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

Background: 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. Objective: The objective of this study is to assess whether the VBEC procedure could improve the training performance of CPR among anesthesiology residents. Methods: 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. Results: 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). Conclusions: VBEC may be a promising strategy compared to video prompting for CPR training among anesthesiology residents.

Advancing CPR Training with Virtual Reality: A Review.

This literature review assesses the effectiveness of virtual reality (VR) serious games in cardiopulmonary resuscitation training, focusing on its impact on skill acquisition, confidence, and knowledge retention.

Exploring the Functionality of Technology-driven CPR Training Methodologies Among Healthcare Practitioners: A Randomized Control Pilot Study.

Introduction: Cardiopulmonary resuscitation training in Malaysia has evolved from traditional to modern approaches, embracing technology for better outcomes. Smartphone-based training apps offer interactive learning with simulations and real-time feedback, improving cardiopulmonary resuscitation skills anytime, anywhere. This study evaluates the effectiveness of the smart-cardiopulmonary resuscitation application for healthcare practitioners. Methods: This randomized controlled pilot study was conducted with 30 healthcare practitioners at the University of Malaysia Sabah. Participants underwent a Cardiopulmonary Resuscitation Practical formal educational training program, and data were collected using a Basic Life Support questionnaire and skills assessment checklist sourced from the American Heart Association (2020). Data analysis was conducted utilizing repeated analysis of variance and the Cochran 'Q' test supported by Statistical Package for the Social Sciences statistical software. Result: The control and intervention groups showed improved knowledge and skills from pre-to post-cardiopulmonary resuscitation courses; a significant increase was observed in the intervention group compared to the control group. The F-test indicated a significant time-group effect (F-stat (df) = 16.14 (2), p = 0.01). Cochran's 'Q' test also revealed significant changes in the proportion of healthcare practitioners passing their skills assessments over time (2 = 14.90, control 01). Conclusion: The smart-cardiopulmonary resuscitation application is convenient for refreshing cardiopulmonary resuscitation skills and maintaining proficiency. While it doesn't replace formal cardiopulmonary resuscitation courses, it saves healthcare practitioners and the community time and money. Both groups showed improved cardiopulmonary resuscitation knowledge and skills, with the intervention group using the smart-cardiopulmonary resuscitation application showing higher success rates after two months. Adopting smartphone-based cardiopulmonary resuscitation training with comprehensive content is recommended.

Under pressure: What individual characteristics lead to performance of high-quality chest compressions during CPR practice sessions?

Aim: Despite well-established protocols for cardiopulmonary resuscitation training, performance during real-life cardiac arrests can be suboptimal. Understanding personal characteristics which could influence performance of high-quality chest compressions could provide insight into the practice-performance gap. This study examined chest compression performance, while employing feedback and introducing code team sounds as an anxiety-inducing factor in registered nurses using a cardiopulmonary resuscitation training manikin. Methods: Participants included 120 registered nurses with basic life support certification randomized to one of the following groups: no feedback and no code team sounds, feedback without code team sounds, or feedback with code team sounds. Chest compression sessions occurred at baseline, 30-days and 60-days. Demographic variables and anxiety level were also collected. The primary outcome was chest compression performance, defined as average percent of time with correct rate and percent with correct depth as captured by the defibrillator. Statistical analysis included linear mixed effects analysis. Results: The effect of feedback on chest compression performance depended on the value of other parameters. The benefit of feedback on the primary outcome depended on: age, with feedback less beneficial among older participants (p = 0.0413); and time, with feedback more beneficial with repetition (p = 0.011). These interactions also affected the outcome percent of time with correct compression depth. Increased anxiety was associated with decreased percent correct compression depth (p < 0.001). Conclusion: Feedback emerged as important in determining chest compression performance. Chest compression quality was limited by the performer's age and anxiety level. Future research should focus on identifying factors related to individual characteristics which may influence chest compression performance.

Contemporary levels of cardiopulmonary resuscitation training in Denmark.

Aim: Many efforts have been made to train the Danish population in cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. We assessed CPR and AED training levels among the broad Danish population and volunteer responders. Methods: In November 2018, an electronic cross-sectional survey was sent to (1) a representative sample of the general Danish population (by YouGov) and (2) all volunteer responders in the Capital Region of Denmark. Results: A total of 2,085 people from the general population and 7,768 volunteer responders (response rate 36%) completed the survey. Comparing the general Danish population with volunteer responders, 81.0% (95% CI 79.2-82.7%) vs. 99.2% (95% CI 99.0-99.4%) p < 0.001 reported CPR training, and 54.0% (95% CI 51.8; 56.2) vs. 89.5% (95% CI 88.9-90.2) p < 0.001 reported AED training, at some point in life.In the general population, the unemployed and the self-employed had the lowest proportion of training with CPR training at 71.9% (95% CI 68.3-75.4%) and 65.4% (95% CI 53.8-75.8%) and AED training at 39.0% (95% CI 35.2-42.9%) and 34.6% (95% CI 24.2-46.2%), respectively.Applicable to both populations, the workplace was the most frequent training provider. Among 18-29-year-olds in the general population, most reported training when acquiring a driver's license. Conclusions: A large majority of the Danish population and volunteer responders reported previous CPR/AED training. Mandatory training when acquiring a driver's license and training through the workplace seems to disseminate CPR/AED training effectively. However, new strategies reaching the unemployed and self-employed are warranted to ensure equal access.

