Mpotos Nicolas, De Wever Bram, Cleymans Nick, Raemaekers Joris, Loeys Tom, Herregods Luc, Valcke Martin, Monsieurs Koenraad G
Emergency Department, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium.
Department of Educational Studies, Ghent University, H. Dunantlaan 2, B-9000 Ghent, Belgium.
Resuscitation. 2014 Sep;85(9):1282-6. doi: 10.1016/j.resuscitation.2014.06.011. Epub 2014 Jun 28.
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).
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.
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.
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.
研究与进行额外练习的形成性自我测试重复课程（RFSTAP）相比，形成性自我测试重复课程（RFST）是否能带来同等水平的心肺复苏（CPR）技能。
在一项非劣效性试验中，196名三年级医学生被随机分为RFST组或RFSTAP组。测试和练习在一个配备有与计算机相连的人体模型的自学站进行。RFST的每个周期包括一次2分钟的CPR测试，随后是反馈和前馈。在RFSTAP组中，额外练习包括带有计算机语音反馈的CPR练习。要取得成功，在6周内必须达到由以下各项组成的综合分数：按压深度≥50毫米且按压次数≥70%、完全放松（<5毫米）且按压次数≥70%、按压速率为100 - 120次/分钟（-1）以及通气量为400 - 1000毫升且通气次数≥70%。6个月后测量技能保留情况。非劣效性界值预先定义为成功率相差10%。
六周后，两组的成功率均为96%：RFST组为99/103，RFSTAP组为89/93。6个月后，合格学生中，RFST组的成功率为26/96（27%），RFSTAP组为32/86（37%）（每组有三名学生退出）。RFSTAP组与RFST组成功率的差异分别为10%和90%（置信区间 -2至23%）。由于上限超过了10%，非劣效性结论不明确。对于每项CPR技能单独来看，RFST在通气和完全放松方面非劣效，在按压深度方面更优，在按压速率方面较差。
RFST和RFSTAP在6周内刷新技能方面同样有效。6个月后，综合分数的非劣效性结论不明确。我们的结果表明RFST在刷新CPR技能方面具有潜力。
