The timing of testing influences skill retention after basic life support training: a prospective quasi-experimental study

Enikő Kovács; Zsigmond Máté Jenei; Katalin Csordás; Gábor Fritúz; Balázs Hauser; V Anna Gyarmathy; Endre Zima; János Gál

doi:10.1186/s12909-019-1881-7

The timing of testing influences skill retention after basic life support training: a prospective quasi-experimental study

BMC Med Educ. 2019 Dec 4;19(1):452. doi: 10.1186/s12909-019-1881-7.

Authors

Enikő Kovács¹, Zsigmond Máté Jenei², Katalin Csordás³, Gábor Fritúz⁴, Balázs Hauser⁴, V Anna Gyarmathy⁵, Endre Zima⁶, János Gál⁴

Affiliations

¹ Department of Anaesthesiology and Intensive Therapy, Semmelweis University, P.O.B. 2, Budapest, H-1428, Hungary. kovacs.eniko2@med.semmelweis-univ.hu.
² 3rd Department of Internal Medicine, Semmelweis University, P.O.B. 2, Budapest, H-1428, Hungary.
³ National Institute of Hematology and Infectious Diseases, Central Hospital of Southern Pest, Albert Flórián út 5-7, Budapest, H-1097, Hungary.
⁴ Department of Anaesthesiology and Intensive Therapy, Semmelweis University, P.O.B. 2, Budapest, H-1428, Hungary.
⁵ Johns Hopkins University, Baltimore, MD, USA.
⁶ Heart and Vascular Center, Semmelweis University, P.O.B. 2, Budapest, H-1428, Hungary.

Abstract

Background: Proper basic life support (BLS) is key in improving the survival of out-of-hospital cardiac arrest. BLS skills deteriorate in three to 6 months after training. One method to improve skill retention may be using the "testing effect" to test skills at the end of a BLS course. The aim of our study was to investigate whether either testing or the timing of such testing after BLS training have any influence on skill retention.

Methods: This was a post-test only, partial coverage, prospective quasi-experimental study designed to evaluate a BLS training course among 464 fifth year medical students at Semmelweis University in the first semester of 2013/2014. Groups were systematically but non-randomly assigned to either a control group that took no exam or one of two experimental groups that took an exam (N = 179, NoExam group; N = 165, EndExam group - exam at the end of the BLS training; N = 120, 3mExam group - exam 3 months after the BLS training). The ability to perform ten prescribed essential BLS steps was evaluated during a skill retention assessment 2 months after the course in the NoExam, 2 months after the course (and the exam) in the EndExam and 5 months after the course (2 months after the exam) in the 3mExam group to measure skill retention and the effect of our intervention. Scores were calculated for each BLS step, and also summed up as a total score. We used Kruskal-Wallis test to assess differences in skill retention.

Results: Overall, NoExam and EndExam groups showed similar skill retention. The mean total score (and many of the sub-scores) of students was significantly higher in the 3mExam group compared to both the NoExam and the EndExam groups, and there was no difference in the total score (and many of the sub-scores) of the latter two groups. The 3mExam group had less variability in total scores (and many of the sub-scores) than the other two groups.

Conclusion: Our study provides evidence that testing these skills 3 months after BLS training may be more effective than either testing immediately at the end of the course or no testing at all.

Keywords: Basic life support; Cardiopulmonary resuscitation; Exam; Out-of-hospital cardiac arrest; Skill retention; Testing effect.

MeSH terms

Cardiopulmonary Resuscitation / education
Clinical Competence
Educational Measurement*
Female
Humans
Hungary
Life Support Care*
Male
Prospective Studies
Retention, Psychology*
Students, Medical*