Seeking efficiency in life support refresher training – when, how and by whom?
Pawar A1, O’Donnell A1, Hardy E1, Percival H1, Hulme J1,3 Owen A1,3, Alderman J1,2
1) College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. B15 2TU
2) Department of Anaesthesia and Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, UK. B15 2TH
3) Department of Anaesthesia and Critical Care, Sandwell and West Birmingham NHS Trust, West Bromwich, West Midlands, B71 4HJ
Purpose of study
Survival rates following out-of-hospital cardiac arrest in the UK lag behind other developed countries at 8%. (1) Training the public leads to increased bystander basic life support (BLS) rate. (2) Leading health organisations have called for improved cardiopulmonary resuscitation (CPR) and BLS training. (3) However, CPR skills decay rapidly, even amongst qualified clinicians. (4-8). Refresher training is resource intensive, and may be recurrently needed. The University of Birmingham trains all medical students in BLS during their studies. (9) We sought to investigate the nature and rate of students’ BLS skill decay, and develop an efficient method to refresh these skills.
Materials and methods
Medical students were recruited to participate in a pragmatic randomised trial 1-3 years after BLS training. Participants performed BLS on a Laerdal Little Anne manikin and were assessed against current European Resuscitation Council BLS guidelines by two examiners. Participants were then randomised to receive rapid refresher BLS training in a 30-minute tutorial using one of three methods:
- One-to-one practice session with accredited BLS instructor
- Video assisted training with time for unguided practice
- No hands on practice; only written BLS sequence instructions
Participants were then re-examined; assessors were blinded to participants’ refresher training group.
51 participants were recruited. BLS compliance had deteriorated within a year after training (38% pre-refresher compliance), and worsened each year thereafter (9% after 2 years, 17% after 3 years). Initial compliance with BLS guidelines rose from 23.7% to 64.5% after refresher training of any type (p