Evaluation of different approaches to teaching basic resuscitation

Basic resuscitation skills have been taught using a variety of methods. In general, acquisition of these skills is not good. Furthermore, retention of skills is also poor (over all intervals of time tested). The aim of the current study was to assess the effectiveness of feedback and two methods of teaching upon skill acquisition and retention. A group of third year clinical medical students (n=84) were taught basic resuscitation by two different approaches to teaching: 1) traditional didactic approach or 2) self-paced approach. Half of each group received assessment with feedback, the other half did not receive feedback on their performance. Students were assessed prior to and immediately after the course to determine acquisition of skill. Performance was assessed by recording strips from the manikin and rated by trained assessors using a checklist. The basic resuscitation skills of mutually exclusive randomly selected groups of students were measured for retention of skill at 2 weeks (n=29), 15 weeks (n=24), 26 weeks (n=20) and the whole group at 1 year (n=67). Self assessment of confidence, knowledge, attitudes to further training and outcome expectancy from cardiac arrests were measured using questionnaires. There was an overall increase in basic resuscitation skills for students who received assessments with feedback from pre training to immediately after training. This tended to be greatest for the self taught group when feedback of performance was given, although this was not statistically significant. The resuscitation skills for all the groups deteriorated over a six month period. However, basic resuscitation skills were still greater at one year compared with pretraining levels. There were no significant differences at one year in skills between the groups taught by the different methods. During the year of the study confidence to perform basic life support increased as did basic resuscitation skills. Confidence was related to the number of arrests attended: the more arrests attended, the more confident the students felt they were at performing basic resuscitation. Prior to the initial assessment, students' judgments of their basic resuscitation skills were accurate. One year later, prior to assessment of skills, there was no relationship between confidence at performing resuscitation and actual skill. However immediately after the assessment, the students' judgments were more accurate. In conclusion, teaching method did not influence the initial acquisition of skill, and had little effect on retention of skill over a six month or one year period. Skills deteriorated for all groups over a six month period but not to the pretraining level. The results of this study suggest the importance of focusing upon initial acquisition of skills as a pre requisite to better retention