Abstract:

Introduction:
In the implementation of cardio pulmonary resuscitation (CPR) in the Flemish school curriculum and within the given limitations in time and training equipment, there is a need for alternative training strategies. Literature suggests laypeople can train themselves in basic life support (BLS) and AED-skills using a web-based micro-simulation programme. Alternative equipment can be effective to train compression-only CPR-skills in schools [1]. Knowledge and skills positively affects the attitude for providing help for witnesses of sudden collapse. This study measures learning outcomes of basic lifesaving actions, taught by an online simulation scenario.

Methods:
Flemish secondary school pupils (N=41, 15-17 years, 29 male, 12 female) without previous CPR training were randomly selected in three different schools for a self-training intervention on basic life support and use of AED.
In a 50 minutes training-session, the use of the simulation platform was explained. Participants were asked to train themselves during six weeks. Participants were free to choose what to train and how frequent they would train on the platform. The training tool consists of theoretical information (10%), training cognitive skills (30%) and training practical skills by an interactive video-simulation (60%). A training certificate was linked to an overall score of 90% on the training tool. They were also informed about a five minutes test that would assess their skills at the end of these six weeks. Variables about basic lifesaving actions were defined: calling 112, ability to check consciousness, ability to check ventilation and correct position of the AED-electrodes. Data about training activity and training frequency of each participant were collected on the web application. Testing was recorded on video. An expert evaluated qualitative aspects of BLS, based on the assessment form of the European Resuscitation Council courses. Data on motor skills were collected with Skillreporting software® (Laerdal, Norway). Data were analysed by the calculation of frequencies and by cross tabulation with IBM® SPSS® Statistics version 21.

Results:
Out of 41 participants, 36 (88%) registered on the learning tool and 17 (47%) succeeded for the certificate. No significant differences were found between the certified group and the non-certified group for calling 112, efficiency of control of consciousness, efficiency of control of breathing, use of AED, correct hand position for compression and correct compressions. Alerting 112 and consciousness control was performed correctly by respectively 93% and 66% of the participants. None of the participants could perform control of breathing and ventilation efficiently, mainly because the head of the victim was not tilt backwards.

Conclusion:
Self-training in first aid is feasible for alerting professional help, learning how to use an AED and the basics of compression skills. The way to perform head tilt for correct breathing control should be more stressed in the learning platform. Optimisation of ventilation and compression skills cannot be taught without hands-on time. The online learning tool can be useful to prepare pupils before hands-on training in CPR techniques and can help in the implementation of CPR in the school curriculum.

Keywords:

Self-training, cardiopulmonary resuscitation, AED, e-learning.