Save a Life: Implementation and Evaluation of a Community-Focused CPR Education Program in Houston, Texas.

Over 350 000 people in the United States experience out-of-hospital cardiac arrest (OHCA) annually-and almost 90% die as a result. However, survival varies widely between counties, ranging from 3.4% to 22.0%-a disparity that the American Heart Association (AHA) largely attributes to variation in rates of bystander CPR. Studies show that regions with low rates of bystander CPR have low rates of CPR training, making CPR training initiatives a high-priority intervention to reduce OHCA mortality. In Houston, Texas, researchers have identified census tracts with higher OCHA incidence and lower rates of bystander CPR. We developed a free, annual Hands-Only CPR bilingual health education program central to these high-risk neighborhoods. In 5 years, this collaborative effort trained over 2700 individuals. In 2016, 2017, and 2018, we conducted a process evaluation to assess fidelity, dose delivered, and dose received. We also conducted an outcome evaluation using the Kirkpatrick Model for Training Evaluation to assess participants' reactions and learning. Overall, the program yielded positive outcomes. Of the 261 respondents (from 314 attendees), 63% were first-time learners. The majority (87%) were satisfied with the event and 85% felt that information was presented clearly and concisely. Pre- and post-knowledge assessments showed a 51% increase in the proportion of respondents who could correctly identify the steps for Hands-Only CPR. This program exemplifies how collaborative education can impact a community's health status. Leveraging each partner's resources and linkages with the community can enhance the reach and sustainability of health education initiatives.

Evaluation of Awareness, Knowledge, and Attitudes Towards Basic Life Support Among Non-Medical Students at Two Academic Institutions in Jeddah, Saudi Arabia.

BACKGROUND: Cardiac arrests are a leading cause of mortality in Saudi Arabia. Prompt and quick intervention using early cardiopulmonary resuscitation (CPR) can be a life-saving strategy. Sufficient knowledge and awareness regarding CPR are important in initial care, particularly during an out-of-hospital cardiac arrest. We aim to assess the knowledge, awareness, and attitude toward CPR among the students of King Abdulaziz University and Jeddah University. MATERIALS AND METHODS: A descriptive, cross-sectional study design with a sample of 1053 non-medical students, regardless of their academic year, was conducted from May to July 2019 at both universities. Data were analyzed through chi-square and analysis of variance where a P-value <0.05 was considered statistically significant. RESULTS: Out of 1053 students, 28.7% received CPR training. Also, the majority of the subjects were female 71%. The science department provided the largest response. Results showed that chest pain was the most observed early sign of cardiac arrest among participants by a percentage of 84.6. Majority of the participants (90.9%) felt no hesitation in performing early CPR on a family member. Additionally, committing a mistake was the most feared factor that deterred students from performing CPR. CONCLUSION: Knowledge and awareness of CPR among non-medical university students were poor, despite positive attitudes toward it. Integrating mandatory CPR courses in the orientation and in the first year of the undergraduate curriculum could increase awareness and improve the outcomes of out-of-hospital cardiac arrest (OHCA).

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses.

CONTEXT: Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. AIMS: To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. SETTING AND DESIGN: Tertiary care hospital, Prospective, repeated-measures design. SUBJECTS AND METHODS: A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. STATISTICAL ANALYSIS USED: SPSS for Windows version 21.0. RESULTS: The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). CONCLUSIONS: Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

Low compliance with the 2 minutes of uninterrupted chest compressions recommended in the 2010 International Resuscitation Guidelines.

BACKGROUND: We aimed to analyze compliance with 2010 European guidelines' quality criteria for external chest compressions (ECC) during 2 minutes of uninterrupted cardiopulmonary resuscitation. METHODS: Seventy-two healthy nurses and physicians trained in advanced cardiopulmonary resuscitation performed 2 uninterrupted minutes of ECC on a training manikin (Resusci Anne Advanced SkillTrainer; Laerdal Medical AS, Stavanger, Norway) that enabled us to measure the depth and rate of ECC. When professionals agreed to participate in the study, we recorded their age, body mass index (BMI), smoking habit, and their own subjective estimation of their physical fitness. To measure fatigue, we analyzed participants' heart rates, percentage of maximum tolerated heart rate (MHR), and subjective perception of their fatigue on a visual analog scale. RESULTS: Nearly half (48.6%) the rescuers failed to achieve a minimum average ECC depth of 50 mm. Only 48.1% of ECCs fulfilled the 2010 guidelines' quality criteria; quality deteriorated mainly after the first minute. Poor ECC quality and deteriorating quality after the first minute were associated with BMI < 23 kg/m(2). Rescuers with BMI ≥ 23 kg/m(2) fulfilled the quality criteria throughout the 2 minutes, whereas those with BMI < 23 kg/m(2) fulfilled them for 80% of ECCs during the first minute, but for only 30% at the end of the 2 minutes. CONCLUSIONS: Compliance with the 2010 guidelines' quality criteria is often poor, mainly due to lack of proper depth. The greater depth recommended in the 2010 guidelines with respect to previous guidelines requires greater force, so BMI < 23 kg/m(2) could hinder compliance. Limiting each rescuer's uninterrupted time doing ECC to 1 minute could help ensure compliance.