Modularer Lehrerausbildungskurs des Deutschen Rates für Wiederbelebung (GRC) für den Wiederbelebungsunterricht in Schulen

Facilitators and Barriers Perceived by German Teachers Considering Basic Life Support Education in School-A Qualitative Study

This qualitative study aims to analyse the personal qualification, attitudes and the pedagogical concepts of German teachers as experts in their profession regarding basic life support (BLS) education in secondary schools. Thirteen (n = 13) secondary school teachers participated in semi-structured expert interviews and were interviewed for at least 20 to 60 min regarding BLS student education. Interviews were semi-structured with guiding questions addressing (1) personal experience, (2) teacher qualification for BLS and (3) implementation factors (e.g., personal, material and organisational). Audio-recorded interviews were analysed by content analysis, generating a coding system. School teachers provided a heterogeneous view on implementation-related processes in BLS education. Many teachers were educated in first aid, acknowledge its importance, but had no experience in teaching BLS. They want to assure being competent for teaching BLS and need tailored trainings, materials, pedagogical information and the incorporation into the curriculum. Also, the management of time constraints, unwilling colleagues, or young students being overwhelmed were commonly mentioned considerations. Concluding, teachers reported to be willing to teach BLS but a stepwise implementation framework incorporating practice-oriented qualification and educational goals is missing.

[Role of German cardiac arrest centers in mediating basic life support]

BACKGROUND AND OBJECTIVE

Despite a measurable increase in recent years, the bystander resuscitation rate in Germany lags behind the European comparison. Special centers for the care of patients after cardiac arrest, so-called cardiac arrest centers (CAC), have been established. The aim of this work is to evaluate the role of CACs, in addition to in-hospital patient care, in improving the bystander resuscitation rate in Germany and what obstacles exist in the implementation of resuscitation training.

MATERIALS AND METHODS

Online survey by the working group cardiopulmonary resuscitation (AG42) of the German Society of Cardiology (DGK) and the German Resuscitation Council (GRC) RESULTS: Of the 74 participating clinics (78.4% certified as CAC), 23 (31.1%) conduct lay resuscitation training. These mainly take place within the framework of action days for resuscitation (82.6%) or in schools (39.1%). Permanent cooperation with at least one school existed in 52.2%. Basic life support (BLS) resuscitation dummies are available in 63.5% of these clinics and an automated external defibrillator (AED) demonstration device in 43.2%. According to the interviewees, the biggest obstacles to the consistent implementation of resuscitation courses in schools include lack of qualified instructors, lack of refinancing and difficulties with regard to coordinating activities between schools and providers.

CONCLUSIONS

Direct training of lay rescuers by hospitals faces several obstacles. To increase the bystander resuscitation rate, focusing on targeted training of teachers as multipliers (train-the-trainer) can be a good approach for cardiac arrest centers.

Basic Resuscitation Training for Third-Cycle Primary School Students: A Qualitative Research of Training Providers' Experiences

The purpose of our research was to identify the experiences, obstacles, and self-reflective opinions regarding the qualifications of the training providers of cardiopulmonary resuscitation to third-cycle primary school students. The effectiveness and success of a training program in basic resuscitation procedures depend on the qualifications and knowledge of the training provider and the type of didactic materials used. The qualitative method was used with 3 non-homogenous focus groups. Training providers (n = 8) from primary health care participated. The selected text was analyzed using a thematic analysis. The focus groups were organized after the training conducted on basic resuscitation procedures to third-cycle primary school students in September and October 2018. Prior to conducting the research we gained approval by the Medical Ethics Committee. Twenty-five codes, 11 categories and 3 themes were designed: Obstacles that are present in conducting training on cardiopulmonary resuscitation, the effects of training on primary school students and the development of components of prosocial behavior, and systemic responsibility for the qualifications and knowledge of training providers. The research has found that training providers must have the skills and knowledge to motivate the participants of training sessions and encourage them to gain knowledge and skills on resuscitation. They should be familiar with various methods and forms of learning and use relevant teaching materials, so that they can conduct training sessions effectively. Activities are needed to implement minimal criteria for conducting training on resuscitation such as appropriately qualified providers that should follow the European Resuscitation Guidelines, an appropriate pedagogical approach employed by the providers, appropriate equipment and tools, content adjusted to the age of the primary school students, conducting training in small groups, revision of knowledge for training providers and primary school students.

