Improved basic life support performance by ward nurses using the CAREvent Public Access Resuscitator (PAR) in a simulated setting

INTRODUCTION: The CAREvent Public Access Resuscitator (PAR, O-Two Medical Technologies, Ontario, Canada) is a new oxygen-driven device alternating two ventilations with 15 prompts for chest compressions. The PAR is designed for use with a standard resuscitation face mask and is equipped with mask leakage and obstruction alarms. The purpose of this study was to assess the quality of basic life support (BLS) by hospital nurses and to evaluate if BLS with the PAR is better than BLS using the mouth-to-mask technique. METHODS: The study group consisted of 352 nurses from Ghent University Hospital working outside the critical care and emergency departments. BLS skills were measured using a Laerdal Skillreporter manikin (Laerdal, Norway) connected to a Laerdal PC Skillreporting system. To assess base line skills, 200 nurses were tested without previous notice in single rescuer BLS using a pocket mask (PM, Laerdal, Norway) or a bag-valve mask device (Laerdal, Norway) over a period of 2 min. A separate consecutive sample of 152 nurses was randomised to the PM or PAR groups after a standard BLS refresher course. The PAR group received a short period of training in PAR use. Immediately after training, both groups performed the 2 min single rescuer BLS test. RESULTS: Unprepared nurses achieved only 26 compressions and 3 ventilations/min. Immediately after training, nurses using the PAR delivered 54 compressions/min as opposed to 35 for the PM group (p<0.0001). PAR users ventilated six times/min compared to five times for PM users (p<0.0001). CONCLUSION: Immediately after training, the use of the PAR improved BLS performance by ward nurses significantly, bringing the number of ventilations and compressions per minute close to the theoretical maximum achievable within the current guidelines. Retention tests after 6 and 12 months will show if the effect is sustained.     

A web-based micro-simulation program for self-learning BLS skills and the use of an AED. Can laypeople train themselves without a manikin?

AIM: Various methods, including self-instruction, have been used to try to improve the acquisition of basic life support skills. This is a preliminary report of the effectiveness of a web-based self-training program for BLS and the use of an AED. METHODS: Sixteen volunteers completed on-line training in their own time over a period of 8 weeks. The program included theory, scenario training and self-testing, but without practice on a manikin, or any instructor input. The volunteers were assessed, without prior warning, in a scenario setting. A recording manikin, expert assessors and video recording were used with a modified version of the Cardiff Test. RESULTS: All 16 volunteers performed the assessed skills in the use of an AED correctly. Most of the skills of BLS assessed were performed well. Chest compression depth and rate were performed less well (59% and 67% of participants, respectively, performed correctly). Opening the airway and lung inflation were performed poorly (38% and 13% of participants performed correctly), as was checking for safety (19% participants performed correctly). There was no significant correlation between the time a participant spent on-line and the quality of performance. Only 5 of the volunteers had ever attended a BLS course or used a resuscitation manikin before the assessment; their performance scores were not significantly better than those of the other 11 volunteers. CONCLUSION: These results suggest that it may be possible to train people in BLS and AED skills using a micro-simulation web-based interactive program but without any practice on a manikin. This seems to be particularly the case for the use of an AED, where performance achieved a uniformly high standard.     

Laypersons may learn basic life support in 24min using a personal resuscitation manikin

