the degree of agreement between an FD and an instructor in the assessment of high-quality CPR. METHOD: 60 undergraduate nursing students participated in a descriptive observational study. Variables related to the quality of chest compressions (CC) and ventilation were recorded. Students were evaluated during 2-minute compression/ventilation cycles by an expert instructor and using the CPR training torso, Little Anne™ QCPR (Laerdal Medical) with its associated QCPR Instructor App software for iOS. RESULTS: The degree of agreement between instructor and FD assessments was moderate-good: CC rate per minute (Intracass correlation coeficiente [ICC] = 0.791), complete chest recoil (ICC = 0.437); CC depth (k = 0.804); CC with correct depth (ICC = 0.557); correct ventilations (k = 0.510); ventilations per cycle (ICC = 0.635); CC per cycle (ICC = 0.215); overall quality of CPR (ICC = 0.602). However, the degree of agreement should be considered poor since the limits were broad. CONCLUSIONS: Although there were discrepancies between the FD and the instructor, it would be advisable to follow a combined approach in CPR training, whereby the quantitative feedback supplied by the FD is complemented by the qualitative assessment of an instructor.