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Wang YF, Hsu YF, Fang KT, Kuo LT. Gamification in medical education: identifying and prioritizing key elements through Delphi method. MEDICAL EDUCATION ONLINE 2024; 29:2302231. [PMID: 38194415 PMCID: PMC10778414 DOI: 10.1080/10872981.2024.2302231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Gamification has gained popularity in medical education, but key elements have not been formally identified. This study aimed to generate and prioritize a list of key elements of gamification in medical education. METHODS This study utilized a two-stage approach, including the Delphi method and qualitative interview. Nineteen medical educators with expertise in gamification participated in the Delphi method stage. Experts who had more than three years of experience with gamification in medical education constituted the expert panel. The experts were then asked to rate the gamification elements using the Likert five-point scale through at least two consensus-seeking rounds. Consensus for key elements was predefined as ≥ 51% of respondents rating an element as 'important' or"very important." In the qualitative interview stage, 10 experts provided feedback on the application of these key gamification elements. RESULTS Eighteen participants (11 males and 7 females) completed the entire Delphi process for this study. After two rounds of surveys, the consensus was reached on all elements. Thirteen elements scored more than 4 points (37%) and reached the criteria of key elements of gamification in medical education. The top five key elements were integration with instruction objectives, game rules, rapid feedback, fairness, and points/scoring. The thirteen key elements for successful gamification in medical education were further organized into two main categories: (1) gamification design principles and (2) game mechanisms. CONCLUSIONS Integration with educational objectives, gamification in curriculum design and teaching methods, and balancing between the mechanisms and principles were the three key components for successful gamification. This study explored the gamification key elements, providing practical tips for medical educators in their efforts to gamify medical education. Future studies involving learners could be performed to examine the efficacy of these key elements in gamification.
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Affiliation(s)
- Yung-Fu Wang
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Ya-Fang Hsu
- Department of Long-term Care and Health Promotion, Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Kwo-Ting Fang
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Liang-Tseng Kuo
- Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Donoghue A, Sawyer T, Olaussen A, Greif R, Toft L. Gamified learning for resuscitation education: A systematic review. Resusc Plus 2024; 18:100640. [PMID: 38666256 PMCID: PMC11043884 DOI: 10.1016/j.resplu.2024.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Aim To systematically review published literature to evaluate the impact of gamified learning on educational and clinical outcomes during life support education. Methods This systematic review was conducted as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). A search of PubMed, Embase, and Cochrane was conducted from inception until February 12, 2024. Studies examining incorporation of gamified learning were eligible for inclusion. Reviewers independently extracted data on study design and outcomes; appropriate risk of bias assessment tools were used across all outcomes. Results 2261 articles were identified and screened, yielding sixteen articles (seven randomized trials, nine observational studies) which comprised the final review. No meta-analyses were conducted due to significant heterogeneity of intervention, population, and outcome. Only one study was found to have a low risk of bias; the remaining studies were found to have moderate to high risk. Fourteen studies were in healthcare providers and two were in laypersons. Most studies (11 of 16) examined the impact of a digital platform (computer or smartphone). Most (15 of 16) studies found a positive effect on at least one educational domain; one study found no effect. No included study found a negative effect on any educational domain. Conclusion This systematic review found a very heterogeneous group of studies with low certainty evidence, all but one of which demonstrated a positive effect on one or more educational domains. Future studies should examine the underlying causes of improved learning with gamification and assess the resource requirements with implementation and dissemination of gamified learning.
