The pediatric cardiopulmonary resuscitation graduates’ training

Abstract

Сardiopulmonary resuscitation (CPR) history starts since 1740, in 1960 modern CPR was developed. In 2015 some Pediatric basic life support (PBLS) guideline changes have been made by the American Heart Association (AHA). CPR practical skills with peculiarities in childhood is a stage of a final practically oriented exam in Pediatrics. We have chosen AHA PBLS guidelines for graduates’ training in 2017- 2018 as a stage in preparing to the final exam in Pediatrics. The aim of the CPR training was to recognize need of CPR and master basic CPR skills in children of two age groups (up to 1 year old and 1-8 years old) except neonates. Two low-fidelity and one mid-fidelity manikins (two infants, one toddler) were used to master CPR skills. The aim of the study was to evaluate the effectiveness of the basic CPR training using initial and final testing. Training class was incorporated within module 5 for Ukrainian speaking 6 year students and modules 5/6 for English speaking groups, totally 25 groups. The course duration was 1,5 hours. Finally course was divided in 7 stages: (1) initial paper testing - 10 min; (2) instructor’s introduction – 5 min; (3) demonstration of 6 short training videos – 25 min; (4) comments and discussion - 5 min; (5) students’ practice with manikins - 30 min; (6) cross-exam and debriefing – 5 min; (7) final paper testing - 10 min. In the instructor-led course, students participated in simulated clinical scenarios and learning stations. We have developed a base of paper tests, total number of tests was 24 short questions with single answer choice out of 4 proposed answers. These tests were chosen out of 40 free available tests on official AHA website. Set of 24 tests consisted of 12 questions on PBLS (6 of basic CPR, 6 of first aid) and 12 questions on pediatric advanced life support (PALS): only first 12 tests were used to evaluate the 32 effectiveness of basic CPR training, while the rest 12 questions were used as control set. Current and final academic achievements and results of test anxiety testing were used for association assessment. The results of initial total testing was average of 12,4±2,2 correct answers (min-max: 11-16) or 51,7% and finally there was an improvement up to average 16,4±2,2 (p<0,0001) of the sum of initially correct and corrected for proper answers (min-max: 14-22) or 68,3%: totally 60% of students had improved initial results. PBLS testing was average of 6,0±1,2 correct answers (minmax: 5-8) or 50,0% and finally there was an improvement up to average 7,2±1,3 of correct answers (min-max: 6-9) (p<0,17) or 60% (min-max: 50-75%). All the students have improved their initial results in the PBLS set of tests. There was almost significant difference in gain of correct answers of PBLS versus PALS – 1,2±0,5 versus 0±1,2 correspondingly (p<0,08). The best final results with non-significant gain were demonstrated in basic CPR testing: 3,2±1,3 of correct answers (min-max: 2-5) or 53% with improvement up to 3,6±1,0 (p<0,54) of correct answers (min-max: 3-5) or 60%. Significant gain of correct answers was observed in first aid set of tests: 2,8±0,5 of correct answers (min-max: 2-3) or 47% with improvement up to 3,6±1,0 (p<0,04) of correct answers (min-max: 3-4) or 60%. According to correlation analysis the final results of total testing significantly associated with initial basic CPR testing results (r=0,93; p<0,02), anxiety testing results (r=0,93; p<0,03), and the gain of final CPR testing significantly associated with improvement in step II testing results in Pediatrics (r=0,88; p<0,05). Сonclusion. Pediatric basic CPR training course allowed to master the basics of child CPR with breaths and child choking relief. Effectiveness of the basic CPR training was approved by the significant increase in correct answers of final testing as compared to initial testing due to set of tests of first aid and pediatric basic life support skills.