Repetitive sessions of formative self-testing to refresh CPR skills : a randomised non-inferiority trialRepetitive sessions of formative self-testing to refresh CPR skills : a randomised non-inferiority trial
Faculty of Medicine and Health Sciences
Antwerp Surgical Training, Anatomy and Research Centre (ASTARC)
Resuscitation. - Limerick, 1972, currens
85(2014):9, p. 1282-1286
University of Antwerp
Objectives: To investigate whether repetitive sessions of formative self-testing (RFST) result in an equal cardiopulmonary resuscitation (CPR) skill level compared to repetitive sessions of formative self-testing with additional practice (RFSTAP). Methods: In a non-inferiority trial, 196 third-year medical students were randomised to an RFST or RFSTAP group. Testing and practising took place in a self-learning station equipped with a manikin connected to a computer. Each cycle of RFST consisted of a 2-min CPR test followed by feedback and feedforward. In the RFSTAP group, additional practice consisted of CPR exercises with a computer voice feedback. To be successful, a combined score consisting of >= 70% compressions with a depth of >= 50 mm and >= 70% compressions with complete release (<5 mm) and a compression rate of 100-120 min(-1) and >= 70% ventilations with a volume of 400-1000 ml had to be achieved within 6 weeks. Skill retention was measured after 6 months. The non-inferiority margin was predefined as a 10% difference in success rate. Results: After six weeks the success rate in both groups was 96%: 99/103 (RFST) and 89/93 (RFSTAP). After 6 months, the success rate in the competent students was 26/96 (27%) for RFST and 32/86 (37%) for RFSTAP (three students dropped out in each group). The difference in the success rate between RFSTAP and RFST was 10% and 90% (CI - 2 to 23%), respectively. As the upper bound exceeded 10%, non-inferiority was inconclusive. For each CPR skill separately, RFST was non-inferior for ventilation and complete release, superior for compression depth and inferior for compression rate. Conclusions: RFST and RFSTAP were equally effective to refresh skills within 6 weeks. After 6 months, non-inferiority was inconclusive for the combined score. Our results indicate the potential of RFST to refresh CPR skills. (C) 2014 Elsevier Ireland Ltd. All rights reserved.