Assessment of knowledge and skills in cardiopulmonary resuscitation assimilated by primary health care professionals

Lilia de Souza Nogueira, Ana Maria Miranda Martins Wilson, Anna Carolina Margarido Karakhanian, Eliane Vitoreli Parreira, Valéria Menezes Peixeiro Machado, Vera Lúcia Mira

Abstract


AIMS: To assess the theoretical knowledge retention and skills assimilation by primary health care professionals in cardiopulmonary resuscitation training.

METHODS: Quantitative study involving participants in cardiorespiratory arrest training, held between August 2013 and July 2014. To assess the knowledge retention after one year, the same multiple-choice test on the training content that had been applied immediately after the training was reapplied. The averages of the two test scores were compared by means of the Wilcoxon test, significance being set at 5%. Skill assimilation was assessed using the Objective Structured Clinical Examination tool, which consists of four practical stations with different actions and a maximum length of eight minutes each, according to the objectives the students are expected to achieve. Station 1: correct sequence of cardiopulmonary resuscitation in adults; station 2: effective practice of chest compressions in adults; station 3: correct use of automated external defibrillator in adults; station 4: effective clearance of infant airway. The total score per workstation was ten points.

RESULTS: Most of the 89 professionals in the sample were female (87.6%), with an average age of 37.3±9.9. Forty-eight professionals (53.9%) worked as community health agents. In the knowledge retention analysis, the mean number of right answers dropped when comparing the averages immediately after training (9.5±0.9) and one year later (7.5±1.7) (p<0.001). In the skills assimilation, the students’ best final averages were identified in stations 2 (7.3±1.7) and 3 (7.3±1.6), followed by station 1 (6.2±2.0). In the station about infant airway clearance, the professionals’ performance was low (final average 3.2±1.8).

CONCLUSIONS: The theoretical knowledge retention on cardiopulmonary resuscitation could be considered partially satisfactory, with an observed drop one year after the training. Concerning the skills, the professionals performed well in the practical stations, except for the care related to infant airway clearance.


Keywords


Simulation; Cardiopulmonary Resuscitation; Learning; Primary Health Care; Health Knowledge, Attitudes, Practice; Educational Measurement.

References


American Heart Association. Destaques da American Heart Association 2015: atualização das diretrizes de RCP e ACE. Dallas: Texas; 2015. p. 1-33. Available from: https://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-Portuguese.pdf

Gonzalez MM, Timerman S, Oliveira RG, Polastri TF, Dallan LAP, Araújo S, Lage SG, Schmidt A, Bernoche CSM, Canesin MF, Mancuso FJN, Favarato MH. I Diretriz de ressuscitação cardiopulmonar e cuidados cardiovasculares de emergência da Sociedade Brasileira de Cardiologia: resumo executivo. Arq Bras Cardiol. 2013;100(2):105-13. https://doi.org/10.5935/abc.20130022

Sociedade Brasileira de Cardiologia. Diretrizes. Pocket Book 2013-2015. [Internet]. São Paulo; 2015 [uptaded 2017 Jun; cited 2017 Sep 10]. Available from: http://publicacoes.cardiol.br/2014/img/pockets/POCKETBOOK_2015_Interativa.pdf

Potts J, Lynch B. The American Heart Association CPR Anytime Program: the potencial impacto of highly acessible training in cardiopulmonary resuscitation. J Cardiopulm Rehabil. 2006;26(6):346-54. https://doi.org/10.1097/00008483-200611000-00002

Ferreira AVS, Garcia E. Suporte básico de vida. Rev Soc Cardiol Estado de São Paulo. 2001;11(2):214-25.

Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63-81. https://doi.org/10.1161/CIRCOUTCOMES.109.889576

Stiell I, Nichol G, Wells G, De Maio V, Nesbitt L, Blackburn J, Spalte D, OPALS Study Group. Health-related quality of life is better for cardiac arrest survivors who received citizen cardiopulmonary resuscitation. Circulation. 2003;108(16):1939-44. https://doi.org/10.1161/01.CIR.0000095028.95929.B0

Brasil. Ministério da Saúde. PORTARIA Nº 198/GM Em 13 de fevereiro de 2004. Institui a Política Nacional de Educação Permanente em Saúde como estratégia do Sistema Único de Saúde para a formação e o desenvolvimento de trabalhadores para o setor e dá outras providências [Internet]. Brasília; 2004 [updated 2017 Sep; cited 2017 Oct 1]. Available from: http://www.prefeitura.sp.gov.br/cidade/secretarias/upload/saude/cgp/coord_sudeste/imagens/NEP/PORTARIA_N_198_de_13_de_fevereiro_de_2004.pdf

Otrenti E, Mira VL, Bucchi SM, Borges-Andrade JE. Evaluación de los procesos educativos formales para los profesionales sanitarios. Invest Educ Enferm. 2014;32(1):103-12.

Gonçalves VLG. Avaliação de programas de treinamento e desenvolvimento da equipe de enfermagem de dois hospitais do município de São Paulo [thesis]. [São Paulo]: Escola de Enfermagem da Universidade de São Paulo; 2010. 226p. Available from: http://www.teses.usp.br/teses/disponiveis/livredocencia/7/tde-14022012-100136/en.php

Brunk I, Schauber S, Georg W. Do they know too little? An inter-institutional study on the anatomical knowledge of upper-year medical students based on multiple choice questions of a progress test. Ann Anat. 2017;209:93-100. https://doi.org/10.1016/j.aanat.2016.09.004

Tibério IFLC, Daud-Gallotti RM, Pavanelli MC, Rodrigues MAV. Avaliação Estruturada de habilidade tipo OSCE: planejamento, elaboração, preparação e correção. In: Tibério IFLC, Daud-Gallotti RM, Troncon LEA, Martins MA. Avaliação prática de habilidades clínicas em Medicina. São Paulo: Atheneu; 2012. p.97-104.

