Mancini M E, Kaye W
Am J Emerg Med. 1985 Jan;3(1):31-2. doi: 10.1016/0735-6757(85)90008-7.
Currently, the American Heart Association (AHA) recommends that physicians be certified in cardiopulmonary resuscitation (CPR) every two years. This study was undertaken to determine the effects of time since training on retention of CPR skills of physicians and to identify at what point performance deteriorates to a level requiring retraining with supervised practice. The physicians' performance of CPR one year or less after training was compared with that of more than one year after training. Thirty-three medical residents who had been taught CPR by the same instructor were tested without warning for one-person CPR on a recording mannikin. Performance was evaluated according to AHA Heartsaver criteria. The data were analyzed by organizing all CPR steps or behavioral objectives into three categories: assessment, skills (which included ventilation and compression), and sequence (which included calls for assistance). The data suggest that the knowledge of CPR sequence remains stable and that assessment improves while skill performance deteriorates after one year. This apparent contradiction in overall CPR performance may relate to the effect of experience. Assessment may improve because of involvement in actual resuscitations in the hospital. Deterioration of skills may reflect the fact that senior residents do not actually perform CPR, but become team leaders and thereby lose their skills, or that poor performance is not corrected in actual "code" situations. If a two-year certification standard is maintained, CPR skill testing at least every 12 months should be considered. If skills have deteriorated, hands-on-practice should be undertaken at that time.
目前，美国心脏协会（AHA）建议医生每两年进行一次心肺复苏（CPR）认证。本研究旨在确定自培训以来的时间对医生心肺复苏技能保持情况的影响，并确定在何时其操作水平会下降到需要在监督下重新训练的程度。将培训后一年及以内的医生的心肺复苏操作表现与培训后一年以上的医生进行比较。对由同一位教员教授心肺复苏的33名住院医师在无预警情况下使用模拟人进行单人心肺复苏测试。根据美国心脏协会的急救员标准对操作进行评估。通过将所有心肺复苏步骤或行为目标分为三类来分析数据：评估、技能（包括通气和按压）和顺序（包括呼救）。数据表明，心肺复苏顺序的知识保持稳定，一年后评估能力提高而技能操作下降。心肺复苏总体表现中这种明显的矛盾可能与经验的影响有关。评估能力提高可能是因为参与了医院的实际复苏操作。技能下降可能反映出这样一个事实，即高年级住院医师实际上并不进行心肺复苏，而是成为团队领导者，从而失去了他们的技能，或者在实际的“急救”情况下，不佳的操作没有得到纠正。如果维持两年的认证标准，则应考虑至少每12个月进行一次心肺复苏技能测试。如果技能已经下降，届时应进行实际操作练习。