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Affiliation(s)
- Aaron Donoghue
- Departments of Critical Care Medicine and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Taylor Sawyer
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Alexander Olaussen
- Alfred Health Emergency Service, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
- National Trauma Research Institute, Melbourne, Australia
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Lorrel Toft
- Department of Internal Medicine, Cardiology, University of Nevada Reno School of Medicine, Reno, NV, USA
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Gutiérrez-Puertas L, García-Viola A, Márquez-Hernández VV, Garrido-Molina JM, Granados-Gámez G, Aguilera-Manrique G. Guess it (SVUAL): An app designed to help nursing students acquire and retain knowledge about basic and advanced life support techniques. Nurse Educ Pract 2020; 50:102961. [PMID: 33421681 DOI: 10.1016/j.nepr.2020.102961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022]
Abstract
To design an app that helps nursing students to acquire and retain knowledge of Basic and Advanced Life Support techniques, as well as analyze the students' gamification experience. The study had two phases: 1) App design and development and 2) experimental study. A total of 184 students participated, with 92 in the experimental group and 92 in the control group. The instruments used were the Guess it (SVUAL) app, a test on knowledge and the Gameful Experience Scale. The app was deemed to have a suitable level of content and user-friendliness of 97%. The experimental group obtained a higher average score on the knowledge test than the control group (U = 2835.500; Z = -3.968; p < 0.05). On the re-test, the experimental group also obtained a higher average score than the control group. As for the experience within the game, all the dimensions scored higher than average, except the absence of negative effects dimension, which indicates that the app had very few negative consequences on the participants. The developed app has proven to have a good level of content and to be user-friendly, improving knowledge levels and retention of information in nursing students.
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Affiliation(s)
- Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Alba García-Viola
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - José Miguel Garrido-Molina
- Empresa Pública de Emergencias Sanitarias 061, Edificio Antiguo Hospital Virgen Del Mar, Ctra. de Ronda, 226, 04009, Almería, Spain.
| | - Genoveva Granados-Gámez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
PURPOSE OF REVIEW This review highlights the emerging fields of simulation research by tying innovation into principles of learning and process improvement. RECENT FINDINGS Advances have been made in both educational simulation and simulation for quality improvement, allowing this versatile modality to be more broadly applied to healthcare and systems. SUMMARY Simulation in pediatric critical care medicine continues to evolve. Although the majority of simulation is focused on learner education, emerging research has broadened to focus on patient- and system-centered outcomes, leading to improvement in the quality of care delivered in the ICU.
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Affiliation(s)
- Ilana Harwayne-Gidansky
- Division of Critical Care, Stony Brook Children’s Hospital, Renaissance School of Medicine, Stony Brook, NY USA
| | - Rahul Panesar
- Division of Critical Care, Stony Brook Children’s Hospital, Renaissance School of Medicine, Stony Brook, NY USA
| | - Tensing Maa
- Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH USA
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Chang TP, Raymond T, Dewan M, MacKinnon R, Whitfill T, Harwayne-Gidansky I, Doughty C, Frisell K, Kessler D, Wolfe H, Auerbach M, Rutledge C, Mitchell D, Jani P, Walsh CM. The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial. Resuscitation 2019; 138:273-281. [PMID: 30946919 DOI: 10.1016/j.resuscitation.2019.02.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Little is known about how best to motivate healthcare professionals to engage in frequent cardiopulmonary resuscitation (CPR) refresher skills practice. A competitive leaderboard for simulated CPR can encourage self-directed practice on a small scale. The study aimed to determine if a large-scale, multi-center leaderboard improved simulated CPR practice frequency and CPR performance among healthcare professionals. METHODS This was a multi-national, randomized cross-over study among 17 sites using a competitive online leaderboard to improve simulated practice frequency and CPR performance. All sites placed a Laerdal® ResusciAnne or ResusciBaby QCPR manikin in 1 or more clinical units - emergency department, ICU, etc. - in easy reach for 8 months. These simulators provide visual feedback during 2-minute compressions-only CPR and a performance score. Sites were randomly assigned to the intervention for the first 4-months or the second 4-months. Following any CPR practice by a healthcare professional, participants uploaded scores and an optional 'selfie' photo to the leaderboard. During the intervention phase, the leaderboard displayed ranked scores and high scores earned digital badges. The leaderboard did not display control phase participants. Outcomes included CPR practice frequency and mean compression score, using non-parametric statistics for analyses. RESULTS Nine-hundred nineteen participants completed 1850 simulated CPR episodes. Exposure to the leaderboard yielded 1.94 episodes per person compared to 2.14 during the control phase (p = 0.99). Mean CPR performance participants did not differ between phases: 90.7 vs. 89.3 (p = 0.19). CONCLUSION A competitive leaderboard was not associated with an increase in self-directed simulated CPR practice or improved performance.
