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Early or late booster for basic life support skill for laypeople: a simulation-based randomized controlled trial

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Abstract

Purpose

Retention of skills and knowledge has been shown to be poor after resuscitation training. The effect of a “booster” is controversial and may depend on its timing. We compared the effectiveness of an early versus late booster session after Basic Life Support (BLS) training for skill retention at 4 months.

Methods

We performed a single-blind randomized controlled trial in a simulation environment. Eligible participants were adult laypeople with no BLS training or practice in the 6 months prior to the study. We provided participants with formal BLS training followed by an immediate BLS skills post-test. We then randomized participants to one of three groups: control, early booster, or late booster. Based on their group allocation, participants attended a brief BLS refresher at either 3 weeks after training (early booster), at 2 months after training (late booster), or not at all (control). All participants underwent a BLS skills retention test at 4 months. We measured BLS skill performance according to the Heart and Stroke Foundation’s skills testing checklist for adult CPR and the use of an automated external defibrillator.

Results

A total of 80 laypeople were included in the analysis (control group, n = 28; early booster group, n = 23; late booster group, n = 29). The late booster group achieved better skill retention (mean difference in checklist score at retention compared to the immediate post-test = – 0.8 points out of 15, [95% CI – 1.7, 0.2], P = 0.10) compared to the early booster (– 1.3, [– 2.6, 0.0], P = 0.046) and control group (– 3.2, [– 4.7, – 1.8], P < 0.001).

Conclusion

A late booster session improves BLS skill retention at 4 months in laypeople.

Trial registration number: NCT02998723.

Résumé

Objectif

Il a été démontré que la rétention des compétences et des connaissances est faible après une formation en réanimation. L'effet d'un "booster" est controversé et peut dépendre de son moment. Nous avons comparé l'efficacité d'une session de rappel précoce ou tardive après la formation Basic Life Support (BLS) pour le maintien des compétences après quatre mois.

Méthodes

Nous avons réalisé un essai contrôlé randomisé en simple aveugle dans un environnement de simulation. Les participants éligibles étaient des laïcs adultes n'ayant pas suivi de formation ou pratiqué le BLS dans les 6 mois précédant l'étude. Nous avons fourni aux participants une formation BLS formelle suivie d'un post-test immédiat sur les compétences BLS. Nous avons ensuite randomisé les participants dans l'un des trois groupes suivants: groupe témoin, rappel précoce ou rappel tardif. En fonction de leur répartition dans le groupe, les participants ont assisté à un bref rappel de BLS soit 3 semaines après la formation (rappel précoce), soit 2 mois après la formation (rappel tardif), soit pas du tout (groupe témoin). Tous les participants ont été soumis à un test de maintien des compétences BLS après quatre mois. Nous avons mesuré la performance des compétences BLS selon la liste de contrôle des compétences de la Fondation des maladies du cœur pour la RCP chez l'adulte et l'utilisation d'un défibrillateur externe automatisé.

Résultats

Au total, 80 profanes ont été inclus dans l'analyse (groupe témoin, n = 28; groupe de rappel précoce, n = 23; groupe de rappel tardif, n = 29). Le groupe de rappel tardif a obtenu un meilleur maintien des compétences (différence moyenne du score de la liste de contrôle au moment du maintien par rapport au post-test immédiat = -0,8 points sur 15, [IC 95% -1,7, 0,2], P = 0,10) par rapport au groupe de rappel précoce (-1,3, [-2,6, 0,0], P = 0,046) et au groupe témoin (-3,2, [-4,7, -1,8], P < 0,001).

Conclusion

Une session de rappel tardive améliore la rétention des compétences BLS à 4 mois chez les profanes.

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Acknowledgements

This research project was funded by the Royal College of Physicians and Surgeons of Canada through a Medical Education Research Grant. S.B. is also supported by The Ottawa Hospital Anesthesia Alternate Funds Association. The sponsors did not have any role in the design, methods, recruitment, data collection, analysis or preparation of the manuscript. The investigators thank Yannick Frechette for his help in an early stage of the project and Fatima Kazoun, Rosiane Simeon, and Ivy Salter for their help with data collection.

Funding

This work was supported by the Royal College of Physicians and Surgeons of Canada. Dr. Boet was supported by The Ottawa Hospital Anesthesia Alternate Funds Association and the Faculty of Medicine, University of Ottawa with a Tier 2 Clinical Research Chair. The funders did not have a role in study design, data analysis, interpretation of the results, writing the manuscript, or in submitting the article for publication.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M2, Canada

    Sylvain Boet, Chilombo Bould, Stéphane Moffett & Graeme McBride

  2. Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada

    Sylvain Boet, Richard Waldolf & M. Dylan Bould

  3. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Sylvain Boet, Sandy Lam, Joseph K. Burns, Tim Ramsay & M. Dylan Bould

  4. Institut du Savoir Montfort, Ottawa, ON, Canada

    Sylvain Boet & Richard Waldolf

  5. Faculty of Medicine, Francophone Affairs, University of Ottawa, Ottawa, ON, Canada

    Sylvain Boet

  6. Faculty of Education, University of Ottawa, Ottawa, ON, Canada

    Sylvain Boet

  7. Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada

    Richard Waldolf

  8. Department of Anesthesiology, The Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada

    M. Dylan Bould

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Ethical approval obtained from the Ottawa Health Science Network Research Ethics Board (Protocol #: 20150174-01H) and the University of Ottawa Office of Research Ethics and Integrity (H11-16–22).

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Boet, S., Waldolf, R., Bould, C. et al. Early or late booster for basic life support skill for laypeople: a simulation-based randomized controlled trial. Can J Emerg Med 24, 408–418 (2022). https://doi.org/10.1007/s43678-022-00291-3

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