Four-step CPR--improving skill retention.

This study is an attempt to see if simplifying the teaching of basic life support leads to better skill acquisition and retention. Forty-eight lay volunteers received instruction in CPR; 24 were taught the standard 8-step sequence whereas 24 were taught a simplified 4-step sequence. Tests of performance were carried out on a manikin before and after training. Those in the 4-step group were significantly better than those in the 8-step group at remembering the sequence of skills immediately after training (P = 0.04), 1 week later (P < 0.001) and at 6 weeks (P < 0.001). Twenty-three out of the 24 volunteers in the 4-step group got the sequence completely correct each time they were tested, in contrast to only 2 out of the 24 in the 8-step group. There was no difference, however, in the quality of performance of the skills between the two groups. In addition, it was shown that use of the 4-step sequence should result in a useful reduction in the time taken before a rescuer calls for the emergency services and commences CPR. Whether such a radical change in teaching should be introduced is a matter for further discussion and research.