Medical Student Skill Retention After Cardiopulmonary Resuscitation Training: A Cross-Sectional Simulation Study.

INTRODUCTION: The retention of cardiopulmonary resuscitation skills and the ideal frequency of retraining remain unanswered. This study investigated the retention of cardiopulmonary resuscitation skills by medical students for up to 42 months after training. METHODS: In a cross-sectional study, 205 medical students received 10 hours of training in basic life support in 3 practical classes, during their first semester at school. Then, they were divided into 4 groups, according to the time elapsed since the training: 73 after 1 month, 55 after 18 months, 41 after 30 months, and 36 after 42 months. Nineteen cardiopulmonary resuscitation skills and 8 potential technical errors were evaluated by mannequin-based simulation and reviewed using filming. RESULTS: The mean retention of the skills was 90% after 1 month, 74% after 18 months, 62% after 30 months, and 61% after 42 months (P < 0.001). The depth of chest compressions had the greatest retention over time (87.8%), with no significant differences among groups. Compressions performed greater than 120 per minute were less likely to be done with adequate depth. Ventilation showed a progressive decrease in retention from 93% (n = 68) after 1 month to 19% (n = 7) after 42 months (P < 0.001). All 205 students were able to turn the automated external defibrillator on and deliver the shock. CONCLUSIONS: The depth of chest compressions and the use of an automated external defibrillator were the skills with the highest retention over time. Based on a skills retention prediction curve, we suggest that 18 to 24 months as the minimum retraining interval to maintain at least 70% of skills.

Directing student response to early patient contact by questionnaire.

CONTEXT: First year medical students experienced early patient contact by observing outpatient consultations. OBJECTIVES: To evaluate a questionnaire designed to examine emerging attitudes during the development of a doctor-patient relationship. METHODS: First year medical students participated in medical outpatient consultations as observers. These consultations represented a total of 295 registered clinical appointments. After each observation, the students completed a questionnaire surveying themes related to the doctor-patient encounter. An instructor met the students at the end of the appointments to discuss the questions raised. The Dundee Ready Education Environment Measure was used to assess the course environment. RESULTS: Students found the activity useful and enjoyable. They reported increased self-esteem and enhanced enthusiasm for the study of medicine. They completed write-ups describing and evaluating the questionnaire data. The questionnaire notes showed homogeneity among the students. The Dundee Measure indicated the students regarded the learning environment positively (62.2%); social and ambient conditions were rated highly (64.6% and 64.7%, respectively). CONCLUSION: The teaching of humanitarian attitudes by observation of the doctor-patient relationship in practice was welcomed by students. The environment in which this educational programme was carried out was considered adequate. The outpatient service schedule and the limited time available for student instruction on the part of staff doctors made this activity productive. The programme motivated students towards higher achievement and the pursuit of medical responsibility as well as more developed humanitarian behaviour patterns.