Development Of Personal Computers-based CPR-D Skills Training System For Healthcare Providers

ObjectiveCardiopulmonary Resuscitation(CPR) and defibrillation, namely CPR-D skills, are the most important elements of early resuscitation for Sudden Cardiac Arrest(SCA), which are also indispensable skills for healthcare providers. CPR-D training and retraining means a lot for them. However, there is a lack of widely-accepted CPR-D teaching materials in China so far, and the existing training courses are not enough for spreading of CPR-D skills. This study aims to build teaching resource database of CPR-D skills, to develop personal computers(PC)-based training system, and then to improve the CPR-D skills training system and make a future development plan meeting users’ demands.Methods(1) Stage 1. Study on current status of CPR-D skills training among healthcare providers. A self-designed questionnaire was sent to sampled healthcare providers to investigate their training situation of CPR-D skills, and we evaluated their competence in conducting CPR, manual external defibrillation and automated external defibrillation, the ability to read electrocardiograms(ECG) using test paper. Then the shortcomingswere analyzed, which can provide the basis for the design of CPR-D skills training system.(2) Stage 2. Development of CPR-D skills training system. A brainstorming meeting was held to finalize the content and module of the CPR-D skills training system based on the findings of the first stage, literature search and Dale’s Cone of Experience. CPR-D skills training resource database was established and the training system was developed.(3) Stage 3. Improvement of CPR-D skills training system by using the Kano model. Literature search and Norminal Group Technique were conducted to classify quality requirements of the CPR-D skills training system for the healthcare providers and to develop the Kano questionnaire. The modified Kano categorization was determined based on primary Kano categorization. The CPR-D skills training system Version 1.0 was improved to Version 2.0 and the future development plan was made according to the results above.(4) Stage 4. Application of CPR-D skills training system. While the CPR-D skills training system was used to healthcare providers for CPR-D skills training, self-designed feedback questionnaire was sent to study the trainees’ evaluation on this system.Results(1) Stage 1. Study on current status of CPR-D skills training among healthcare providers. Their competence in implementing CPR-D skills was poor. Their training rates of most CPR-D skills were less than 50%, which was mainly caused by the lack of training resources. Most participants were williing to take the training course based on digital devices. The main problems of CPR implementation were the performance of chest compression and ventilation. It showed that high-quality CPR was mostly failed to be done, while the most common mistakes to defibrillate were about the placement of electrodes, the defibrillation power, the safety and the operation immediately after defibrillation. The average recognition accuracy of ECG was below 50%, of which, the recognition accuracy of shockable rhythms was even lower.(2) Stage 2. Development of CPR-D skills training system. Four modules(Microlecture, Self-test, Simulation Game and Risk Evaluation of Cardiovascular Disease) and ten skills of CPR-D(Adult/Infant CPR, Manual/Automated External Defibrillation, Adult/Infant Foreign Body Airway Obstruction, Bag-Mask Ventilation, Oropharytngeal/Nasopharyngeal Ventilation, ECG Recognition) were determined. The Dale’s Cone of Experience theory was used to build teachinig resources, and then the CPR-D skills training system was developed. The Microlecture contained ten videos of CPR-D skills, each of them less than 15 minutes. The Self-test can generate a new test paper randomly as well as mark and analyze test paper automatically after its submission. The Simulation Game provided trainees the chance to practice the procedure and learn main knowledge by rescuing a SCA patient. The Risk Evaluation of Cardiovascular Disease was developed according to the expert consensus, which can analyze the individual risk of suffering from cardiovascular disease.(3) Stage 3. Improvement of CPR-D skills training system based on Kano model. A total of 28 quality requirements of CPR-D system were classified, among which 4 were attractive requirements, 15 were one-dimentional requirements, 7 were indifferent requirements, 1 was reverse requirement, and 1 was indeterminate requirement. The distribution changed by using modified Kano categorization: 4 were attractive requirements, 19 were one-dimentional requirements, 4 were indifferent requirements, 1 was reverse requirement. Comprehensively considering the results, 6 qualityrequirements were improved for CPR-D training system Version 2.0, and the future improvement plan was also made.(4) Stage 4. Application of CPR-D skills training system. Most participants prefered to the training with CPR-D skills training system than traditional training. The total evaluation of the training system was good, but the evaluation on self-perceived competence was relatively low.ConclusionThe CPR-D skills training system can be used for both healthcare providers and medical students. Trainees can choose the modules and adjust the sequence of learning flexibly according to their learning demands. Abundant teaching materials and novel teaching methods are available from this system, indicating that it is practical and valuable for the advancement of the system continuously.