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Distance learning in BLS increases skill retention
Abstracts / Resuscitation 81S (2010) S1–S114 AP297 Benefits and perceptions of the BLS/AED peer-assessment role Macrae A.L. 1 , Brown G. 1 , Harvey P.R. 1 , Hulme J. 2 1 The Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK 2 Department of Anaesthesia and Intensive Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
Background: Instructors and assessors can be costly (time and money) resources for Basic Life Support (BLS) and Automated External Defibrillation (AED) courses. Healthcare students are an inexpensive, effective and available supply at our institution and train other healthcare students.1,2 Trained volunteer peer assessors perform the majority of BLS/AED course assessments; approximately 700 healthcare students annually. We gathered student assessors’ perceptions of their own competence, senior support, adequacy of training and willingness to undertake future assessment roles. Methods: Peer assessors completed an anonymous questionnaire at the end of the academic year, stating answers as yes/no or on a ten-point scale, as appropriate. Data from two consecutive years is presented. Results: 34/37 (91.9%) questionnaires returned. Mean confidence scores for assessing BLS and AED skills were 8.55/10 ± 1.02 and 9.25/10 ± 0.74 respectively. 33/34 (97.1%) felt adequately trained in their role; 33/34 (97.1%) felt support was readily available, mostly from senior student supervisors. 29/34 (85.3%) felt respected by candidates and 33/34 (97.1%) that they had sufficient authority to pass/fail candidates. 34/34 (100%) enjoyed the role and 31/34 (91.2%) hope to continue direct involvement. 33/34 (97.1%) have been inspired to undertake future assessment roles. Conclusions: This self-selecting group of peer assessors perform well when evaluating their colleagues.2 They are confident in this role and empowered to critique their contemporaries’ performance with high levels of perceived support and training: this is straightforward to deliver. Support is typically reassurance and technical advice; only a small minority need additional feedback to improve performance. Involvement is an enjoyable and positive experience that contributes to undergraduate professional development and provides competent, enthusiastic and inexpensive assessors for course validation. Most look forward to future positions of responsibility and this role provides preparation and experience to help develop these aspirations.
S109
AP299 Doctors resuscitation training in a district general hospital—From zeros to heroes in 18 months Warlow C., Williams L., O’Donoghue S.O. Resuscitation Service, Northampton General Hospital, Northampton, UK Purpose of the study: That Doctors have to undertake resuscitation training is not in debate within the UK. The Resuscitation Council (UK)1 states (2008) that staff should undergo regular resuscitation training appropriate to their level, and this should be updated annually. At NGHT only 33% of Doctors were trained to speciality requirements thus demonstrating that previous delivery methods had been relatively unsuccessful. Therefore the aim was to increase both the level of training and learners motivation regarding the method used. Method: In January 2009, a speciality curriculum scheme was developed and individual appointments were offered. All bookings were made direct with the individual and a short evaluation was completed post training. Appointment times varied according to the speciality and ranged from 10 min to 1 h. A comprehensive data base was created storing accurate training figures and prompting the generation of reminder/invitation emails. In addition to annual reminders, there was scope to contact those who change speciality. Results: Within 18 months of employing this method of training and accessibility, there was an increase from 33% to 93% of hospital Doctors trained to speciality requirements. 50 evaluations were completed, all indicating that this was the preferred delivery method in terms of learning interactions and objectives. Conclusions: There has been a positive change in both training levels and method of delivery of resuscitation skills within NGHT. Whilst this system is relatively labour intensive the results demonstrated and the praise and encouragement received suggests that this delivery method should continue and could be adopted by other training providers. Reference 1. Resuscitation Council (UK). Cardiopulmonary resuscitation, standards for clinical practice and training; 2008.