American Heart Association. SBV para profissionais de saúde - manual do aluno. São Paulo: Sesil; 2011.

Pergola AM, Araujo IEM. O leigo e o suporte básico de vida. Rev Esc Enferm USP. 2009;43(2):335-42. https://doi.org/10.1590/S0080-62342009000200012

Troncon LEA. Clinical skills assessment limitations to the introduction of an "OSCE"(Objective Structured Clinical Examination) in a traditional Brazilian medical school. São Paulo Med J. 2004;22(1):12-7. https://doi.org/10.1590/S1516-31802004000100004

Miraveti JC. Suporte básico de vida para leigos: em estudo quase experimental [thesis]. [Ribeirão Preto]: Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo; 2016. 239p. Available from: http://www.teses.usp.br/teses/disponiveis/22/22132/tde-30032017-193956/pt-br.php

Pande S, Pande S, Parate V, Pande S, Sukhsohale N. Evaluation of retention of knowledge and skills imparted to first-year medical students through basic life support training. Adv Physiol Educ. 2014;38(1):42-5. https://doi.org/10.1152/advan.00102.2013

Einspruch EL, Lynch B, Aufderheide TP, Nichol G, Becker L. Retention of CPR skills learned in a traditional AHA Heartsaver course versus 30-min video self-training: a controlled randomized study. Resuscitation. 2007;74(3):476-86. https://doi.org/10.1016/j.resuscitation.2007.01.030

Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, Sinz EH, Cheng A. Part 14: education. 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(suppl2):S561-73. https://doi.org/10.1161/CIR.0000000000000268

Flato UAP, Guimarães HP. Educação baseada em simulação em medicina de urgência e emergência: a arte imita a vida. Rev Bras Clin Med. 2011;9(5):360-4.

Reynolds T, Kong ML. Shifting the learning curve. BMJ 2010;341:c6260. https://doi.org/10.1136/bmj.c6260

Brim NM, Venkatan SK, Gordon JA, Alexander EK. Long-term educational impact of a simulator curriculum on medical student education in an internal medicine clerkship. Simul Healthc 2010;5(2):75-81. https://doi.org/10.1097/SIH.0b013e3181ca8edc

Meissner TM, Kloppe C, Hanefeld C. Basic life support skills of high school students before and after cardiopulmonar resuscitation training: a longitudinal investigation. Scand J Trauma Resusc Emerg Med. 2012;20:31. https://doi.org/10.1186/1757-7241-20-31

Kopacek KB, Dopp AL, Dopp JM, Vardeny O, Sims JJ. Pharmacy student's retention of knowledge and skills following training in automated external defibrillator use. Am J Pharm Educ. 2010;74(6):109. https://doi.org/10.5688/aj7406109

Charalampopoulos D, Karlis G, Barouxis D, Syggelou A, Mikalli C, Kountouris D, Modestou N, Van de Voorde P, Danou F, Lacovidou N, Xanthos T. Theoretical knowledge and skill retention 4 months aftter a European Paediatric Life Support course. Eur J Emerg Med. 2016; 23(1):56-60. https://doi.org/10.1097/MEJ.0000000000000208

Varga CRR, Almeida VC, Germano CMR, Melo DG, Chachá SGF, Souto BGA, Fontanella BJB, Lima VV. Relato de experiência: o uso de simulações no processo de ensino-aprendizagem em medicina. Rev Bras Educ Méd. 2009;33(2):291-7. https://doi.org/10.1590/S0100-55022009000200018

Troncon LEA. Utilização de pacientes simulados no ensino e na avaliação de habilidades clínicas. Medicina. Ribeirão Preto. 2007;40(2):180-91.

Agel AA, Ahmad MM. High-fidelity simulation effects on CPR knowledge, skills, acquisition, and retention in nursing students. Worldviews Evid Based Nurs. 2014; 11(6):394-400. https://doi.org/10.1111/wvn.12063

Ribeiro LG, Germano R, Menezes PL, Schmidt A, Filho AP. Medical students teaching cardiopulmonary resuscitation to middle school brazilian students. Arq Bras Cardiol. 2013;101(4):328-35. https://doi.org/10.5935/abc.20130165

Chamberlain D, Smith A, Woollard M, Colquhoun M, Handley AJ, Leaves S, Kern KB. Trials of teaching methods in basic life support (3): comparison of simulated CPR performance after first training and at 6 months, with a note on the value of re-training. Resuscitation. 2002;53(2):179-87. https://doi.org/10.1016/S0300-9572(02)00025-4

Anderson GS, Gaetz M, Statz C, Kin B. CPR skill retention of first aid attendants within the workplace. Prehosp Disaster Med. 2012;27(4):312-8. https://doi.org/10.1017/S1049023X1200088X




DOI: http://dx.doi.org/10.15448/1980-6108.2018.1.28843

e-ISSN: 1980-6108 | ISSN-L: 1806-5562


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