Improving pediatric basic life support performance through blended learning with web-based virtual patients: Randomized controlled trial

Journal of Medical Internet Research

Volumn 17, Issue 7, 2015, Pages

  Lehmann, Ronny ^a   Thiessen, Christiane ^a   Frick, Barbara ^a   Bosse, Hans Martin ^b   Nikendei, Christoph ^a   Hoffmann, Georg Friedrich ^a   Tönshoff, Burkhard ^a   Huwendiek, Sören ^c  

^a UNIVERSITY HOSPITAL HEIDELBERG   (Germany)

^b UNIVERSITY HOSPITAL DÜSSELDORF   (Germany)

^c UNIVERSITY OF BERN   (Switzerland)

Author keywords

Blended learning; Pediatric basic life support; Performance; Simulation; Virtual patients

Indexed keywords

ADULT; CLINICAL COMPETENCE; CONTROLLED STUDY; EDUCATION; FEMALE; HUMAN; INTERNET; MALE; MEDICAL STUDENT; PEDIATRICS; PROCEDURES; RANDOMIZED CONTROLLED TRIAL; RESUSCITATION; TEACHING; YOUNG ADULT;

ADULT; CARDIOPULMONARY RESUSCITATION; CLINICAL COMPETENCE; COMPUTER-ASSISTED INSTRUCTION; FEMALE; HUMANS; INTERNET; MALE; PATIENT SIMULATION; PEDIATRICS; STUDENTS, MEDICAL; YOUNG ADULT;

EID: 84938559505     PISSN: None     EISSN: 14388871     Source Type: Journal    
DOI: 10.2196/jmir.4141     Document Type: Article

References (39)