BACKGROUND: Bystander basic life support (BLS) is an important part of cardiopulmonary resuscitation (CPR) and improves outcome after out-of-hospital cardiac arrest. However, the general population has poor BLS skills. Several training initiatives could be used to improve this situation and the challenge is to find the most efficient one. AIMS: To compare the efficiency of a 24 min instruction using a DVD-based self-training BLS course combined with a simple, take-home resuscitation manikin to a conventional 6h course for teaching BLS to laypersons. METHODS: In total, 238 laypersons (age 21-55 years) without previous BLS-training were allocated into two groups: one group received 24 min of instruction using a DVD-based instruction tool on a big screen combined with a BLS self-training device, Laerdal MiniAnne manikin (MAM), before taking home the instruction material for subsequent self-training. The second group attended a conventional 6 h BLS course (6 HR). After 3 months BLS skills were assessed on a Laerdal ResusciAnne manikin using the Laerdal PC Skill reporting System, and a total score was calculated. RESULTS: There was no significant difference between groups in BLS performance using the total score. Assessment of breathing was performed significantly more often in the 6 HR-group (91% versus 72%, P=0.03). In the MAM-group, average inflation volume and chest compression depth were significantly higher (844 mL versus 524 mL, P=0.006, and 45 mm versus 39 mm, P=0.005). CONCLUSIONS: When assessed after 3 months, a 24 min DVD-based instruction plus subsequent self-training in BLS appears equally effective compared to a 6h BLS course and hence is more efficient.     

Online Resuscitation Training. Does it improve high school students’ ability to perform cardiopulmonary resuscitation in a simulated environment?

There are no published data on the efficacy of online first aid or resuscitation learning programmes in Australia. Our goal was to compare the knowledge and first aid skills of subjects who have undertaken the St. John Ambulance Australia (WA) "online crash course", with those who have no first aid training. We evaluated first aid knowledge and basic life support (BLS) skills of two groups of students. The control group (n = 11) had received no first aid training of any type and the test group (n = 12) had undertaken and passed the St. John Ambulance online "crash course". This course is purely theoretical. BLS skills were assessed using standardised patients and manikins. Knowledge was assessed by a written assessment. Assessors were blinded to which group the students belonged. There were significant differences in the performance of the written test, between the group who completed the course and the group who did not complete the course (P = 0.036: Mann-Whitney U-test). There were no significant differences in the performance of any other practical tasks between the two groups. We conclude from this that the online course improved course participant's knowledge of BLS significantly, but not their ability to perform; that online first aid courses may be useful for knowledge acquisition but that they do not confer any benefit, in performance of BLS skills.     

Will changing the emphasis from 'pulseless' to 'no signs of circulation' improve the recall scores for effective life support skills in children?

This study analyses, retrospectively, an established data set to measure the effect of the circulation change in European Resuscitation Council Guidelines. This prospective matched control study examined the extent to which Year 6 (10-11 years) children retained and were able to demonstrate the sequencing and assessment skills of Basic Life Support (BLS) techniques 5 months after BLS training through the Injury Minimization Programme for Schools (I.M.P.S.). A total of 1292 children were enrolled at the beginning of the study: 657 in the intervention group received BLS through I.M.P.S., 635 children in the control group received no planned intervention. Children in both groups were tested 5 months after intervention using small portable manikins. Chi-square analysis of individual variables indicated that the intervention group was better (P<0.0005) than controls in almost all areas of basic life support (BLS). 'Adequate' BLS skills, the minimum skills considered to be effective, were also demonstrated in both groups, intervention 4.1%, controls 0.5%. Recalculation of these variables removing the check on the carotid pulse resulted in an increase to 24% of adequate BLS skills in the intervention group. Conversely, only 2.1% of controls performed to this standard. With strict adherence to Resuscitation Council guidelines, 'optimal' life saving procedures (all primary BLS steps performed optimally), were initiated by very few, marginally better in the intervention than the control group, intervention 6 (1.1%) controls 0 (0%). Some children in both groups performed the cardio-pulmonary resuscitation (CPR) element of BLS in an ineffective manner. Changing the circulation assessment would seem appropriate and allow recognition of life support attempts that are beneficial if not optimal.     

Peer evaluation in reciprocal learning with task cards for acquiring Basic Life Support (BLS)

Background

Research emphasises the need for instructional methods and tools which can improve Basic Life Support (BLS) performance or reduce instructional time.

Aim

To investigate the effect of peer evaluation to improve reciprocal learning with task cards as instructional tools for acquiring BLS.

