RCT comparing the clinical effectiveness of conventional instructor-facilitated cardiac compression training to automated training using high-fidelity mannequins

Procedures and materials used: The difference in staff competence in performing cardiac compressions will be measured between: 1. A control group who will undergo one off traditional cardiac compression training, using mannequins, incorporating either no feedback or low-fidelity visual feedback mechanisms (Group A); 2. An intervention group who will receive technology-enhanced training, using high-fidelity mannequins, via the Resuscitation Quality Improvement (RQI) training system, and will have continuous access to the training system to practise their skills (Group B) throughout the six months of the trial; and 3. An intervention group who will receive technology-enhanced training, via the RQI training system, but will have no further access to practise their skills (Group C). The RQI training system incorporates the latest in computer technology into a realistic-looking full body which provides objective, real time, audio-visual feedback to the trainee on compression rate, depth, release and hand position during assessment, to enable trainees to provide high quality continuous chest compressions of appropriate rate and depth. The RQI training system provides objective measurement of cardiac compression skills and records training compliance rates. The aim of the research is to determine whether technology-enhanced training, using a high-fidelity mannequins, is as effective as standard instructor facilitated training and assessment for cardiac compression skill acquisition and to determine whether regular practise maintains skill levels compared to no practise. The difference in staff competence in performing CPR over time will be measured between the control group and intervention groups. Intervention administration and mode of delivery: The traditional one-off cardiac compression training will be delivered by nurse educators, within the hospital skills development unit, to individuals and small groups of up to 5 staff, as per current practice and will take approximately 15 minutes. One-off training in the use of the technology-enhanced high-fidelity mannequins will be provided on a 1:1 basis, via the RQI training system, which provides standardised instructions for recommended use, and will take approximately 15 minutes. Once logged onto the system staff will watch a video recording demonstrating the correct cardiac compression technique; carry out compressions on the mannequin whilst receiving visual and auditory feedback on their technique; and, complete scenarios. The same nurse educators, who provide the traditional cardiac compression training, will be available to demonstrate how to access and navigate the RQI system to participants, as required. Number of times the intervention will be delivered and over what timeframe: The three groups will receive one off training following baseline assessment and randomisation. Groups A and C will then be deactivated on the RQI training system so that they have no further access to it and Group B will be able to access the system to practise their skills throughout the 6 months of the trial. Location/setting: This three-group randomised controlled trial (RCT) will be carried out in a regional hospital in Queensland, Australia. Fidelity to the intervention: Fidelity will be assessed at the conclusion of the study by cross checking whether Groups A and C accessed the RQI training system outside of scheduled contacts for baseline and re-assessments. The number of times group B participants practised the skills on the RQI training system over the 6 month period will be calculated from the data stored electronically in the RQI training system to determine whether they practised their skills as requested.