1. Bullock I. Skill acquisition in resuscitation. Resuscitation 2000 Jul;45(2):139-143. [Medline: 10950322]
2. Adler MD, Vozenilek JA, Trainor JL, Eppich WJ, Wang EE, Beaumont JL, et al. Development and evaluation of a simulation-based pediatric emergency medicine curriculum. Acad Med 2009 Jul;84(7):935-941. [doi: 10.1097/ACM.0b013e3181a813ca] [Medline: 19550192]
3. Cheng A, Goldman RD, Aish MA, Kissoon N. A simulation-based acute care curriculum for pediatric emergency medicine fellowship training programs. Pediatr Emerg Care 2010 Jul;26(7):475-480. [doi: 10.1097/PEC.0b013e3181e5841b] [Medline: 20577139]
4. Cheng A, Hunt EA, Donoghue A, Nelson K, Leflore J, Anderson J, EXPRESS Pediatric Simulation Research Investigators. EXPRESS - Examining Pediatric Resuscitation Education Using Simulation and Scripting. The birth of an international pediatric simulation research collaborative - from concept to reality. Simul Healthc 2011 Feb;6(1):34-41. [doi: 10.1097/SIH.0b013e3181f6a887] [Medline: 21330848]
5. Lynagh M, Burton R, Sanson-Fisher R. A systematic review of medical skills laboratory training: where to from here? Med Educ 2007 Sep;41(9):879-887. [doi: 10.1111/j.1365-2923.2007.02821.x] [Medline: 17696985]
6. Carrero E, Gomar C, Penzo W, Fábregas N, Valero R, Sánchez-Etayo G. Teaching basic life support algorithms by either multimedia presentations or case based discussion equally improves the level of cognitive skills of undergraduate medical students. Med Teach 2009 May;31(5):e189-e195. [doi: 10.1080/01421590802512896] [Medline: 19241215]
7. Braslow A, Brennan RT, Newman MM, Bircher NG, Batcheller AM, Kaye W. CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation. Resuscitation 1997 Jun;34(3):207-220. [Medline: 9178381]
8. Sopka S, Biermann H, Rossaint R, Knott S, Skorning M, Brokmann JC, et al. Evaluation of a newly developed media-supported 4-step approach for basic life support training. Scand J Trauma Resusc Emerg Med 2012;20:37 [FREE Full text] [doi: 10.1186/1757-7241-20-37] [Medline: 22647148]
9. Todd KH, Braslow A, Brennan RT, Lowery DW, Cox RJ, Lipscomb LE, et al. Randomized, controlled trial of video self-instruction versus traditional CPR training. Ann Emerg Med 1998 Mar;31(3):364-369. [Medline: 9506495]
10. Cook DA, Triola MM. Virtual patients: a critical literature review and proposed next steps. Med Educ 2009 Apr;43(4):303-311. [doi: 10.1111/j.1365-2923.2008.03286.x] [Medline: 19335571]
11. Huwendiek S, Reichert F, Bosse H, de Leng BA, van der Vleuten CP, Haag M, et al. Design principles for virtual patients: a focus group study among students. Med Educ 2009 Jun;43(6):580-588. [doi: 10.1111/j.1365-2923.2009.03369.x] [Medline: 19493183]
12. Iserbyt P, Charlier N, Mols L. Learning basic life support (BLS) with tablet PCs in reciprocal learning at school: are videos superior to pictures? A randomized controlled trial. Resuscitation 2014 Jun;85(6):809-813. [doi: 10.1016/j.resuscitation.2014.01.018] [Medline: 24503451]
13. Burnette K, Ramundo M, Stevenson M, Beeson MS. Evaluation of a web-based asynchronous pediatric emergency medicine learning tool for residents and medical students. Acad Emerg Med 2009 Dec;16 Suppl 2:S46-S50. [doi: 10.1111/j.1553-2712.2009.00598.x] [Medline: 20053211]
14. Roe D, Carley S, Sherratt C. Potential and limitations of e-learning in emergency medicine. Emerg Med J 2010 Feb;27(2):100-104. [doi: 10.1136/emj.2008.064915] [Medline: 20156859]
15. Shah IM, Walters MR, McKillop JH. Acute medicine teaching in an undergraduate medical curriculum: a blended learning approach. Emerg Med J 2008 Jun;25(6):354-357. [doi: 10.1136/emj.2007.053082] [Medline: 18499818]
16. Spedding R, Jenner R, Potier K, Mackway-Jones K, Carley S. Blended learning in paediatric emergency medicine: preliminary analysis of a virtual learning environment. Eur J Emerg Med 2013 Apr;20(2):98-102. [doi: 10.1097/MEJ.0b013e3283514cdf] [Medline: 22415016]
17. Lehmann R, Bosse HM, Simon A, Nikendei C, Huwendiek S. An innovative blended learning approach using virtual patients as preparation for skills laboratory training: perceptions of students and tutors. BMC Med Educ 2013;13:23 [FREE Full text] [doi: 10.1186/1472-6920-13-23] [Medline: 23402663]
18. de Vries W, Handley AJ. A web-based micro-simulation program for self-learning BLS skills and the use of an AED. Can laypeople train themselves without a manikin? Resuscitation 2007 Dec;75(3):491-498. [doi: 10.1016/j.resuscitation.2007.05.014] [Medline: 17629390]