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Affiliation(s)
- Todd P Chang
- Division of Emergency Medicine & Transport, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, United States.
| | - Tia Raymond
- Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, TX, United States
| | - Maya Dewan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Ralph MacKinnon
- Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Travis Whitfill
- Departments of Pediatrics and Emergency Medicine, Yale University School, Division of Medicine, New Haven CT, United States
| | - Ilana Harwayne-Gidansky
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stony Brook Children's Hospital, Stony Brook, NY, United States
| | - Cara Doughty
- Department of Pediatrics, Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | | | - David Kessler
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, United States
| | - Heather Wolfe
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Marc Auerbach
- Departments of Pediatrics and Emergency Medicine, Yale University School, Division of Medicine, New Haven CT, United States
| | - Chrystal Rutledge
- Division of Pediatric Critical Care, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Diana Mitchell
- Department of Pediatrics, Section of Critical Care Medicine, Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States
| | - Priti Jani
- Department of Pediatrics, Section of Critical Care Medicine, Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States
| | - Catharine M Walsh
- Department of Paediatrics, the Research and Learning Institutes, Hospital for Sick Children, University of Toronto, Toronto, Canada
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Khan R, Scaffidi MA, Grover SC, Gimpaya N, Walsh CM. Simulation in endoscopy: Practical educational strategies to improve learning. World J Gastrointest Endosc 2019; 11:209-218. [PMID: 30918586 PMCID: PMC6425285 DOI: 10.4253/wjge.v11.i3.209] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/06/2019] [Accepted: 03/11/2019] [Indexed: 02/06/2023] Open
Abstract
In gastrointestinal endoscopy, simulation-based training can help endoscopists acquire new skills and accelerate the learning curve. Simulation creates an ideal environment for trainees, where they can practice specific skills, perform cases at their own pace, and make mistakes with no risk to patients. Educators also benefit from the use of simulators, as they can structure training according to learner needs and focus solely on the trainee. Not all simulation-based training, however, is effective. To maximize benefits from this instructional modality, educators must be conscious of learners' needs, the potential benefits of training, and associated costs. Simulation should be integrated into training in a manner that is grounded in educational theory and empirical data. In this review, we focus on four best practices in simulation-based education: deliberate practice with mastery learning, feedback and debriefing, contextual learning, and innovative educational strategies. For each topic, we provide definitions, supporting evidence, and practical tips for implementation.
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Affiliation(s)
- Rishad Khan
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London ON N6A 5C1, Canada
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto ON M5G 2C4, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto ON M5G 2C4, Canada
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston ON K7L 3N6, Canada
| | - Samir C Grover
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto ON M5G 2C4, Canada
| | - Nikko Gimpaya
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto ON M5G 2C4, Canada
| | - Catharine M Walsh
- Division of Gastroenterology, Hepatology, and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, University of Toronto, Toronto ON M5G 1X8, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto ON M5G 1X8, Canada
- The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto ON M5G 2C4, Canada
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Rutledge C, Walsh CM, Swinger N, Auerbach M, Castro D, Dewan M, Khattab M, Rake A, Harwayne-Gidansky I, Raymond TT, Maa T, Chang TP. Gamification in Action: Theoretical and Practical Considerations for Medical Educators. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1014-1020. [PMID: 29465450 DOI: 10.1097/acm.0000000000002183] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Gamification involves the application of game design elements to traditionally nongame contexts. It is increasingly being used as an adjunct to traditional teaching strategies in medical education to engage the millennial learner and enhance adult learning. The extant literature has focused on determining whether the implementation of gamification results in better learning outcomes, leading to a dearth of research examining its theoretical underpinnings within the medical education context. The authors define gamification, explore how gamification works within the medical education context using self-determination theory as an explanatory mechanism for enhanced engagement and motivation, and discuss common roadblocks and challenges to implementing gamification.Although previous gamification research has largely focused on determining whether implementation of gamification in medical education leads to better learning outcomes, the authors recommend that future research should explore how and under what conditions gamification is likely to be effective. Selective, purposeful gamification that aligns with learning goals has the potential to increase learner motivation and engagement and, ultimately, learning. In line with self-determination theory, game design elements can be used to enhance learners' feelings of relatedness, autonomy, and competence to foster learners' intrinsic motivation. Poorly applied game design elements, however, may undermine these basic psychological needs by the overjustification effect or through negative effects of competition. Educators must, therefore, clearly understand the benefits and pitfalls of gamification in curricular design, take a thoughtful approach when integrating game design elements, and consider the types of learners and overarching learning objectives.
