Cooper Simon, Johnston Elaine, Priscott David
C501, Portland Square, Faculty of Health and Social Work, University of Plymouth, Plymouth, UK.
Resuscitation. 2007 Jan;72(1):92-9. doi: 10.1016/j.resuscitation.2006.06.004. Epub 2006 Oct 27.
To evaluate immediate life support (ILS) training in a primary care setting.
A 12 month pre/post-quasi-experimental and qualitative evaluation of ILS training across the counties of Devon and Cornwall (UK). Data were collected via feedback forms, pre/post course knowledge and skills tests and by focus group interviews with key stakeholders.
One hundred and seventy-three professionals from 10 courses took part in the evaluation with a response rate of 93%. Feedback on the course was overwhelmingly positive. A significant improvement in both skills (p < or = 0.001) and knowledge (p < or = 0.001) was shown. However, a proportion of participants had a decline in knowledge by the end of the course. Those attending ILS had a significantly higher knowledge score at the start of the course (p = 0.002) than a group attending a BLS course, indicating that the preparatory course manual had been beneficial. Knowledge did not decline significantly by 6 months but skills did (p = 0.02), but remained higher than pre-course levels (p < or = 0.001). Knowledge (p = 0.008) and skill (p < or = 0.002) retention following the ILS course was significantly higher than in the BLS course sub-group, indicating the added value of ILS. The focus groups raised a number of themes relating to release of staff; funding issues; and the observed and reported effects of assessment inequity mainly relating to 'failure to fail' and 'dove and hawk' approaches.
The course leads to a significant increase in skills and knowledge with good knowledge retention. Skill decline is significant which raises questions about the practice of practitioners who are not updated regularly. Issues of funding, staff resources and the assessment ethics and strategy need to be addressed.
评估在基层医疗环境中进行的即时生命支持(ILS)培训。
对英国德文郡和康沃尔郡各县的ILS培训进行为期12个月的前后准实验和定性评估。通过反馈表、课程前后的知识和技能测试以及与关键利益相关者的焦点小组访谈收集数据。
来自10个课程的173名专业人员参与了评估,回复率为93%。对该课程的反馈总体上是积极的。技能(p≤0.001)和知识(p≤0.001)均有显著提高。然而,一部分参与者在课程结束时知识有所下降。参加ILS培训的人员在课程开始时的知识得分(p = 0.002)显著高于参加基础生命支持(BLS)课程的一组人员,这表明预备课程手册是有益的。6个月时知识没有显著下降,但技能有所下降(p = 0.02),但仍高于课程前水平(p≤0.001)。ILS课程后的知识(p = 0.008)和技能(p≤0.002)保留率显著高于BLS课程子组,表明了ILS的附加价值。焦点小组提出了一些与人员调配、资金问题以及观察到和报告的评估不公平影响相关的主题,主要涉及“未能淘汰不合格者”和“温和与严格”的方法。
该课程导致技能和知识显著提高,且知识保留良好。技能下降显著,这对未定期更新知识的从业者的实践提出了疑问。资金、人员资源以及评估伦理和策略等问题需要得到解决。