Methods

A total of 78 kinesiology students from a Belgian university were paired and randomised across two groups to learn BLS in 20 min with task cards. In the control group, students worked together in a defined doer–helper relationship and switched roles every 5 min. In the peer evaluation group, students followed the same co-operation procedure as in the control group. In addition, 1 min before every switching of roles, the helper evaluated the doer's performance. All BLS skills were individually assessed on a Laerdal AED Resusci Anne mannequin (Laerdal Medical, Vilvoorde, Belgium) using the Laerdal PC-Skill reporting system. A total BLS score was calculated and performance was measured before training (baseline), immediately after training (intervention) and 2 weeks later (retention).

Results

Significantly more students from the evaluation group remembered and consequently performed all BLS skills at intervention (P = 0.03). No significant differences were found between groups for main cardiopulmonary resuscitation (CPR) variables and total BLS scores at baseline, intervention and retention. Both groups achieved more than 70% of the maximum BLS score at intervention and retention.

Conclusions

This study demonstrated that 20 min reciprocal-learning setting with task cards is an effective method to learn BLS. The implementation of peer evaluation in this setting has an immediate, however small, positive impact on BLS skill learning.     

Pre-training evaluation and feedback improved skills retention of basic life support in medical students

Background

Pre-training evaluation and feedback have been shown to improve medical students’ skills acquisition of basic life support (BLS) immediately following training. The impact of such training on BLS skills retention is unknown. This study was conducted to investigate effects of pre-training evaluation and feedback on BLS skills retention in medical students.

Methods

Three hundred and thirty 3rd year medical students were randomized to two groups, the control group (C group) and pre-training evaluation and feedback group (EF group). Each group was subdivided into four subgroups according to the time of retention-test (at 1-, 3-, 6-, 12-month following the initial training). After a 45-min BLS lecture, BLS skills were assessed (pre-training evaluation) in both groups before training. Following this, the C group received 45 min training. 15 min of group feedback corresponding to students’ performance in pre-training evaluation was given only in the EF group that was followed by 30 min of BLS training. BLS skills were assessed immediately after training (post-test) and at follow up (retention-test).

Results

No skills difference was observed between the two groups in pre-training evaluation. Better skills acquisition was observed in the EF group (85.3 ± 7.3 vs. 68.1 ± 12.2 in C group) at post-test (p < 0.001). In all retention-test, better skills retention was observed in each EF subgroup, compared with its paired C subgroup.

Conclusions

Pre-training evaluation and feedback improved skills retention in the EF group for 12 months after the initial training, compared with the control group.     

Retention of basic life support skills 6 months after training with an automated voice advisory manikin system without instructor involvement

AIM: To evaluate the retention of skills 6 months after training in ventilation and chest compressions (CPR) on a manikin with computer based on-line voice advisory feedback and the possible effects of initial overtraining. METHODS: Thirty five volunteers had 20 min provisional CPR training on a manikin with computer based voice advisory feedback but without an instructor. The appropriate feedback was taken from a pre-recorded list depending on performance measured by the manikin--computer system versus set limits for ventilation and compression variables. One group in addition was randomised to receive 10 similar 3 min training sessions during 1 week in the following month (overtrained group). All ventilation and compression variables were measured without feedback before and after the initial training session, with feedback immediately thereafter, and both without and with feedback 6 months after the initial training session. RESULTS: The initial training improved all variables. Compressions with correct depth increased from a mean of 33 to 77%, and correct inflations from a mean of 9 to 58%. After 6 months, the results for the controls were not significantly different from pre-training, except for a higher of correct inflations (18%), while the overtrained group had better retention of skills including the correct compression depth (mean 61%) and inflations (mean 42%). When verbal feedback was added both the compressions and ventilations immediately improved both when tested immediately and 6 months after the initial training session. CONCLUSIONS: The computer-based voice advisory manikin (VAM) feedback system can improve immediate performance of basic life support (BLS) skills, with better long-term retention with overtraining.     