Reference 1. Perkins GD, Hulme J, Bion JF. Peer-led resuscitation training for healthcare students: a randomised controlled study. Intens Care Med 2002;28:698–700. 2. Bucknall V, Sobic EM, Wood HL, Howlett SC, Taylor R, Perkins GD. Peer assessment of resuscitation skills. Resuscitation 2008;77:211–5. doi:10.1016/j.resuscitation.2010.09.442
doi:10.1016/j.resuscitation.2010.09.444 AP300 Distance learning in BLS increases skill retention Garvey J.P.
AP298 Learning effect of video-based self-instruction without a manikin De Martelaer K. 1 , Van Raemdonck V. 1 , Soons B. 1 , Monsieurs K.G. 2 1 Faculty of Physical Education en Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium 2
Emergency Department, Ghent University Hospital, Ghent, Belgium
In studies concerning video-based CPR self-instruction, learners usually have the possibility to practice skills on a personal manikin.1,2 However, video instruction without a manikin may be an efficient strategy to shorten subsequent hands-on training. The aim of our study was to analyze the CPR motor skills of university students following video-based CPR self-instruction without practice on a manikin. During a seven week period, first year physiotherapy students (n = 61) without previous CPR training, were given the opportunity to study a CPR video course (6.5 min) from the Flemish Red Cross DVD (Help!) at home. Subsequently, CPR motor skills were tested using a Resusci Anne Skill Reporter manikin with Skillreporting software (Laerdal, Norway). Skills not recorded by the manikin (observable) were scored using a checklist of six dichotomous variables (checking safety, checking responsiveness, shouting for help, opening airway, checking for breathing, calling 112). With the exception of ‘checking for breathing’ the other observable actions were performed correctly by more than 76% of the participants. Students with an insufficient score on ‘checking for breathing’ had problems with the time to do this long enough (observation criteria = 5 –10 ). Mean compression depth was 32 mm (SD 11 mm), mean compression rate 93/min (SD 18), mean ventilation volume 639 ml (SD 292 ml) and mean number of ventilations per minute was four (SD 2). The proportion of students achieving a good compression performance was 56%. Forty-one percent never achieved a single compression of a correct depth (38–51 mm), usually too shallow. Only 26% of the students was able to perform an adequate ventilation. The results of video CPR self-instruction without a manikin are promising especially because the learners had no previous CPR training. Subsequent hands-on training should focus on checking for breathing, sufficient compression depth and ventilation. Reference 1. Sarac¸ L, Ok A. The effects of different instructional methods on student’s acquisition and retention of cardiopulmonary resuscitation skills. Resuscitation 2010;81:555–61. 2. Thorén A-B, et al. DVD-based or instructor-led CPR education—a comparison. Resuscitation 2007;72:333–4. doi:10.1016/j.resuscitation.2010.09.443
Manchester Metropolitan University, United Kingdom Purpose of the study: A serendipitous, multi-method, concatenated study, investigating ways in which Basic Life Support (BLS) could be taught that would help to increase skill retention. Material and methods: Several methods were used:
• • • •
Questionnaires to schools in 4 countries. Observations of trainee and qualified nurses undertaking BLS in 4 countries. Semi-structured interviews with candidates who had undertaken first aid courses in the U.K. The development of a distance learning course and comparison of results with conventional training courses.
