Braslow A, Brennan R T, Newman M M, Bircher N G, Batcheller A M, Kaye W
Braslow and Associates, Alexandria, VA 22304, USA.
Resuscitation. 1997 Jun;34(3):207-20. doi: 10.1016/s0300-9572(97)01096-4.
Traditional classroom-based instruction of cardiopulmonary resuscitation (CPR) has failed to achieve desired rates of bystander CPR. Video self-instruction (VSI) is a more accessible alternative to traditional classroom instruction (TRAD), and it achieves better CPR skill performance. VSI employs a 34-min training tape and an inexpensive manikin. VSI combines simplified and reordered content focusing on the delivery of one-rescuer CPR with the 'practice-as-you-watch' approach of an exercise video. Performance of CPR skills immediately following VSI was compared to performance immediately following TRAD using an instrumented manikin, a valid and reliable skill checklist, and an overall competency rating. Compared with TRAD subjects, VSI subjects performed more compressions correctly (P < 0.001), more ventilations correctly (P < 0.001), and more assessment and sequence skills correctly (P < 0.001). TRAD subjects delivered twice as many compressions that were too shallow, and underinflated the lungs twice as often. VSI subjects were rated 'competent' or better 80.0% of the time, compared with TRAD subjects, who achieved this rating only 45.1% of the time (P < 0.001). TRAD subjects were rated to be 'not competent' in performing CPR nearly 10 times more often than VSI subjects (P < 0.001). Subjects 40 years of age and older performed better after VSI than after TRAD. Superior skill performance among subjects exposed to VSI persisted 60 days following training. VSI has the potential to reach individuals unlikely to participate in TRAD classes because of its greater convenience, lower cost, and training in about 0.50 h compared with 3-4 h for TRAD classes.
传统的基于课堂的心肺复苏术（CPR）教学未能达到理想的旁观者心肺复苏实施率。视频自学（VSI）是一种比传统课堂教学（TRAD）更容易获得的替代方式，并且能取得更好的心肺复苏技能表现。VSI使用一盘34分钟的训练录像带和一个价格低廉的人体模型。VSI将简化并重新编排的内容（聚焦于单人实施心肺复苏）与健身视频的“边看边练”方法相结合。使用配备仪器的人体模型、一份有效且可靠的技能清单以及一项整体能力评级，对VSI后立即进行的心肺复苏技能表现与TRAD后立即进行的技能表现进行了比较。与TRAD组受试者相比，VSI组受试者正确进行的按压更多（P<0.001），正确进行的通气更多（P<0.001），正确进行的评估和操作顺序技能更多（P<0.001）。TRAD组受试者进行的过浅按压次数是前者的两倍，肺部通气不足的频率也是前者的两倍。VSI组受试者有80.0%的时间被评为“合格”或更好，相比之下，TRAD组受试者只有45.1%的时间达到这一评级（P<0.001）。TRAD组受试者被评为心肺复苏操作“不合格”的频率几乎是VSI组受试者的10倍（P<0.001）。40岁及以上的受试者在接受VSI培训后的表现优于接受TRAD培训后的表现。接受VSI培训的受试者在培训60天后仍保持较高的技能表现。由于VSI更加便捷、成本更低，且培训时间约为0.50小时，而TRAD课程为3 - 4小时，因此它有可能让那些不太可能参加TRAD课程的人也接受培训。