Medical students teaching basic life support to school children as a required element of medical education: a randomised controlled study comparing three different approaches to fifth year medical training in emergency medicine

OBJECTIVES: Basic life support (BLS) by doctors has been shown to be of poor quality. To improve medical education training should be simplified, and simultaneously the learner should be involved more actively. To combine both ideas we trained medical students to give BLS courses and sent them to teach school children. This was a requirement for their emergency medicine course. Our model was compared to conventional teaching. DESIGN: Medical students were assigned at random to one of three groups. Group 1 ("university") attended a conventional university BLS/ALS course. Group 2 ("EMS") accompanied a BLS vehicle of the emergency medical service (EMS) after suitable preparation. Group 3 ("school") was instructed to teach BLS and then sent to teach at schools. MAIN OUTCOME MEASURES: Clinically significant BLS skills, and overall BLS skills, each assessed by structured clinical examination (SCE). Theoretical knowledge assessed by written (open question) test. RESULTS: Clinically relevant mistakes were seen in 37.5% in group 1 ("university"), compared to 28.8% in group 2 ("EMS"), and 11.3% in group 3 ("school"). Highly significant differences were shown between "school" and "EMS" (p=0.011), and between "school" and "university" (p<0.001). In practical testing for overall performance the "university" group reached a median of 78.8% (25th-75th percentile 69.2-84.6%), group "EMS" reached 76.9% (69.2-88.5%), and group "school" 84.6% (76.9-90.0). Group "school" showed significant advantages over "university" (p=0.015) and "EMS" (p=0.010). Written test results did not differ statistically. CONCLUSION: Medical students teaching BLS to school children as a compulsory element of their own medical training showed superior practical skills as compared to conventional teaching. Theoretical knowledge was equivalent to the control groups, although their course contained less theoretical information.     

Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students

BACKGROUND: The aim of the study is to evaluate the theoretical knowledge and psychomotor skill acquisition of basic life support (BLS) by a group of secondary school students in Nigeria pre and post BLS training. METHODS: This was quasi-experimental study design with 210 participants. They were taught on adult BLS and all the participants practiced BLS on a Resusci-Anne manikin immediately after the training. Data were collected using American Heart Association (AHA) structured questionnaire and psychomotor skills checklist for BLS at baseline, and post BLS training. RESULTS: The pre-training knowledge score was 1.9±1.4. This increased after the BLS training to 11.4±2.4, and the mean difference between the pre and post BLS training scores was 9.48571. Pre-training psychomotor skill score was 0.00±0.00, this increased to 8.9±1.9 after the training, and the mean difference was 8.90000. The knowledge and psychomotor skill difference between pre and post BLS training was significant (P<0.000). CONCLUSION: Most Nigerian secondary school students were not knowledgeable about BLS. Therefore, there is need for the creation of more awareness among the students.     

Educational packages: adult education about basic and advanced methods of life support measures. Analysis of some educational systems

Educational courses are increasingly being offered in Italy to health care workers who want to acquire or improve their basic (BLS) or advanced (ACLS) resuscitation skills. Since 1994 the Italian Resuscitation Council planned and implemented educational BLS and ACLS packages. Their content, methodology and implementation strategies was analysed on the basis of the educational and informational materials offered to the learners and instructors. The duration of the courses varies (never exceeding the three days): the performance of the participants is evaluated and certified. The courses are open to critical care doctors, nurses, technicians and in some cases to the lay people. They are based on the adult learning principles and the learning strategies are both formal and interactive. The course instructors are doctors and nurses specifically trained after a successful result (with optimal performance) of a BLS and ACLS course. At least 50,000 people attended to a BLS course and a lower number (1270) to an ACLS course. To date, the number of recognised BLS instructors is 229 and 79 for the ACLS courses. The recommended costs are around 120 US $ for a BLS course and 400 US $ for an ACLS course. Although the debate on the effectiveness of such a training on the survival of people treated for a cardiac arrest is still ongoing, the learning packages show the feasibility of a multi-professional approach to a systematic training in a critical health area.     