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Affiliation(s)
- Chrystal Rutledge
- C. Rutledge is assistant professor, Department of Pediatrics, Division of Pediatric Critical Care, University of Alabama School of Medicine, and codirector, Children's of Alabama Pediatric Simulation Center, Birmingham, Alabama. C.M. Walsh is assistant professor, Department of Paediatrics, University of Toronto Faculty of Medicine, staff gastroenterologist, Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, and cross-appointed scientist, Wilson Centre for Research in Education, Toronto, Ontario, Canada. N. Swinger is assistant professor, Department of Pediatrics, Riley Children's Hospital, Indianapolis, Indiana. M. Auerbach is associate professor, Department of Pediatrics and Emergency Medicine, director of pediatric simulation, Yale Center for Medical Simulation, and associate pediatric trauma medical director, Yale University School of Medicine, New Haven, Connecticut. D. Castro is assistant professor, Department of Pediatrics, Section of Critical Care Medicine, Baylor College of Medicine, Houston, Texas. M. Dewan is assistant professor, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. M. Khattab is assistant professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas. A. Rake is clinical assistant professor, Department of Pediatrics, Keck School of Medicine of the University of Southern California, and medical director, Children's Hospital Los Angeles Simulation Center and Las Madrinas Pediatric Simulation Research Laboratory, Los Angeles, California. I. Harwayne-Gidansky is assistant professor of clinical pediatrics, Stony Brook Children's Hospital, Stony Brook, New York. T.T. Raymond is professor, Department of Pediatrics, Division of Cardiac Critical Care, Medical City Children's Hospital, Dallas, Texas. T. Maa is assistant clinical professor, Department of Pediatrics, Ohio State University College of Medicine, and medical director, In Situ Simulation Program, Nationwide Children's Hospital, Columbus, Ohio. T.P. Chang is associate professor of clinical pediatrics, Keck School of Medicine of the University of Southern California and Children's Hospital Los Angeles, Los Angeles, California
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González-Salvado V, Abelairas-Gómez C, Peña-Gil C, Neiro-Rey C, Barcala-Furelos R, González-Juanatey JR, Rodríguez-Núñez A. Basic life support training into cardiac rehabilitation programs: A chance to give back. A community intervention controlled manikin study. Resuscitation 2018; 127:14-20. [PMID: 29545137 DOI: 10.1016/j.resuscitation.2018.03.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/12/2018] [Accepted: 03/10/2018] [Indexed: 01/09/2023]
Abstract
AIM Early basic life support is crucial to enhance survival from out-of-hospital cardiac arrest but rates remain low, especially in households. High-risk groups' training has been advocated, but the optimal method is unclear. The CArdiac REhabilitation and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two basic life support educational strategies implemented in a cardiac rehabilitation program. METHODS A community intervention study including consecutive patients enrolled on an exercise-based cardiac rehabilitation program after acute coronary syndrome or revascularization was conducted. A standard basic life support training (G-Stan) and a novel approach integrating cardiopulmonary resuscitation hands-on rolling refreshers (G-CPR) were randomly assigned to each group and compared. Basic life support performance was assessed by means of simulation at baseline, following brief instruction and after the 2-month program. RESULTS 114 participants were included and 108 completed the final evaluation (G-Stan:58, G-CPR:50). Basic life support performance was equally poor at baseline and significantly improved following a brief instruction. A better skill retention was found after the 2-month program in G-CPR, significantly superior for safety and sending for an automated external defibrillator. Confidence and self-perceived preparation were also significantly greater in G-CPR after the program. CONCLUSIONS Integrating cardiopulmonary resuscitation hands-on rolling refreshers in the training of an exercise-based cardiac rehabilitation program is feasible and improves patients' skill retention and confidence to perform a basic life support sequence, compared to conventional training. Exporting this formula to other programs may result in increased numbers of trained citizens, enhanced social awareness and bystander resuscitation.
