• Ron Eshel, Oren Wacht, and Dagan Schwartz.
• From the Goldman Medical School (R.E.), and Department of Emergency Medicine (O.W., D.S.), Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel; and Department of Emergency Medicine (D.S.), Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
• Simul Healthc. 2019 Dec 1; 14 (6): 359-365.

ObjectiveThe aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance.MethodsThis is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One class (control group) was taught using manikin-based standard CPR education models. The second class (intervention group) was taught similarly, but with the addition of real-time CPR quality feedback provided by the manikins. Students' performance was assessed using a standardized Objective Structured Clinical Examination scenario, during which no real-time feedback was provided. Critical CPR parameters were measured including compression depth, chest recoil, ventilation volume, and "hands-off" time.ResultsA total of 201 participants were included in the study, 106 in the control group and 95 in the intervention group. Baseline demographic characteristics and previous medical knowledge were similar for the 2 groups. A significant improvement was observed for all primary study outcomes in favor of the real-time feedback group for median (interquartile range) chest compression fraction [57 (52.75%-60%) vs. 49 (43%-55%), P < 0.001], compressions with adequate depth [66.5 (19.5%-95.25%) vs. 0 (0%-12%), P < 0.001], ventilations with adequate volume [68.5 (33%-89%) vs. 37 (0%-70%), P < 0.00], and a simulator-derived composite "total CPR score" [39 (24%-61.25%) vs. 13 (3.5%-22%), P < 0.001]. In multiple regression analysis, the real-time feedback group's performance was significantly better than the control group in all primary outcomes, adjusting for participant's characteristics of age, sex, and body mass index.ConclusionsThe use of audiovisual feedback techniques to teach CPR improves skill acquisition with significant improvement in crucial prognosis-improving parameters, as tested in a "no-feedback" test scenario.

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