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  • Title: Repetitive sessions of formative self-testing to refresh CPR skills: a randomised non-inferiority trial.
    Author: Mpotos N, De Wever B, Cleymans N, Raemaekers J, Loeys T, Herregods L, Valcke M, Monsieurs KG.
    Journal: Resuscitation; 2014 Sep; 85(9):1282-6. PubMed ID: 24983199.
    Abstract:
    OBJECTIVES: To investigate whether repetitive sessions of formative self-testing (RFST) result in an equal cardiopulmonary resuscitation (CPR) skill level compared to repetitive sessions of formative self-testing with additional practice (RFSTAP). METHODS: In a non-inferiority trial, 196 third-year medical students were randomised to an RFST or RFSTAP group. Testing and practising took place in a self-learning station equipped with a manikin connected to a computer. Each cycle of RFST consisted of a 2-min CPR test followed by feedback and feedforward. In the RFSTAP group, additional practice consisted of CPR exercises with a computer voice feedback. To be successful, a combined score consisting of ≥70% compressions with a depth of ≥50 mm and ≥70% compressions with complete release (<5 mm) and a compression rate of 100-120 min(-1) and ≥70% ventilations with a volume of 400-1000 ml had to be achieved within 6 weeks. Skill retention was measured after 6 months. The non-inferiority margin was predefined as a 10% difference in success rate. RESULTS: After six weeks the success rate in both groups was 96%: 99/103 (RFST) and 89/93 (RFSTAP). After 6 months, the success rate in the competent students was 26/96 (27%) for RFST and 32/86 (37%) for RFSTAP (three students dropped out in each group). The difference in the success rate between RFSTAP and RFST was 10% and 90% (CI -2 to 23%), respectively. As the upper bound exceeded 10%, non-inferiority was inconclusive. For each CPR skill separately, RFST was non-inferior for ventilation and complete release, superior for compression depth and inferior for compression rate. CONCLUSIONS: RFST and RFSTAP were equally effective to refresh skills within 6 weeks. After 6 months, non-inferiority was inconclusive for the combined score. Our results indicate the potential of RFST to refresh CPR skills.
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