19. Kononowicz AA, Krawczyk P, Cebula G, Dembkowska M, Drab E, Frączek B, et al. Effects of introducing a voluntary virtual patient module to a basic life support with an automated external defibrillator course: a randomised trial. BMC Med Educ 2012;12:41 [FREE Full text] [doi: 10.1186/1472-6920-12-41] [Medline: 22709278]
20. Ventre KM, Collingridge DS, DeCarlo D. End-user evaluations of a personal computer-based pediatric advanced life support simulator. Simul Healthc 2011 Jun;6(3):134-142. [doi: 10.1097/SIH.0b013e318207241e] [Medline: 21646982]
21. Biarent D, Bingham R, Eich C, López-Herce J, Maconochie I, Rodríguez-Núñez A, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 6. Paediatric life support. Resuscitation 2010 Oct;81(10):1364-1388. [doi: 10.1016/j.resuscitation.2010.08.012] [Medline: 20956047]
22. Kopp V, Möltner A, Fischer M. Key feature problems for the assessment of procedural knowledge: a practical guide. GMS Z Med Ausbild 2006;23(3):Doc50 [FREE Full text] [WebCite Cache]
23. Page G, Bordage G, Allen T. Developing key-feature problems and examinations to assess clinical decision-making skills. Acad Med 1995 Mar;70(3):194-201. [Medline: 7873006]
24. Adler MD, Vozenilek JA, Trainor JL, Eppich WJ, Wang EE, Beaumont JL, et al. Comparison of checklist and anchored global rating instruments for performance rating of simulated pediatric emergencies. Simul Healthc 2011 Feb;6(1):18-24. [doi: 10.1097/SIH.0b013e318201aa90] [Medline: 21330846]
25. Donoghue A, Nishisaki A, Sutton R, Hales R, Boulet J. Reliability and validity of a scoring instrument for clinical performance during Pediatric Advanced Life Support simulation scenarios. Resuscitation 2010 Mar;81(3):331-336. [doi: 10.1016/j.resuscitation.2009.11.011] [Medline: 20047787]
26. Donoghue A, Ventre K, Boulet J, Brett-Fleegler M, Nishisaki A, Overly F, EXPRESS Pediatric Simulation Research Investigators. Design, implementation, and psychometric analysis of a scoring instrument for simulated pediatric resuscitation: a report from the EXPRESS pediatric investigators. Simul Healthc 2011 Apr;6(2):71-77. [doi: 10.1097/SIH.0b013e31820c44da] [Medline: 21358564]
27. Lockyer J, Singhal N, Fidler H, Weiner G, Aziz K, Curran V. The development and testing of a performance checklist to assess neonatal resuscitation megacode skill. Pediatrics 2006 Dec;118(6):e1739-e1744. [doi: 10.1542/peds.2006-0537] [Medline: 17074839]
28. Krautter M, Weyrich P, Schultz J, Buss SJ, Maatouk I, Jünger J, et al. Effects of Peyton's four-step approach on objective performance measures in technical skills training: a controlled trial. Teach Learn Med 2011;23(3):244-250. [doi: 10.1080/10401334.2011.586917] [Medline: 21745059]
29. Centre for Virtual Patients. CAMPUS-Software URL: http://www.medizinische-fakultaet-hd.uni-heidelberg.de/CAMPUS-Software.109992.0.html?&FS=0&L=en [accessed 2015-06-25] [WebCite Cache ID 6ZYS3m5w6]
30. Cummins RO. Advanced Cardiovascular Life Support, Instructor's Manual (American Heart Association). Dallas, TX: American Heart Association; 2001.
31. th edition. London, UK: Resuscitation Council; 2001.
32. Peyton JWR, editor. Teaching & Learning in Medical Practice. Rickmansworth, UK: Manticore Publishers; 1998.
33. Issenberg SB, McGaghie WC, Petrusa ER, Lee GD, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005 Jan;27(1):10-28. [doi: 10.1080/01421590500046924] [Medline: 16147767]
34. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979 Mar;86(2):420-428. [Medline: 18839484]
35. Fleiss JL. The Design and Analysis of Clinical Experiments. New York, NY: Wiley-Interscience; 1986.
36. Beckers SK, Biermann H, Sopka S, Skorning M, Brokmann JC, Heussen N, et al. Influence of pre-course assessment using an emotionally activating stimulus with feedback: a pilot study in teaching Basic Life Support. Resuscitation 2012 Feb;83(2):219-226. [doi: 10.1016/j.resuscitation.2011.08.024] [Medline: 21924220]
37. Sweller J, van Merrienboer JJG, Paas FGWC. Cognitive architecture and instructional design. Educ Psychol Rev 1998 Sep;10(3):251-296 Print ISSN 1040-726X. [doi: 10.1023/A:1022193728205]
38. van Merriënboer JJ, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Med Educ 2010 Jan;44(1):85-93. [doi: 10.1111/j.1365-2923.2009.03498.x] [Medline: 20078759]
39. Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA 2006 Sep 6;296(9):1094-1102. [doi: 10.1001/jama.296.9.1094] [Medline: 16954489]