Li Peitong, Milkovic Anita, Morley Peter, Ng Louisa
Melbourne Medical School, The University of Melbourne, Parkville, Victoria 3010, Australia.
Department of Intensive Care, Royal Melbourne Hospital, 300 Grattan Street, Victoria 3050, Australia.
Resusc Plus. 2023 Sep 26;16:100463. doi: 10.1016/j.resplu.2023.100463. eCollection 2023 Dec.
Training schoolchildren in cardiopulmonary resuscitation (CPR) can increase the number of qualified people in the community, which in turn can improve survival rates of out-of-hospital cardiac arrests (OHCA). Medical students could be a valuable resource for providing the training. This systematic review aims to determine the outcomes of medical students providing CPR training to schoolchildren, aged 13-18 (who are thought to have the strength for effective chest compression), specifically CPR skills for both and non-technical skills such as communication and leadership for medical students.
A literature search of academic databases was conducted on 5 July 2023 using the following keywords: cardiopulmonary resuscitation, basic life support, medical students and high/middle/secondary school students. For the purpose of this review, "schoolchildren" refer to those aged 13-18. Studies were included where the primary focus was medical students teaching CPR to schoolchildren. The studies were critically appraised using the Medical Education Research Study Quality Instrument (MERSQI) tool and outcomes categorised by Kirkpatrick's Levels.
Eleven studies were included, six randomised controlled trials and five cohort studies, with 1670 schoolchildren and 355 medical students as participants. Eight studies examined outcomes targeting schoolchildren, two examined outcomes for medical students and one examined both. Four of the eleven studies used validated outcome measures. Only outcomes at Kirkpatrick Level 1 and 2 were found, and all outcomes for both schoolchildren and medical students were positive. Schoolchildren showed improvements in theoretical and practical elements of CPR post-training, while medical students demonstrated improved professional practice skills such as leadership and mentorship as well as improvements in their own CPR skills post-teaching.
Schoolchildren can effectively acquire CPR skills through being trained by medical students, who themselves also benefit from improved CPR and professional practice skills after teaching. Further studies with robust methodology such as multi-site randomised controlled trials, the use of consistent and validated outcome measures, and the measurement of outcomes at higher Kirkpatrick levels to determine the impact on bystander CPR rates and community OHCA survival rates, are needed.
对学童进行心肺复苏术（CPR）培训可以增加社区中合格人员的数量，进而提高院外心脏骤停（OHCA）的存活率。医学生可能是提供此类培训的宝贵资源。本系统评价旨在确定医学生为13至18岁学童（被认为具备进行有效胸外按压的力量）提供CPR培训的效果，具体包括学童和医学生的CPR技能以及沟通和领导力等非技术技能。
于2023年7月5日使用以下关键词对学术数据库进行文献检索：心肺复苏术、基础生命支持、医学生和高/初/中学生。在本评价中，“学童”指13至18岁的学生。纳入的研究主要是医学生向学童教授CPR。使用医学教育研究质量工具（MERSQI）对研究进行严格评价，并根据柯克帕特里克层次对结果进行分类。
纳入了11项研究，其中6项随机对照试验和5项队列研究，共有1670名学童和355名医学生参与。8项研究考察了针对学童的结果，2项研究考察了医学生的结果，1项研究同时考察了两者。11项研究中有4项使用了经过验证的结果测量方法。仅发现了柯克帕特里克第1级和第2级的结果，学童和医学生的所有结果均为阳性。学童在培训后CPR的理论和实践方面均有进步，而医学生在教学后展示出领导和指导等专业实践技能的提升以及自身CPR技能的提高。
学童通过医学生的培训能够有效地掌握CPR技能，而医学生自身在教学后也能从CPR技能和专业实践技能的提升中受益。需要开展进一步的研究，采用多中心随机对照试验等高质性方法，使用一致且经过验证的结果测量方法，并在更高的柯克帕特里克层次上测量结果，以确定对旁观者CPR率和社区OHCA存活率的影响。