Results: The results indicated: Schools were keenly interested in incorporating a graded programme of BLS within their curriculum but for reasons related to; lack of time, funding, an over-burdened curriculum, and BLS was not being taught with any level of standardisation or regularity. Young people were missing out on the opportunity of learning this life saving skill. Nurses were confident in being able to demonstrate BLS but when observed their lack of competency was exhibited to a high degree which was in keeping with previous studies and showed that there had been little progression within the profession in this specific skill. 280 members of the public who had undertaken BLS refresher courses and had a minimum of at least 3 years BLS experience were interviewed and indicated their concerns with the current method of delivery of BLS courses. One of their chief concerns related to the quality of teaching from the instructor indicating that once again the instructor may still be the weakest link in training courses. That Distance Learning, (DL) produces better quality practitioners of BLS than the conventional method of instruction Conclusions: That DL methods of delivery should be utilised on a wider scale for BLS and First Aid in general as a means of improving the quality of best practice and reducing skill decay. doi:10.1016/j.resuscitation.2010.09.445
Background: Instructors and assessors can be costly (time and money) resources for Basic Life Support (BLS) and Automated External Defibrillation (AED) courses. Healthcare students are an inexpensive, effective and available supply at our institution and train other healthcare students.1,2 Trained volunteer peer assessors perform the majority of BLS/AED course assessments; approximately 700 healthcare students annually. We gathered student assessors’ perceptions of their own competence, senior support, adequacy of training and willingness to undertake future assessment roles. Methods: Peer assessors completed an anonymous questionnaire at the end of the academic year, stating answers as yes/no or on a ten-point scale, as appropriate. Data from two consecutive years is presented. Results: 34/37 (91.9%) questionnaires returned. Mean confidence scores for assessing BLS and AED skills were 8.55/10 ± 1.02 and 9.25/10 ± 0.74 respectively. 33/34 (97.1%) felt adequately trained in their role; 33/34 (97.1%) felt support was readily available, mostly from senior student supervisors. 29/34 (85.3%) felt respected by candidates and 33/34 (97.1%) that they had sufficient authority to pass/fail candidates. 34/34 (100%) enjoyed the role and 31/34 (91.2%) hope to continue direct involvement. 33/34 (97.1%) have been inspired to undertake future assessment roles. Conclusions: This self-selecting group of peer assessors perform well when evaluating their colleagues.2 They are confident in this role and empowered to critique their contemporaries’ performance with high levels of perceived support and training: this is straightforward to deliver. Support is typically reassurance and technical advice; only a small minority need additional feedback to improve performance. Involvement is an enjoyable and positive experience that contributes to undergraduate professional development and provides competent, enthusiastic and inexpensive assessors for course validation. Most look forward to future positions of responsibility and this role provides preparation and experience to help develop these aspirations.
S109
AP299 Doctors resuscitation training in a district general hospital—From zeros to heroes in 18 months Warlow C., Williams L., O’Donoghue S.O. Resuscitation Service, Northampton General Hospital, Northampton, UK Purpose of the study: That Doctors have to undertake resuscitation training is not in debate within the UK. The Resuscitation Council (UK)1 states (2008) that staff should undergo regular resuscitation training appropriate to their level, and this should be updated annually. At NGHT only 33% of Doctors were trained to speciality requirements thus demonstrating that previous delivery methods had been relatively unsuccessful. Therefore the aim was to increase both the level of training and learners motivation regarding the method used. Method: In January 2009, a speciality curriculum scheme was developed and individual appointments were offered. All bookings were made direct with the individual and a short evaluation was completed post training. Appointment times varied according to the speciality and ranged from 10 min to 1 h. A comprehensive data base was created storing accurate training figures and prompting the generation of reminder/invitation emails. In addition to annual reminders, there was scope to contact those who change speciality. Results: Within 18 months of employing this method of training and accessibility, there was an increase from 33% to 93% of hospital Doctors trained to speciality requirements. 50 evaluations were completed, all indicating that this was the preferred delivery method in terms of learning interactions and objectives. Conclusions: There has been a positive change in both training levels and method of delivery of resuscitation skills within NGHT. Whilst this system is relatively labour intensive the results demonstrated and the praise and encouragement received suggests that this delivery method should continue and could be adopted by other training providers. Reference 1. Resuscitation Council (UK). Cardiopulmonary resuscitation, standards for clinical practice and training; 2008.
Reference 1. Perkins GD, Hulme J, Bion JF. Peer-led resuscitation training for healthcare students: a randomised controlled study. Intens Care Med 2002;28:698–700. 2. Bucknall V, Sobic EM, Wood HL, Howlett SC, Taylor R, Perkins GD. Peer assessment of resuscitation skills. Resuscitation 2008;77:211–5. doi:10.1016/j.resuscitation.2010.09.442
doi:10.1016/j.resuscitation.2010.09.444 AP300 Distance learning in BLS increases skill retention Garvey J.P.
