medical students. Problems with device operation were recorded and data collected in this phased was used to calculate the number of sample size in the next phase. Phase 3 -A randomized, non-inferiority trial was conducted to compare the efficacy of the novel device with the current device in BLS training for 60 lay rescuers. Phase 4 -A 6-point Likert type scale was evaluated by 44 BLS instructors for a satisfaction survey after using the novel device. Stage 3: The novel device's cost effectiveness was evaluated.Results: Novel device (Figure ) can give CPR quality feedback, can be used in AED training, and can operate on both functions consecutively and simultaneously. Expert opinions were in consistent with the device being up to standard and practical (Kappa ¼ 0.94). The factorial design, randomized controlled trial-design pilot study demonstrated that the best BLS practice test result was yielded in the group using the novel device, with a median(IQR) of 26(26-26) (p-value < 0.01), while the randomized, non-inferiority trial showed that the novel device was not inferior to the current device (p-value 0.28). The satisfaction survey using a 6-point Likert type scale demonstrated a median(IQR) satisfaction score for the novel device in terms of convenience and realism at 5(4-6) and 5(4-5.75), respectively. Cost-effectiveness analysis from the study showed that 1 set of novel BLS training device cost 3-5 times less than commercial models, and mass production of the device could reduce the cost by 5-10 times.Conclusions: Novel BLS training device can increase the instructor's convenience and the trainer's realism during the training. Its effectiveness in BLS training is equivalent to other commercial models and its cost is appropriate for a developing country. We expect to make quality BLS education accessible for all kinds of people.
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