RCT comparing the clinical effectiveness of conventional instructor-facilitated cardiac compression training to technology enhanced training using high-fidelity mannequins-A pilot study

Abstract

Introduction: Healthcare professionals often provide substandard chest compression following cardiac arrest. This is deemed a preventable harm because this skill can be acquired. The recent development of technology-enhanced cardiac compression training devices provides an alternative to traditional instructor-facilitated training. This pilot study compared the effectiveness of conventional and technology-enhanced training modalities.

Methods: A pilot randomised controlled trial design was used in a regional hospital in Queensland. Following baseline assessment, healthcare staff were randomised to one of three groups: traditional instructor-facilitated training; high-fidelity mannequin training and continuous access to the training system to practise skills; and, high-fidelity mannequin training with no further access to the training system to practise skills. The primary outcome, cardiac compression skill levels, was analysed using analysis of co-variance, adjusting for predictive co-variates. Secondary measures were analysed using inferential statistics or presented descriptively.

Results: Between January and February 2017, 502 healthcare staff were recruited. At baseline, 21\% were competent in cardiac compression, increasing to 38% on reassessment. The mode of training did not affect skill level (F(92,392) = 0.061, p = .94), however, participants in the high-fidelity mannequin training group who practised their skills had statistically significantly higher reassessment scores (z = -2.34, p = .019). Baseline score and the number of times participants practised their skills were significant predictors of reassessment scores (F(2,392) = 7.73, p = .001).

Conclusions: Most hospital staff who may need to perform cardiac compression were not competent in this skill. Neither training modality was more effective. Both training and practise increased cardiac compression skill levels, indicating that frequent, low-dose training is required.