Comparison of instructor-led Automated External Defibrillation training and two alternative web-based self-training methods

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4. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists’ NonTechnical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth 2003;90:580–8. 5. ILS course documents – Core Programme 2011.

http://dx.doi.org/10.1016/j.resuscitation.2014.03.150 AP102 Children drawing CPR process during the Restart a Heart Day Diana Cimpoesu 1,∗ , Mihaela Dumea 1 , Ovidiu Popa 1 , Anca Haisan 1 , Mihaela Corlade-Andrei 1 , Paul Nedelea 2 , Antoniu Petris 1 1 University of Medicine and Pharmacy “Gr.T. Popa”, Iasi, Romania 2 Sf. Spiridon Clinical Emergency Hospital, Iasi, Romania

Objectives: To analyse the children drawings after the first course or refresher course of BLS, to present the most important elements learnt by children during the training and reflected in their drawings which are extremely significant in assessing memory and sentiments at infant years and teen age. Materials and methods: On the 16th of October of 2013, within the University of Medicine and Pharmacy Iasi, a team of 6 physicians led by an ERC ALS instructor organised a BLS course for school children and presented the Viral Video provided by the ERC. After the course, the children were invited to draw for half an hour the most significant thing to them about the cardiopulmonary resuscitation. All four elements of the chain of survival were analyzed, looking to the drawings. Results: 73 children were involved, 29 from the primary school (about 11 years old), 27 from the eighth grade (about 15 years old) and 17 from the high-school (19 years old). 60 drawings were provided by the school children after the course. The most frequent element in their drawings was the chest compressions – 63.8%, followed by the ambulance presence (means ALS) – 41.6%, and the 112 number, in 33.3% of the drawings. Only nine children drew the mouth to mouth ventilation (all from the 15 and 19 years groups) and 18 children drew a written message about CPR. Conclusion: Chest compression was the most frequent element children kept in their minds and then put in their drawings after the BLS course, that is, one of the most important elements to save a life by CPR within the chain of survival. Drawing CPR process could be a good feed-back for BLS training. http://dx.doi.org/10.1016/j.resuscitation.2014.03.151 AP103 Student generated and tutor generated web based resuscitation education resources – Mind the gap? Alan R. Williams ∗ , Richard Windle, Heather Wharrad University of Nottingham, Nottingham East Midlands, UK Nurses are often the first health professional in a hospital to assess a patient has suffered a cardiac arrest, initiate a call for assistance and provide CPR. Literature has demonstrated deficiencies in resuscitation knowledge and skill.1,2 If student nurses’ learning of resuscitation knowledge in their pre-registration education can be improved this could enhance their subsequent practice.

This study compares a student created web resource and a tutor created web resource, developed to assist student nurse to learn essential resuscitation knowledge, building on the work of as Perkins et al.3 who demonstrated the effectiveness of peer led education. Both groups working independently received the same briefing to develop a basic life support resource from established Resuscitation Council (UK) 2010 guidelines. Each group determined what should be included in the resource and the level of interaction (e.g. video, quizzes) included in the resource. The author then developed each resource following the instructions of the respective group who were also able to view the final product created in ArticulateTM , to ensure it reflected their discussions. Reviewing the video of each group in the resource development workshop and the final product enabled examination of the priorities each group expressed. Initial findings suggesting the student group emphasised simplicity and initially viewing a scenario before considering each component of CPR. The tutor group appeared more constrained, discussing what should be included and referring back to course requirements. During initial preparations the student group searched for resources on the internet, whereas the tutor group placed more emphasis on technical aspects and the University resources suggesting there is a different in what student want to learn from and what is provided. Further research into the learning effect of student and tutor developed educational resources is warranted. References 1. Josipovic P, Webb M, Mc Grath I. Basic life support knowledge of undergraduate nursing and chiropractic students. Aust J Adv Nurs 2009;26:58–63. 2. Madden C. Undergraduate nursing students’ acquisition and retention of CPR knowledge and skills. Nurse Educ Today 2006;26:218–27. 3. Perkins G, Hulme J, Bion J. Peer-led resuscitation training for healthcare students: a randomised controlled study. Intensive Care Med 2002;28:698–700.

http://dx.doi.org/10.1016/j.resuscitation.2014.03.152 AP104 Comparison of instructor-led Automated External Defibrillation training and two alternative web-based self-training methods Wiebe de Vries 1,∗ , Jeroen Oude Nijhuis 2 1

Doczero, Veghel, The Netherlands Region Emergency Medical Services Ambulance Oost, Hengelo, The Netherlands 2

Purpose: CPR/AED courses last on average 3–4 h.1,2 Selfdirected training has been shown to be as effective in less time.3,4 We compared online training with and without a personal training manikin, with the standard ERC CPR/AED training. Materials and methods: Ninety-eight voluntary lay persons were trained in three groups. Group A received a standard instructor-guided ERC CPR/AED training. Group B and C received licenses to access the web-based training 14 days before the scheduled post-test. Group C received together with this license a personal training manikin. All participants were tested before, immediately after and six months after the course/self-training. Non-inferiority criteria were evaluated based on two-sided 90% CI. A relative risk margin of less than 0.2 was assumed for noninferiority.5 The null hypothesis (H0 ) stated that both web-based trainings were inferior to instructor-led training. Item analysis between groups was done with the Kruskal–Wallis test. Results: None of the web based training methods met the criterion of non-inferiority, (see Table). During the post-test 37.9% of the participants of the web based training only passed (>70% score) vs 37.8% in the web based with manikin group and 96.8% in the