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Affiliation(s)
- Violeta González-Salvado
- Cardiology Department, University Clinical Hospital of Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Institute of Health Research of Santiago (IDIS), Spain.
| | - Cristian Abelairas-Gómez
- Institute of Health Research of Santiago (IDIS), Spain; CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Faculty of Educational Sciences, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Peña-Gil
- Cardiology Department, University Clinical Hospital of Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Institute of Health Research of Santiago (IDIS), Spain
| | - Carmen Neiro-Rey
- Cardiology Department, University Clinical Hospital of Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Roberto Barcala-Furelos
- Institute of Health Research of Santiago (IDIS), Spain; CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain; REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
| | - José Ramón González-Juanatey
- Cardiology Department, University Clinical Hospital of Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Institute of Health Research of Santiago (IDIS), Spain
| | - Antonio Rodríguez-Núñez
- Institute of Health Research of Santiago (IDIS), Spain; CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Paediatric Emergency and Critical Care Division, University Clinical Hospital of Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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González-Salvado V, Fernández-Méndez F, Barcala-Furelos R, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Very brief training for laypeople in hands-only cardiopulmonary resuscitation. Effect of real-time feedback. Am J Emerg Med 2016; 34:993-8. [PMID: 26964823 DOI: 10.1016/j.ajem.2016.02.047] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Bystander cardiopulmonary resuscitation (CPR) improves survival from out-of-hospital cardiac arrest, but rates and performance quality remain low. Although training laypeople is a primary educational goal, the optimal strategy is not well defined. This study aimed to determine whether a short training with real-time feedback was able to improve hands-only CPR among untrained citizens. METHODS On the occasion of the 2015 World Heart Day and the European Restart a Heart Day, a pilot study involving 155 participants (81 laypeople, 74 health care professionals) was conducted. Participants were invited to briefly practice hands-only CPR on a manikin and were after evaluated during a 2-minute chest compression (CC) test. During training brief instructions regarding hand position, compression rate and depth according to the current guidelines were given and real-time feedback was provided by a Laerdal SkillReporting System. RESULTS Mean CC rate was significantly higher among health care professionals than among laypeople (119.07 ± 12.85 vs 113.02 ± 13.90 min(-1); P = .006), although both met the 100-120 CC min(-1) criterion. Laypeople achieved noninferior results regarding % of CC at adequate rate (51.46% ± 35.32% vs health care staff (55.97% ± 36.36%; P = .43) and depth (49.88% ± 38.58% vs 50.46% ± 37.17%; P = .92), % of CC with full-chest recoil (92.77% ± 17.17% vs 0.91% ± 18.84; P = .52), and adequate hand position (96.94% ± 14.78% vs 99.74 ± 1.98%; P = .11). The overall quality performance was greater than 70%, noninferior for citizens (81.23% ± 20.10%) vs health care staff (85.95% ± 14.78%; P = .10). CONCLUSION With a very brief training supported by hands-on instructor-led advice and visual feedback, naïve laypeople are able to perform good-quality CC-CPR. Simple instructions, feedback, and motivation were the key elements of this strategy, which could make feasible to train big numbers of citizens.
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Affiliation(s)
- Violeta González-Salvado
- Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Felipe Fernández-Méndez
- University School of Nursing, Universidade de Vigo, Pontevedra, Spain; CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Roberto Barcala-Furelos
- CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain; REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
| | - Carlos Peña-Gil
- Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain
| | - José Ramón González-Juanatey
- Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain; Paediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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