An evaluation of objective feedback in basic life support (BLS) training

BACKGROUND: Studies show that acquisition and retention of BLS skills is poor, and this may contribute to low survival from cardiac arrest. Feedback from instructors during BLS training is often lacking. This study investigates the effects of continuous feedback from a manikin on chest compression and ventilation techniques during training compared to instructor feedback alone. MATERIALS AND METHODS: A prospective randomised controlled trial. First-year healthcare students at the University of Birmingham were randomised to receive training in standard or feedback groups. The standard group were taught by an instructor using a conventional manikin. The feedback group used a 'Skillreporter' manikin, which provides continuous feedback on ventilation volume and chest compression depth and rate in addition to instructor feedback. Skill acquisition was tested immediately after training and 6 weeks later. RESULTS: Ninety-eight participants were recruited (conventional n=49; Skillreporter n=49) and were tested after training. Sixty-six students returned (Skillreporter n=34; conventional n=32) for testing 6 weeks later. The Skillreporter group achieved better compression depth (39.96mm versus 36.71mm, P<0.05), and more correct compressions (58.0% versus 40.4%, P<0.05) at initial testing. The Skillreporter group also achieved more correct compressions at week 6 (43.1% versus 26.5%, P<0.05). CONCLUSIONS: This study demonstrated that objective feedback during training improves the performance of BLS skills significantly when tested immediately after training and at re-testing 6 weeks later. However, CPR performance declined substantially over time in both groups.     

Training of police officers as first responders with an automated external defibrillator

A short and effective training programme is an essential prerequisite for the use of automated external defibrillators (AED) by EMS providers and first responders. We evaluated a 3-h AED course based on the ERC requirements. METHODS: As part of a study evaluating the effectiveness of AEDs used by first responders (ARREST 4), we trained all police officers in the region of Amsterdam, the Netherlands. By means of a Basic Life Support (BLS) assessment at the beginning of the course and at the end, we evaluated whether BLS can be improved in a 3-h AED course. Through a combined BLS and AED assessment at the end of the course, we evaluated whether AED skills can be acquired sufficiently. BLS skills were measured with the Laerdal SkillMeter in evaluation mode. AED skills were assessed using 13 criteria. By means of logistic regression, we analysed the influence of student characteristics, such as age, gender, previous training, resuscitation experience and motivation for BLS and AED on BLS and AED skills acquisition. RESULTS: Between September 1999 and June 2000, 823 police officers were trained (76% male, mean age 36 (S.D. 9) years). BLS improved significantly (P < 0.001) in all criteria, except for hypoventilation (P < 0.001). After training, 89% of the students were able to use an AED safely and effectively. Self-confidence and motivation improved from 12 and 73% to 99 and 94% over the course (P < 0.001). Independent student characteristics influencing the success of the AED course were: previous BLS training, motivation before the course for an AED, and resuscitation experience that dated back for more than 12 months. CONCLUSION: The majority of police officers can be trained to use an AED safely and effectively within a 3-h AED course. During this course, they also improve on their BLS skills. Successful completion of the course depends in part on the student characteristics.     

Teaching basic life support skills using self-directed learning, a self-instructional video, access to practice manikins and learning in pairs

Applying adult learning principles in healthcare education is increasingly recognised as useful and effective. We designed and evaluated an educational package for medical student basic life support (BLS) skills that placed the responsibility of skill acquisition with the learner. The package provided hardcopy and web based information, an in-house produced audio-video tape demonstrating BLS, and open access to manikins in a Skills Centre where the students learnt in pairs. Students determined when they were ready to be assessed. This assessment was performed by two independent observers using the Resuscitation Council (UK) BLS assessment sheet. Two groups, comprising in total 51 fourth year medical students were assessed, 47 were found to be competent in performing BLS on their first assessment. Of the remaining four, three were assessed as competent after further self-directed learning and retesting. Only one student required personal tutoring prior to success. Self-directed learning is a successful method of mastering BLS. Where failure occurred, it was due to inadequate student learning in the Skills Centre. The importance of practice needs emphasis in future use of the programme, as does the virtual guarantee of success, if all steps are followed. A similar programme could be devised for other technical skills.     