Der aktuelle Umsetzungsstand von Wiederbelebungsunterricht in Schulen in Deutschland – Umfrageergebnisse einer Abfrage der Ministerien aller Bundesländer

Im April 2019 stellte der Bundesgerichtshof in einem Urteil (III ZR 35/18) klar, dass Lehrkräften die Pflicht zur Ersten Hilfe im Sportunterricht obliegt. Schon 2014 hatte der Schulausschuss der Kulturministerkonferenz den Bundesländern empfohlen, Wiederbelebungsunterricht in den Schulunterricht zu implementieren und dafür Lehrkräfte auszubilden. In einer Umfrage wurden jetzt die zuständigen Ministerien aller Bundesländer vom Deutschen Rat für Wiederbelebung (German Resuscitation Council, GRC), gebeten, ihren diesbezüglichen Projektstand mitzuteilen. Nur 2 der 16 Bundesländer (Baden-Württemberg und Mecklenburg-Vorpommern) meldeten hierbei eine weitgehende Flächendeckung. In 75 % der Fälle führen Lehrerinnen und Lehrer den Wiederbelebungsunterricht durch. Jeweils zur Hälfte wurden hierbei größere professionelle Wiederbelebungspuppen und einfache Wiederbelebungspuppen benutzt, die speziell für den Schulunterricht konzipiert wurden. Die Lehrkräfte wurden in der Ausbildung von Ärztinnen und Ärzten, Hilfsorganisationen und Rettungsdienstpersonal ausgebildet, das teilweise auch selbst Unterrichtseinheiten übernahm. Im Ergebnis befinden sich 6 Jahre nach der Publikation der Empfehlungen der Kultusministerkonferenz zum Wiederbelebungsunterricht an deutschen Schulen fast alle Bundesländer noch in der Aufbauphase. Es muss daher nachdrücklich auf eine zeitnahe Umsetzung der Empfehlung zur Implementierung von Wiederbelebungsunterricht bei Schulen und Kultusministerien hingewirkt werden, um so die Überlebensrate nach einem Herz-Kreislauf-Stillstand auch in Deutschland deutlich zu verbessern. Ziel ist es, dass alle Schulen bundesweit Wiederbelebungsunterricht durchführen und Lehrkräfte entsprechend qualifiziert werden.

Peer video feedback builds basic life support skills: A randomized controlled non-inferiority trial

Introduction

Training Basic Life Support saves lives. However, current BLS training approaches are time-consuming and costly. Alternative cost-efficient and effective training methods are highly needed. The present study evaluated whether a video-feedback supported peer-guided Basic Life Support training approach achieves similar practical performance as a standard instructor-guided training in laypersons.

Methods

In a randomized controlled non-inferiority trial, 288 first-year medical students were randomized to two study arms with different Basic Life Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer Video Feedback (PVF). Outcome parameters were objective data for Basic Life Support performance (compression depth and rate) from a resuscitation manikin with recording software as well as overall Basic Life Support performance and subjective confidence. Non-inferiority margins (Δ) for these outcome parameters and sample size calculation were based on previous studies with Standard Instructor Feedback. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority.

Results

Results confirmed non-inferiority of Peer Video Feedback to Standard Instructor Feedback for compression depth (proportion difference PVF–SIF = 2.9%; 95% CI: -8.2% to 14.1%; Δ = -19%), overall Basic Life Support performance (proportion difference PVF–SIF = 6.7%; 95% CI: 0.0% to 14.3%; Δ = -27%) and subjective confidence for CPR performance (proportion difference PVF–SIF = -0.01; 95% CI: -0.18–0.17; Δ = -0.5) and emergency situations (proportion difference PVF–SIF = -0.02; 95% CI: -0.21–0.18; Δ = -0.5). Results for compression rate were inconclusive.

