Emergency skill training—A randomized controlled study on the effectiveness of the 4-stage approach compared to traditional clinical teaching

Greif, Robert; Egger, Lars; Basciani, Reto; Lockey, Andrew; Vogt, Andreas

doi:10.1016/j.resuscitation.2010.09.478

Cited by 70 publications

(64 citation statements)

References 24 publications

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“…The best training methods for EPA have still to be determined [112], but in general, handson teaching of manual skills is necessary in addition to conventional didactic instructions [113]. Such systematic teaching in a workshop setting improves both confidence [114] and practical skills [114][115][116]. The minimum number of attempts at Seldinger cricothyroidotomy to obtain basic proficiency is suggested to be five [115,116].…”

Section: Trainingmentioning

confidence: 99%

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Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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SummaryThe inability to maintain oxygenation by non‐invasive means is one of the most pressing emergencies in anaesthesia and emergency care. To prevent hypoxic brain damage and death in a ‘cannot intubate, cannot oxygenate’ situation, emergency percutaneous airway access must be performed immediately. Even though this emergency is rare, every anaesthetist should be capable of performing an emergency percutaneous airway as the situation may arise unexpectedly. Clear knowledge of the anatomy and the insertion technique, and repeated skill training are essential to ensure completion of this procedure rapidly and successfully. Various techniques have been described for emergency oxygenation and several commercial emergency cricothyroidotomy sets are available. There is, however, no consensus on the best technique or device. As each has its limitations, it is recommended that all anaesthetists are skilled in more than one technique of emergency percutaneous airway. Avoiding delay in initiating rescue techniques is at least as important as choice of device in determining outcome.

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Section: Trainingmentioning

confidence: 99%

“…Such systematic teaching in a workshop setting improves both confidence [114] and practical skills [114][115][116]. The minimum number of attempts at Seldinger cricothyroidotomy to obtain basic proficiency is suggested to be five [115,116]. Various models have been used for training in EPA.…”

Section: Trainingmentioning

confidence: 99%

Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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“…Some studies report improvements in outcome using newer guidelines but very little is known about the impact of simplification of the BLS algorithm and the different teaching method used for BLS training. (16,17) No advantages of the 4-stage teaching technique have been reported, even in teaching complex skills, (11,18) however two studies reported significant improvement when teaching complex skills. (19,20) Our study showed that more steps of the algorithm were performed correctly if students were taught with the 4-stage approach using 2000 ERC guidelines, while in 2005 ERC guidelines only correct chest compression hand position was significantly improved in the 4-stage teaching group.…”

Section: Comparison Of Both Teaching Techniquesmentioning

confidence: 99%

“…One of them is the »4-stage approach«, proposed by R. Peyton (Royal College of Surgeons) in 1998 (11)(12)(13) and adapted by Bullock for resuscitation courses in the United Kingdom. (14) In the 4-stage approach, the instructors first demonstrate the skill without commentary.…”

Section: Introductionmentioning

confidence: 99%

Medical students perform basic life support skills in a simulated scenario better using a 4-stage teaching approach compared to conventional training

2017

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Introduction. Cardiopulmonary resuscitation is influenced by the quality of basic life support (BLS). The primary objective of our study was to compare efficiency in the acquisition of BLS skills using conventional training and the 4-stage approach as a teaching method for BLS training. Methods. In a prospective, randomised, 2-parallel group study, 266 first year medical students were randomised to either conventional training or the 4-stage approach using 2000 and 2005 ERC (European Resuscitation Council) guidelines. The students were tested immediately after receiving training. Three ERC-certified instructors assessed BLS skills using video recordings. Results. The students who were taught according to the 4-stage approach using 2000 guidelines preformed significantly better in the following steps: calls for help (p<0.01), opens the airway (p<0.01), places hands for chest compression correctly (p<0.01) and performs chest compressions correctly (p<0.01), while using 2005 guidelines, only chest compression hand position improved significantly in the 4-stage teaching group (p<0.01). Conclusions. The 4-stage approach improved the efficiency of several steps of the BLS algorithm and the ability to follow the algorithm in the correct sequence using 2000 ERC guidelines, while in students using the 2005 ERC guidelines only chest compression hand position improved significantly. Students who were taught according to 2000 ERC guidelines had significantly better hand position than students who were taught according to 2005 guidelines, independent of teaching method used.

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“…9 Orde and Grief challenged one of the sacred cows of resuscitation -the four-stage teaching approach. 31,32 Whilst acknowledging the significance of their findings, Barelli and Scapigliati provide a balanced assessment of the evidence and call for further high-quality research before abandoning this approach. 33 Studies exploring advances in computer and multimedia technologies support alternatives to traditional approaches to training.…”

Section: New Approaches To Educationmentioning

confidence: 99%