No abstract

Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.

Introduction. Resuscitation training increases bystander’s ability to perform basic life support (BLS) with an automated external defibrillator (AED) immediately after training. However, several studies indicate that resuscitation skills decay rapidly. Methods. This study evaluates retention of BLS/AED skills three months after an initial study comparing acquisition of BLS/AED skills among laypersons immediately after training with a two-stage versus four-stage teaching technique. Results. There was no difference in retention of BLS/AED skills (pass rate 10.8% versus 10.9%, respectively, p=1) three months after training. Total average number of skills adequately performed (of 17) was 13.3 versus 13.7 among laypersons trained with a two-stage and a four-stage technique, respectively. No difference was found in quality of chest compressions and rescue breaths between the two groups. Conclusion. Three months after training, this study found no difference in retention of BLS/AED skills among laypersons taught using a two-stage compared to a four-stage teaching technique.

Background The use of simulation-based team training has increased over the past decades. Simulation-based team training within emergency medicine and critical care contexts is best known for its use by trauma teams and teams involved in cardiac arrest. In the domain of emergency medicine, simulation-based team training is also used for other typical time-critical clinical presentations. We aimed to review the existing literature and current state of evidence pertaining to non-technical skills obtained via simulation-based team training in emergency medicine and critical care contexts, excluding trauma and cardiac arrest contexts. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Before the initiation of the study, the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. We conducted a systematic literature search of 10 years of publications, up to December 17, 2019, in the following databases: PubMed/MEDLINE, EMBASE, Cochrane Library, and CINAHL. Two authors independently reviewed all the studies and extracted data. Results Of the 456 studies screened, 29 trials were subjected to full-text review, and 13 studies were included in the final review. None of the studies was randomized controlled trials, and no studies compared simulation training to different modalities of training. Studies were heterogeneous; they applied simulation-training concepts of different durations and intensities and used different outcome measures for non-technical skills. Two studies reached Kirkpatrick level 3. Out of the remaining 11 studies, nine reached Kirkpatrick level 2, and two reached Kirkpatrick level 1. Conclusions The literature on simulation-based team training in emergency medicine is heterogeneous and sparse, but somewhat supports the hypothesis that simulation-based team training is beneficial to teams’ knowledge and attitudes toward non-technical skills (Kirkpatrick level 2). Randomized trials are called for to clarify the effect of simulation compared to other modalities of team training. Future research should focus on the transfer of skills and investigate improvements in patient outcomes (Kirkpatrick level 4).