Discussion

Peer Video Feedback achieves comparable results as standard instructor-based training methods. It is an easy-to-apply and cost-efficient alternative to standard Basic Life Support training methods. To improve performance with respect to compression rate, additional implementation of a metronome is recommended.

Die Ausbildung von Lehrerinnen und Lehrern als Multiplikatoren für den Wiederbelebungsunterricht an Schulen

Zielsetzung

Die Einführung des Wiederbelebungsunterrichts an Schulen soll die Reanimationsbereitschaft in der Gesellschaft und das Überleben von Menschen mit einem außerklinischen Herz-Kreislauf-Stillstand nachhaltig verbessern. Ziel der vorliegenden Untersuchung war es zu prüfen, wie Lehrkräfte als qualifizierte Multiplikatoren den Wiederbelebungsunterricht in ihren Schulen eigenständig durchführen.

Methodik

Die Uniklinik Köln qualifizierte in Kooperation mit dem Deutschen Rat für Wiederbelebung e. V. in einem speziell entwickelten Kurs Lehrkräfte von weiterführenden Schulen. Von Juli bis November 2019 erfolgte die Evaluation dieses Lehrermultiplikationskonzepts mittels einer webbasierten Umfrage.

Ergebnisse

An der Befragung nahmen 23 von 26 Schulen teil (88 %). Insgesamt haben 96 % (n = 22) der an der Befragung teilnehmenden Schulen den Wiederbelebungsunterricht eingeführt. Es wurden 229 Lehrkräfte ausgebildet, die in dem 2‑jährigen Beobachtungszeitraum 8612 Schüler trainierten. Im Mittel trainierte eine qualifizierte Lehrkraft in ihrer Schule 38 Schüler in Wiederbelebung. Die Multiplikationsfaktoren (Anzahl der trainierten Schülerinnen und Schüler pro Lehrkraft) waren schulindividuell unterschiedlich (Minimum/Maximum: 10/1747). Die schulintern projektverantwortlichen Lehrkräfte gaben an, sich sehr sicher in der eigenständigen Durchführung des Wiederbelebungsunterrichts zu fühlen.

Zusammenfassung

Speziell qualifizierte Lehrkräfte führen den Wiederbelebungsunterricht an ihren Schulen zuverlässig ein. Um noch mehr Schüler mit dem Wiederbelebungstraining zu erreichen, müssen die Multiplikationsfaktoren durch gezielte Unterstützungsangebote weiter erhöht werden.

[Evaluation of the project for the introduction of bystander resuscitation in schools in North Rhine-Westphalia]

BACKGROUND

Teaching of resuscitation measures is not mandatory in all schools in Germany. It is currently limited to individual, partly mandatory projects despite a low bystander resuscitation rate. For this reason, the Ministry for Schools and Education of North Rhine-Westphalia initiated the project "Bystander resuscitation at schools in NRW" in March 2017.

OBJECTIVE

The aim of this work was to evaluate this project.

MATERIAL AND METHODS

All secondary schools in North Rhine-Westphalia were invited to participate in the project. Medical partners from each administrative district took part, who carried out resuscitation training with existing concepts for teacher or student training. After a 3-year period, the evaluation was carried out using standardized questionnaires for school headmasters, teachers and students.

RESULTS

In total, more than 40,000 pupils from 249 schools in NRW could be trained in resuscitation within the project with 6 different concepts. Of the students 85% answered the questions regarding resuscitation correctly and overall felt safe in resuscitation measures. The one-off investment requirement for all schools is roughly 4-6.5 million € and around 340,000 € in each budget year.

CONCLUSION

A legal constitution and funding are necessary for a nationwide introduction of resuscitation in schools. All established concepts are effective, therefore each school can use them exactly according to their needs, optimally in a stepped form. Training for teachers should focus on resuscitation.