Teaching basic life support algorithms by either multimedia presentations or case based discussion equally improves the level of cognitive skills of undergraduate medical students

Figures & data

Table

Practice points
Instructional methodology in BLS should be based on evidence. The best method to teach Universal BLS Algorithms is not defined. BLS teaching by either multimedia or case based discussion equally improved cognitive skills among medical students. An objective method to assess BLS instruction efficacy is described. Blind studies with sufficient samples in the field are difficult.

Figure 1. Flow chart showing the medical students’ progress in the study.

Figure 2. Outline of the methodology followed in the study. T1 assessment: test and video recording before teaching the basic life support (BLS) algorithms; T2 assessment: after teaching the BLS algorithms; CPR: cardiopulmonary resuscitation.

Table 1.  Personal characteristics and pre-study training experience in cardiopulmonary resuscitation (CPR) of the students. Data are shown as (a) number of students (% in each group) or as (b) median (25th–75th percentiles)

	Group I (n = 34)	Group II (n = 34)	p
Females/males^(a)	27/7 (79.4/20.6)	26/8 (76.5/23.5)	0.77
Age^(b)	20 (20–21)	20 (20–21)	0.65
Students who had received previous CPR training
• lectures plus hands-on^(a)	8 (23.5)	11 (32.4)	0.42
• hands-on^(a)	1 (2.9)	2 (5.9)	1
Students who had performed CPR on a patient or manikin^(a)	10 (29.4)	13 (38.2)	0.44
• Number of CPRs performed^(b)	0 (0–0.75)	0 (0–1)	0.43

Table 2.  Scores obtained at the assessments before (T1) and after (T2) teaching the BLS algorithms. Values are expressed as medians and 25th–75th percentiles. (#) p < 0.001 versus T1 within the group

Assessment	Group	T1	T2
Test	Group I	1.5 (1–2)	2 (2–3)^#
	Group II	1 (1–2)	2 (2–3)^#
	p (between groups)	0.71	0.75
Video recording	Group I	1 (0–1)	2 (2–3)^#
	Group II	1 (0–1)	2 (1.75–3)^#
	p (between groups)	0.72	0.43

Table 3.  Actual increase in the score and gain of score (Δ) at the assessments; T1: score obtained before teaching the BLS algorithms; T2: score obtained after teaching the BLS algorithms. Data are expressed as median and 25th–75th percentiles

Score	Group I (n = 34)	Group II (n = 34)	p
Test T2–Test T1	1 (0–1)	1 (0–1.25)	0.52
Δ (Test T2–Test T1)	50 (0–58.33)	50 (0–83.33)	0.31
Video T2–Video T1	1.5 (1–2)	1 (1–2)	0.25
Δ (Video T2–Video T1)	50 (25–66.66)	50 (0–83.33)	0.33

Table 4.  Number of students who achieved better scores (positive ranks), worse scores (negative ranks) or the same scores (tie ranks) at the assessments (Wilcoxon rank test). Values are expressed as number of cases (percentage within the group). (a) p = 0.012 within group

Score differences	Ranks	Group I (n = 34)	Group II (n = 34)	p
Test T2–Test T1	Positive	19 (55.9)^a	20 (58.8)	0.8
	Negative	2 (5.9)	4 (11.8)	0.39
	Tie	13 (38.2)	10 (29.4)	0.44
Video T2–Video T1	Positive	29 (85.3)^a	28 (82.3)	0.74
	Negative	2 (5.9)	0 (0.0)	0.15
	Tie	3 (8.8)	6 (17.6)	0.28

Table

BLS Step:	Video:
Safety	Victim and rescuer safe
Check responsiveness	Shake and shout: unresponsive
Shout for help	Help!!
Open airway	Head tilt and chin lift
Check breathing	Keeping the airway open, look, listen, and feel: not breathing
Call 112	Call 112
Chest compressions:	Heel of left hand located on victim's upper abdomen, fingers of both hands interlocked, rescuer's position vertical, arms straight, pressure down 4–5 cm, release pressure without losing contact between rescuer hands and victim.
	Chest compression rate 50 times per minute.
Compression to ventilation ratio	5 : 2
Stop to recheck the victim	After 5 compressions and 2 breaths