A scoring system for the assessment of basic life support ability

INTRODUCTION: There are no current validated scoring systems for the assessment of adult single rescuer basic life support (BLS) ability. A system was proposed and prospectively validated. METHODS: The system was tested firstly on 12 skilled BLS providers (all instructors). It was then further evaluated on 75 undergraduate dental students, who were assessed before and after a standard training session on adult BLS. RESULTS: All 12 skilled persons passed the test according to the system. The system successfully showed a positive training effect in the dental students. It correctly identified those who 'passed' after training, i.e. those were capable of providing effective BLS (71/75, 94.7%). It also correctly identified those who were not considered competent (4/71, 5.3%). CONCLUSION: This is a simple, effective, objective system for assessment of basic life support. It is easily adaptable for the 1998 Guidelines on BLS.     

Immediate life support (ILS) training : Impact in a primary care setting?

OBJECTIVE: To evaluate immediate life support (ILS) training in a primary care setting. METHODS: A 12 month pre/post-quasi-experimental and qualitative evaluation of ILS training across the counties of Devon and Cornwall (UK). Data were collected via feedback forms, pre/post course knowledge and skills tests and by focus group interviews with key stakeholders. RESULTS: One hundred and seventy-three professionals from 10 courses took part in the evaluation with a response rate of 93%. Feedback on the course was overwhelmingly positive. A significant improvement in both skills (p < or = 0.001) and knowledge (p < or = 0.001) was shown. However, a proportion of participants had a decline in knowledge by the end of the course. Those attending ILS had a significantly higher knowledge score at the start of the course (p = 0.002) than a group attending a BLS course, indicating that the preparatory course manual had been beneficial. Knowledge did not decline significantly by 6 months but skills did (p = 0.02), but remained higher than pre-course levels (p < or = 0.001). Knowledge (p = 0.008) and skill (p < or = 0.002) retention following the ILS course was significantly higher than in the BLS course sub-group, indicating the added value of ILS. The focus groups raised a number of themes relating to release of staff; funding issues; and the observed and reported effects of assessment inequity mainly relating to 'failure to fail' and 'dove and hawk' approaches. CONCLUSION: The course leads to a significant increase in skills and knowledge with good knowledge retention. Skill decline is significant which raises questions about the practice of practitioners who are not updated regularly. Issues of funding, staff resources and the assessment ethics and strategy need to be addressed.     

Peer education for BLS-training in schools? Results of a randomized-controlled,noninferiority trial

BackgroundThe rate of bystanders who provide cardiopulmonary resuscitation (CPR) is low in Germany. To increase the bystander CPR rates of lay-rescuers in Germany, the national “einlebenretten” (“save one life”) campaign was initiated, and the introduction of CPR-training for all seventh-grade students was recommended. To meet the requirement of offering effective and low-cost mass-training to lay-rescuers, we adopted peer education for the basic life support (BLS) training of the students.MethodsWe used an experimental, prospective, randomized, controlled, and open-label noninferiority trial to test whether the hands-on BLS training of the students that was provided by peers was inferior to the training by professional instructors using a predefined noninferiority margin of 5%. The students from eight different schools were trained in one 45 min practice session to perform BLS based on the educational framework provided by “einlebenretten”. The students were randomly assigned to be trained either by peer-instructors (students in the same school who had been instructed in advance) or by professional instructors. In a structured practical assessment, the eight essential skills of BLS were tested and the examination was scored as either pass or fail.ResultsThe study included 1087 students 14–18 years of age. The performance in the assessment was similar between the two groups: 40.3% (n = 471) of the students in the peer-led group and 41.0% (n = 466) in the professional-led group passed the examination.ConclusionThe students who were trained by peer-instructors showed comparable skills in BLS to the students who were trained by professional instructors. The sample size was too small to demonstrate the noninferiority of the peer-led training.     