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instructor led group. For the retention test this results were 58.3%, 45.9% and 82.7%. Four items (safety, call for help, CPR delivered and average frequency class) remained significant different between the groups, in favour for the instructor led group. Conclusions: The test results showed that the instructor-led training was superior to both web based training methods. Selftraining cannot yet be recommended as an alternative training method. References 1. https://www.erc.edu/index.php/statistics/en/. 2. Soar J, Monsieurs KG, Balance JHW, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 9. Principles of education in resuscitation. Resuscitation 2010;81:1434–44. 3. Roppolo LP, Pepe PE, Campbell L, et al. Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: the American Airlines Study. Resuscitation 2007;74:276–85. 4. De Vries W, Handley AJ. A web-based micro-simulation program for self-learning BLS skills and the use of an AED. Can laypeople train themselves without a manikin? Resuscitation 2007;75:491–8. 5. De Vries W, Turner NM, Monsieurs KG, Bierens JJ, Koster RW. Comparison of instructor-led automated external defibrillation training and three alternative DVD-based training methods. Resuscitation 2010;81:1004–9.

http://dx.doi.org/10.1016/j.resuscitation.2014.03.153 AP105 Profile of educational institutions and teachers interested in learning CPR to teach in their schools Diego Reyero Diez, Clint Jean Louis ∗ , Carlos Beaumont Caminos, José Roldan Ramirez, Bernabe Fernandez Esain, Fermina Beramendi Garciandia Navarra Health Services, Pamplona, Spain Purpose of study: To investigate the profile of educational institutions and teachers who show interest in a CPR training course to spread CPR knowledge in their centres in Navarra, Spain. Material and methods: a free CPR training program to enable teachers to spread CPR knowledge in their schools was offered to all types of educational institutions, at all levels (from kindergarten to secondary) and to any teacher interested. After training, teachers carried out a project in their institutions. Didactic material and manikins were available on a free rental basis. Teachers reported the type of educational centre they belonged to, the level of students they taught and their area of expertise. Results: A 190 teachers from 176 educational institutions participated in one of 7 courses offered between September 2011 and June 2013. 90% were public schools, the rest charter or private. 70% of the schools were located in urban centres (>10,000 inhabitants); 17% small urban (between 3000 and 10,000 inhabitants) and 13% in rural towns (<3000 inhabitants). Training projects were observed from kindergarten up to secondary level. Kindergarten training was directed mainly to colleagues and parents, while throughout primary and secondary schools, mainly students were trained (94%). Early primary school students were taught basic skills like identifying the emergency number (112), and with age more concepts were gradually introduced until full CPR training was given from 10 to 11 years. Teacher area of expertise varied: physical education (64%), biology and health sciences (13%), language 2%; chemistry, mathematics, religion, physics accounted for 2%; Teachers from polytechnics (electronics, mechanics) made up 19%. Other participants included hair dressing schools, the official art school and institutions for children with special needs. Conclusions: There is an interest for CPR training throughout the educational framework and among teachers from different

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backgrounds. Gradual age adjusted CPR training can be introduced in schools from early primary school.

Further reading 1. Colquhoun M. Learning CPR at school-everyone should do it. Resuscitation 2012;83:543–4. 2. Plant N, Taylor K. How best to teach CPR to school children: a systematic review. Resuscitation 2013;84:415–21.

http://dx.doi.org/10.1016/j.resuscitation.2014.03.154 AP106 Instructional quality of official lay BLS courses: Do instructors foster self-confidence of participants? Jan Breckwoldt 1,∗ , Patrick Wagner 2 , Hans-Richard Arntz 2 1

University of Zurich, Zurich, Switzerland Charité – Medical University of Berlin, Berlin, Germany 2

Introduction: ILCOR guidelines strongly advocate CPR training for the lay public. However, many lay bystanders still do not start CPR in real life cardiac arrest (CA), although having attended BLS courses. Amongst other reasons, this could be attributed to the quality how psychomotor skills and attitudes are taught. Therefore, the objective of this study was to analyse the instructional quality in lay BLS courses. Methods: 20 randomly chosen BLS courses were prospectively evaluated by “undercover” participating observation. In particular, it was studied whether (a) severe standardised mistakes conducted by the participating observer were corrected by instructors, whether (b) instruction was “meaningful” (i.e. relevance was explained from a learner’s perspective, practice phases were attributed in a positive way, and fear of mistakes was effectively reduced), and whether (c) teaching contents were correct. For quantification, 5-point Likert scales were used, ranging from -2 (“very poor”) to +2 (“excellent performance”). Results: Of the standardised mistakes conducted by the participating observer 35% (14/40) were not corrected by instructors. Average scores for “Explaining course relevance from a learner’s perspective” were −1.1 (range: −2.0 to 1.0), for “Positive attribution of practice phases” −1.2 (range −2.0 to 2.0), and for “Reducing fear of making mistakes” −0.9 (−2.0 to 1.0). Five instructors gave grossly incorrect information with the potential to deter participants from starting CPR. Discussion: In a substantial proportion of the BLS courses observed, instructional quality (for psychomotor skills and attitudes) was not sufficient. Thus, improvement of instructor training may be a key to raise bystander CPR rates. http://dx.doi.org/10.1016/j.resuscitation.2014.03.155 AP107 Peer assessment of resuscitation skills by secondary school teachers Clint Jean Louis ∗ , Diego Reyero Diez, Yolanda Encina Aguirre, Miguel Castro Neira, Carlos Beaumont Caminos, Amaya Ibarra Bolt Navarra Health Services, Navarra, Spain Purpose of the study: To validate an assessment template to help teachers evaluate resuscitation skills in students.