A randomized education trial of spaced versus massed instruction to improve acquisition and retention of paediatric resuscitation skills in emergency medical service (EMS) providers.

AIM: Resuscitation courses are typically taught in a massed format despite existing evidence suggesting skill decay as soon as 3 months after training. Our study explored the impact of spaced versus massed instruction on acquisition and long-term retention of provider paediatric resuscitation skills. METHODS: Providers were randomized to receive a paediatric resuscitation course in either a spaced (four weekly sessions) or massed format (two sequential days). Infant and adult chest compressions [CC], bag mask ventilation [BMV], and intraosseous insertion [IO] performance was measured using global rating scales. RESULTS: Forty-eight participants completed the study protocol. Skill performance improved from baseline in both groups immediately following training. 3-months post-training the infant and adult CC scores remained significantly improved from baseline testing in both the massed and spaced groups; however, the infant BMV and IO scores remained significantly improved from baseline testing in the spaced: BMV (pre, 1.8 ±â€¯0.7 vs post-3-months, 2.2 ±â€¯7; P = 0.005) IO (pre, 2.5 ±â€¯1 vs post-3-months, 3.1 ±â€¯0.5; P = 0.04) but not in the massed groups: BMV (pre, 1.6 ±â€¯0.5 vs post-3-months, 1.8 ±â€¯0.5; P = 0.98) IO (pre, 2.6 ±â€¯1.1 vs post-3-months, 2.7 ±â€¯0.2; P = 0.98). CONCLUSION: 3-month retention of CC skills are similar regardless of training format; however, retention of other resuscitation skills may be better when taught in a spaced format.

Analysis of eye-tracking behaviours in a pediatric trauma simulation.

ABSTRACTEye-tracking devices are able to capture eye movements, which are further characterized by fixations. The application of eye tracking in a trauma setting has not been explored. Visual fixation can be utilized as a surrogate measure of attention during the management of a trauma patient. We aimed to determine the feasibility of using eye tracking and to characterize eye tracking behaviours of pediatric emergency medicine physicians during management of a simulated pediatric trauma patient. Each participant was equipped with a head-mounted eye-tracking device during a standardized simulated pediatric trauma scenario. Each session was video recorded, with visual fixations defined as >0.2 seconds, and characterized by start time, duration, and the area of interest. Data from seven videos were analysed; 35% of eye fixations were directed towards the mannequin, 16% towards the monitor, and 13% towards the bedside doctor. Visual eye tracking in a trauma simulation is feasible. Frequency of fixations tends to be highest towards the patient. Eye tracking within trauma simulation may provide new insights into quality improvement and inform advancements in pediatric trauma.