Retention of Basic Life Support in Laypeople: Mastery Learning vs. Time-based Education

Objective: To compare the effectiveness of a mastery learning (ML) versus a time-based (TB) BLS course for the acquisition and retention of BLS knowledge and skills in laypeople. Methods: After ethics approval, laypeople were randomized to a ML or TB BLS course based on the American Heart Association (AHA) Heartsaver course. In the ML group, subjects practiced and received feedback at six BLS stations until they reached a pre-determined level of performance. The TB group received a standard AHA six-station BLS course. All participants took the standard in-course BLS skills test at the end of their course. BLS skills and knowledge were tested using a high-fidelity scenario and knowledge questionnaire upon course completion (immediate post-test) and after four months (retention test). Video recorded scenarios were assessed by two blinded, independent raters using the AHA skills checklist. Results: Forty-three subjects were included in analysis (23ML;20TB). For primary outcome, subjects' performance did not change after four months, regardless of the teaching modality (TB from (median[IQR]) 8.0[6.125;8.375] to 8.5[5.625;9.0] vs. ML from 8.0[7.0;9.0] to 7.0[6.0;8.0], p = 0.12 for test phase, p = 0.21 for interaction between effect of teaching modality and test phase). For secondary outcomes, subjects acquired knowledge between pre- and immediate post-tests (p < 0.005), and partially retained the acquired knowledge up to four months (p < 0.005) despite a decrease between immediate post-test and retention test (p = 0.009), irrespectively of the group (p = 0.59) (TB from 63.3[48.3;73.3] to 93.3[81.7;100.0] and then 93.3[81.7;93.3] vs. ML from 60.0[46.7;66.7] to 93.3[80.0;100.0] and then 80.0[73.3;93.3]). Regardless of the group after 4 months, chest compression depth improved (TB from 39.0[35.0;46.0] to 48.5[40.25;58.0] vs. ML from 40.0[37.0;47.0] to 45.0[37.0;52.0]; p = 0.012), but not the rate (TB from 118.0[114.0;125.0] to 120.5[113.0;129.5] vs. ML from 119.0[113.0;130.0] to 123.0[102.0;132.0]; p = 0.70). All subjects passed the in-course BLS skills test. Pass/fail rates were poor in both groups at both the simulated immediate post-test (ML = 1/22;TB = 0/20; p = 0.35) and retention test (ML pass/fail = 1/22, TB pass/fail = 0/20; p = 0.35). The ML course was slightly longer than the TB course (108[94;117] min vs. 95[89;102] min; p = 0.003). Conclusions: There was no major benefit of a ML compared to a TB BLS course for the acquisition and four-month retention of knowledge or skills among laypeople.     

Using technology to enhance physical therapy students’ problem-solving skills around safe patient handling

Abstract

Background: Physical therapy students are at risk of musculoskeletal injuries during patient handling. Current guidelines recommend a risk management approach to reduce the likelihood of injury associated with patient handling.

Objectives: To determine the benefits of online scenarios using scenario-based learning interactive (SBLi^®) to enhance students’ confidence in making decisions around patient handling techniques, including equipment, and in practical patient handling skills.

Methods: Third year undergraduate and first year graduate-entry masters (GEM) students from the 2011 cohort of the physical therapy program at The University of Queensland received comprehensive training in patient handling. Only GEM students completed two SBLi patient scenarios. Students’ confidence in selecting patient handling techniques and equipment was assessed pre- and post-training with three statements scored on a 10-cm visual analogue scale anchored from strongly disagree to strongly agree. Patient handling skills were assessed with a practical skill assessment. Student satisfaction with SBLi as a learning platform was determined with three items and a focus group with eight students.

Results: Students’ confidence in performing a patient risk assessment and selecting appropriate patient handling technique and equipment improved with training. However, the online scenarios provided no additional advantage to the GEM students’ confidence in these tasks or in the practical skill assessment. GEM students were moderately satisfied with SBLi as a learning platform, reporting that it assisted their clinical preparation for the clinical environment and increased their awareness for safety of themselves and others.

Conclusions: The online interactive scenarios provided no additional benefit but may assist student preparation for the clinical environment.