Training interval in cardiopulmonary resuscitation

Abstract

Aim: Although evidence supports brief, frequent CPR training, optimal training intervals have not been established. The purpose of this study was to compare nursing students' CPR skills (compressions and ventilations) with 4 different spaced training intervals: daily, weekly, monthly, and quarterly, each for 4 times in a row.

Methods: Participants were nursing students (n = 475) in the first year of their prelicensure program in 10 schools of nursing across the United States. They were randomly assigned into the 4 training intervals in each of the schools. Students were trained in CPR on a Laerdal Resusci Anne adult manikin on the Resuscitation Quality Improvement (RQI) mobile simulation station. The outcome measures were quality of compressions and ventilations as measured by the RQI program.

Results: Although students were all certified in Basic Life Support prior to the study, they were not able to adequately perform compressions and ventilations at pretest. Overall compression scores improved from sessions 1 to 4 in all training intervals (all p < .001), but shorter intervals (daily training) resulted in larger increases in compression scores by session 4. There were similar findings for ventilation skills, but at session 4, both daily and weekly intervals led to better skill performance.

Conclusion: For students and other novices learning to perform CPR, the opportunity to train on consecutive days or weeks may be beneficial: if learners are aware of specific errors in performance, it may be easier for them to correct performance and refine skills when there is less time in between practice sessions.

Conflict of interest statement

Laerdal Medical Corporation funded the study (through the National League for Nursing) and also supplied the RQI mobile simulation stations and program for the study at no cost to the schools of nursing that served as training sites. MHO received a grant from the National League for Nursing to conduct the study. The United States Air Force Research Laboratory (AFRL) funded the participation of MAK, TSJ, and KAG. Laerdal Medical was engaged in a Cooperative Research and Development Agreement with the AFRL during the execution of this study to test the utility of a personalized learning technology developed by AFRL as an extension of this research. Data on participants’ performance of CPR skills were collected through the RQI program and stored in HealthStream’s learning management system and the AFRL Research Laboratory’s MindModeling system. The National League for Nursing and Laerdal Medical were not involved in the collection, analysis, and interpretation of the data; in writing the manuscript; nor in the decision to submit the manuscript for publication. The investigators had sole responsibility for implementing the study, collecting and analyzing the data, and writing the manuscript. There were no restrictions by the National League for Nursing or Laerdal Medical on the statistical analysis or publication of the findings. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Participant flow chart.

Fig 2. Mean overall compression score (1 SD Error Bar) by interval, pretest/training/posttest assessment, and session.

Horizontal dashed line at 75 represents the minimum performance target.

Fig 3. Mean percentages of compressions with adequate depth, rate, release, and hand placement by interval, session, and pretest/training/posttest assessment.

Fig 4. Mean overall ventilation score (1 SD Error Bar) by interval, session, and pretest/training/posttest assessment.

Horizontal dashed line at 75 represents the minimum performance target.

Fig 5. Mean percentage of ventilations with adequate volume by interval, session, and pretest/training/posttest assessment.