AP298 Learning effect of video-based self-instruction without a manikin De Martelaer K. 1 , Van Raemdonck V. 1 , Soons B. 1 , Monsieurs K.G. 2 1 Faculty of Physical Education en Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium 2
Emergency Department, Ghent University Hospital, Ghent, Belgium
In studies concerning video-based CPR self-instruction, learners usually have the possibility to practice skills on a personal manikin.1,2 However, video instruction without a manikin may be an efficient strategy to shorten subsequent hands-on training. The aim of our study was to analyze the CPR motor skills of university students following video-based CPR self-instruction without practice on a manikin. During a seven week period, first year physiotherapy students (n = 61) without previous CPR training, were given the opportunity to study a CPR video course (6.5 min) from the Flemish Red Cross DVD (Help!) at home. Subsequently, CPR motor skills were tested using a Resusci Anne Skill Reporter manikin with Skillreporting software (Laerdal, Norway). Skills not recorded by the manikin (observable) were scored using a checklist of six dichotomous variables (checking safety, checking responsiveness, shouting for help, opening airway, checking for breathing, calling 112). With the exception of ‘checking for breathing’ the other observable actions were performed correctly by more than 76% of the participants. Students with an insufficient score on ‘checking for breathing’ had problems with the time to do this long enough (observation criteria = 5 –10 ). Mean compression depth was 32 mm (SD 11 mm), mean compression rate 93/min (SD 18), mean ventilation volume 639 ml (SD 292 ml) and mean number of ventilations per minute was four (SD 2). The proportion of students achieving a good compression performance was 56%. Forty-one percent never achieved a single compression of a correct depth (38–51 mm), usually too shallow. Only 26% of the students was able to perform an adequate ventilation. The results of video CPR self-instruction without a manikin are promising especially because the learners had no previous CPR training. Subsequent hands-on training should focus on checking for breathing, sufficient compression depth and ventilation. Reference 1. Sarac¸ L, Ok A. The effects of different instructional methods on student’s acquisition and retention of cardiopulmonary resuscitation skills. Resuscitation 2010;81:555–61. 2. Thorén A-B, et al. DVD-based or instructor-led CPR education—a comparison. Resuscitation 2007;72:333–4. doi:10.1016/j.resuscitation.2010.09.443
Manchester Metropolitan University, United Kingdom Purpose of the study: A serendipitous, multi-method, concatenated study, investigating ways in which Basic Life Support (BLS) could be taught that would help to increase skill retention. Material and methods: Several methods were used:
• • • •
Questionnaires to schools in 4 countries. Observations of trainee and qualified nurses undertaking BLS in 4 countries. Semi-structured interviews with candidates who had undertaken first aid courses in the U.K. The development of a distance learning course and comparison of results with conventional training courses.
Results: The results indicated: Schools were keenly interested in incorporating a graded programme of BLS within their curriculum but for reasons related to; lack of time, funding, an over-burdened curriculum, and BLS was not being taught with any level of standardisation or regularity. Young people were missing out on the opportunity of learning this life saving skill. Nurses were confident in being able to demonstrate BLS but when observed their lack of competency was exhibited to a high degree which was in keeping with previous studies and showed that there had been little progression within the profession in this specific skill. 280 members of the public who had undertaken BLS refresher courses and had a minimum of at least 3 years BLS experience were interviewed and indicated their concerns with the current method of delivery of BLS courses. One of their chief concerns related to the quality of teaching from the instructor indicating that once again the instructor may still be the weakest link in training courses. That Distance Learning, (DL) produces better quality practitioners of BLS than the conventional method of instruction Conclusions: That DL methods of delivery should be utilised on a wider scale for BLS and First Aid in general as a means of improving the quality of best practice and reducing skill decay. doi:10.1016/j.resuscitation.2010.09.445