Comparison of a newly established emotional stimulus approach to a classical assessment-driven approach in BLS training: a randomised controlled trial.

OBJECTIVE: The study objective was to implement two strategies (short emotional stimulus vs announced practical assessment) in the teaching of resuscitation skills in order to evaluate whether one led to superior outcomes. SETTING: This study is an educational intervention provided in one German academic university hospital. PARTICIPANTS: First-yearmedical students (n=271) during the first3 weeks of their studies. INTERVENTIONS: Participants were randomly assigned to one of two groups following a sequence of random numbers: the emotional stimulus group (EG) and the assessment group (AG). In the EG, the intervention included watching an emotionally stimulating video prior to the Basic Life Support (BLS) course. In the AG, a practical assessment of the BLS algorithm was announced and tested within a 2 min simulated cardiac arrest scenario. After the baseline testing, a standardised BLS course was provided. Evaluation points were defined 1 week and 6 months after. PRIMARY OUTCOME MEASURES: Compression depth (CD) and compression rate (CR) were recorded as the primary endpoints for BLS quality. RESULTS: Within the study, 137 participants were allocated to the EG and 134 to the AG. 104 participants from EG and 120 from AG were analysed1 week after the intervention, where they reached comparable chest-compression performance without significant differences (CR P=0.49; CD P=0.28). The chest-compression performance improved significantly for the EG (P<0.01) and the AG (P<0.01) while adhering to the current resuscitation guidelines criteria for CD and CR. CONCLUSIONS: There was no statistical difference between both groups' practical chest-compression-performance. Nevertheless, the 2 min video sequence used in the EG with its low production effort and costs, compared with the expensive assessment approach, provides broad opportunities for applicability in BLS training.

Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study.

BACKGROUND: Learning and training basic life support (BLS)-especially external chest compressions (ECC) within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training. METHODS: A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. RESULTS: The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. CONCLUSIONS: The findings of this work show that the four-step-approach for BLS training addresses all types of learners independent of their learning styles and does not lead to significant differences in the performance of CPR.

Designing Learning Outcomes for Handoff Teaching of Medical Students Using Group Concept Mapping: Findings From a Multicountry European Study.

PURPOSE: To develop, by consultation with an expert group, agreed learning outcomes for the teaching of handoff to medical students using group concept mapping. METHOD: In 2013, the authors used group concept mapping, a structured mixed-methods approach, applying both quantitative and qualitative measures to identify an expert group's common understanding about the learning outcomes for training medical students in handoff. Participants from four European countries generated and sorted ideas, then rated generated themes by importance and difficulty to achieve. The research team applied multidimensional scaling and hierarchical cluster analysis to analyze the themes. RESULTS: Of 127 experts invited, 45 contributed to the brainstorming session. Twenty-two of the 45 (48%) completed pruning, sorting, and rating phases. They identified 10 themes with which to select learning outcomes and operationally define them to form a basis for a curriculum on handoff training. The themes "Being able to perform handoff accurately" and "Demonstrate proficiency in handoff in workplace" were rated as most important. "Demonstrate proficiency in handoff in simulation" and "Engage with colleagues, patients, and carers" were rated most difficult to achieve. CONCLUSIONS: The study identified expert consensus for designing learning outcomes for handoff training for medical students. Those outcomes considered most important were among those considered most difficult to achieve. There is an urgent need to address the preparation of newly qualified doctors to be proficient in handoff at the point of graduation; otherwise, this is a latent error within health care systems. This is a first step in this process.