Introduction and Objectives:
Technological advances allow automation of repetitive tasks that previously required considerable amounts of paper, labour and time. The primary objective of this quality improvement project was to create and implement a technology framework to minimise paper use and improve efficiency of a mid-to-large sized basic life support course (BLS). The secondary objective was to gather user feedback on the use of these technologies.

Materials and Methods:
This quality improvement project was conducted by the University of Birmingham’s Resuscitation for Medical Disciplines (RMD) group, who deliver a European Resuscitation Council (ERC) BLS provider course which trains approximately 900 first-year healthcare students per year. (1) First, an analysis of current inefficiencies was carried out, which identified 4 major areas for improvement: a) team communication, b) instructor recruitment, c) attendance monitoring, d) BLS end-of-course examinations. Next, literature and web searches were conducted to plan suitable solutions, and a technological framework including novel programming code and script was developed and implemented. Finally, questionnaires were sent to BLS course examiners seeking feedback on the approach to examinations. 

Results:
We identified a number of potential solutions for each domain (Fig 1). In summary our final technological framework consists of: 
1. Slack for team communications, allowing compartmentalisation of conversation, searchable content and files, and task organisation and management; 
2. Google Forms for instructor recruitment; (2)
3. A custom-designed Slack “bot” (electronic assistant) with integration into cloud storage to monitor attendance; (3)
4. Custom-built addons for Google Forms to manage examinations electronically. 

For the latter domain, of the 14 examiners surveyed, all (100%) commented that they preferred the electronic forms for examination compared with previous paper forms.

Conclusion:
Use of a technology framework as detailed can enable a paperless BLS course that runs efficiently and can reduce reliance on human administrative work, allowing focus on research and innovation.

6 - The PaTiLEC Framework (Paperless Technology in Life Support Education Courses) for medium-to-large life support provider training courses.