Retention of Cardiopulmonary Resuscitation Skills in Medical Students Utilizing a High-Fidelity Patient Simulator.
Travis Behrend*, John Heineman, Lei Wu, Chad Burk, Ngoc-Truc Duong, Mark Munoz, Dawn Pruett, Michael Seropian, Dawn Dillman.
Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA
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*Corresponding author: Travis Behrend; behrendt[at]ohsu.edu
Key Words: CPR; simulation; medical education; medical students; skills retention.
Objective: To evaluate the difference in retention of cardiopulmonary resuscitation (CPR) skills between first and second year medical students in accordance with American Heart Association (AHA) recommended basic life support (BLS) guidelines from 2005. Introduction: Cardiopulmonary resuscitation has a narrow window of opportunity. It must be started early and followed by defibrillation in a timely manner for maximal benefit. Many studies have demonstrated that health care providers trained in CPR lose their skills quickly. However, little research has been done to evaluate the retention of CPR skills in pre-clinical medical students prior to beginning their clinical training.
Methods: 22 first-year and 19 second-year medical students were voluntarily enrolled in the prospective cohort study. Participants were queried regarding BLS training, familiarity with the computerized mannequin simulator (SimMan), and CPR experience. Each participant was then introduced to SimMan and a standardized cardiac arrest scenario was read to them. Data was collected manually behind a two-way mirror. Participants were scored on their compliance with BLS criteria.
Results: Overall, key steps in CPR were omitted by many participants. One out of five subjects began CPR without first checking for a response, two out of three subjects did not request a defibrillator, and an average of 35.9 (0.0, 100.7) seconds elapsed before CPR was initiated. The average compression rate per minute in first-year medical students (MS1s) (22 subjects) was 63.6 (37.2, 90.1) compared to 52.5 (13.4, 91.6) in second-year students (MS2s) (19 subjects) with a BLS recommendation of 100 (p-0.04). There were 84.2% of MS1s and 68.2% of MS2s that completed an average compressions to two breaths ratio of (greater than or equal to) 27 with BLS recommendation of 30 compressions for every 2 breaths (p=0.04).
Conclusion: Despite their training and proximity to a health care environment, medical students quickly forget important CPR rates and maneuvers. This deterioration of skills occurs regardless of training latency, a potential problem as they enter the patient care environment. Simulation provides a more real-life scenario in which to both train and evaluate medical students CPR skills.
Published: June 25, 2011
Senior Editor: Andrew Wyman
Junior Editor: Marissa Baca
Behrend T, Heineman J, Wu L, Burk C, Duong N, Munoz M, Pruett M, Seropian M, Dillman D. Retention of Cardiopulmonary Resuscitation Skills in Medical Students Utilizing a High-Fidelity Patient Simulator. Medical Student Research Journal. 2011;1(Spring):1-4.
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