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      Comparing the effectiveness of a group-directed video instruction versus instructor-led traditional classroom instruction for learning cardiopulmonary resuscitation skills among first-year medical students: A prospective randomized controlled study Translated title: Vergleich der Wirksamkeit eines gruppengeleiteten Videounterrichts mit einem traditionellen Unterricht unter Anleitung eines Ausbilders zum Erlernen von kardiopulmonalen Wiederbelebungsmaßnahmen bei Medizinstudenten im ersten Studienjahr: eine prospektive, randomisierte, kontrollierte Studie

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          Abstract

          Introduction: Bystander cardiopulmonary resuscitation (CPR) training is inconsistent among students and the public. Existing CPR teaching courses are costly, time-consuming, and inconsistent. This study aimed to determine the association between overall CPR competency and two teaching modules, a group-directed video instruction module versus an instructor-led traditional classroom instruction module.

          Methods: This randomized prospective interventional study involved first year medical students of Universiti Sains Malaysia Health Campus from November 2018 until January 2019. Pass-fail scores representing the overall CPR, individual skill performance, and willingness to perform CPR for strangers and family members were collected. Factors associated with reluctance to perform CPR were assessed in a questionnaire.

          Results: A total of 99 participants were included, 50 in the group-directed video instruction as the intervention module and 49 in the traditional classroom instruction as the control module. There was no statistical significance between the pass and fail outcomes for both video module ( p=0.436). Participants in both modules performed similarly in 8 out of 12 individual CPR skills. There was a significant difference in the distribution of skill scores between the pass and fail outcomes ( p=<0.001). The intervention module is non-inferior compared to the control module, in relation to CPR willingness rates for strangers ( p=0.999) and family members (p=0.117) after the training.

          Conclusions: The group-directed video self-instruction method is as effective as the instructor-led traditional classroom method to help participants to be competent and willing to perform CPR. It can be used as an independent or supplementary teaching tool for first-time learners and refreshers, especially in a group setting when teaching materials are limited.

          Zusammenfassung

          Einleitung: Die Ausbildung zur Herz-Lungen-Wiederbelebung (HLW) durch Laien ist bei Schülern und in der Öffentlichkeit uneinheitlich. Bestehende HLW-Kurse sind kostspielig, zeitaufwendig und uneinheitlich. Ziel dieser Studie war es, den Zusammenhang zwischen der allgemeinen HLW-Kompetenz und zwei Unterrichtsmodulen zu ermitteln: einem gruppengeleiteten Video-Unterrichtsmodul und einem von einem Ausbilder geleiteten traditionellen Unterrichtsmodul.

          Methoden: An dieser randomisierten, prospektiven Interventionsstudie nahmen Medizinstudenten des ersten Studienjahres der Universiti Sains Malaysia Health Campus von November 2018 bis Januar 2019 teil. Pass-Fail-Scores, die die allgemeine HLW, die individuellen Fähigkeiten und die Bereitschaft zur Durchführung einer HLW bei Fremden und Familienmitgliedern darstellen, wurden erfasst. Faktoren, die mit der Zurückhaltung bei der Durchführung der HLW zusammenhängen, wurden in einem Fragebogen bewertet.

          Ergebnisse: Insgesamt wurden 99 Teilnehmer eingeschlossen, 50 in der gruppengeleiteten Videoschulung als Interventionsmodul und 49 in der traditionellen Präsenzschulung als Kontrollmodul. Es gab keine statistische Signifikanz zwischen den bestandenen und nicht bestandenen Ergebnissen für beide Videomodule ( p=0,436). Die Teilnehmer beider Module zeigten bei 8 von 12 einzelnen HLW-Fertigkeiten ähnliche Leistungen. Es bestand ein signifikanter Unterschied in der Verteilung der Fertigkeitsergebnisse zwischen den bestandenen und den nicht bestandenen Ergebnissen ( p=<0,001). Das Interventionsmodul ist dem Kontrollmodul nicht unterlegen, was die Bereitschaft zur Wiederbelebung von Fremden (p=0,999) und Familienmitgliedern ( p=0,117) nach dem Training betrifft.

          Schlussfolgerungen: Die gruppengeleitete Video-Selbstinstruktionsmethode ist ebenso wirksam wie die von einem Ausbilder geleitete traditionelle Unterrichtsmethode, wenn es darum geht, den Teilnehmern zu helfen, kompetent und bereit zu sein, eine HLW durchzuführen. Sie kann als unabhängiges oder ergänzendes Lehrmittel für Erst- und Auffrischungsschüler eingesetzt werden, insbesondere in einem Gruppenumfeld, in dem die Unterrichtsmaterialien begrenzt sind.

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          Epidemiology of coronary heart disease and acute coronary syndrome.

          The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.
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            Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.

            The aim of this investigation was to estimate and contrast the global incidence and outcome of out-of-hospital cardiac arrest (OHCA) to provide a better understanding of the variability in risk and survival of OHCA. We conducted a review of published English-language articles about incidence of OHCA, available through MEDLINE and EmBase. For studies including adult patients and both adult and paediatric patients, we used Utstein data reporting guidelines to calculate, summarize and compare incidences per 100,000 person-years of attended OHCAs, treated OHCAs, treated OHCAs with a cardiac cause, treated OHCA with ventricular fibrillation (VF), and survival-to-hospital discharge rates following OHCA. Sixty-seven studies from Europe, North America, Asia or Australia met inclusion criteria. The weighted incidence estimate was significantly higher in studies including adults than in those including adults and paediatrics for treated OHCAs (62.3 vs 34.7; P<0.001); and for treated OHCAs with a cardiac cause (54.6 vs 40.8; P=0.004). Neither survival to discharge rates nor VF survival to discharge rates differed statistically significant among studies. The incidence of treated OHCAs was higher in North America (54.6) than in Europe (35.0), Asia (28.3), and Australia (44.0) (P<0.001). In Asia, the percentage of VF and survival to discharge rates were lower (11% and 2%, respectively) than those in Europe (35% and 9%, respectively), North America (28% and 6%, respectively), or Australia (40% and 11%, respectively) (P<0.001, P<0.001). OHCA incidence and outcome varies greatly around the globe. A better understanding of the variability is fundamental to improving OHCA prevention and resuscitation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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              Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis.

              Prior studies have identified key predictors of out-of-hospital cardiac arrest (OHCA), but differences exist in the magnitude of these findings. In this meta-analysis, we evaluated the strength of associations between OHCA and key factors (event witnessed by a bystander or emergency medical services [EMS], provision of bystander cardiopulmonary resuscitation [CPR], initial cardiac rhythm, or the return of spontaneous circulation). We also examined trends in OHCA survival over time. An electronic search of PubMed, EMBASE, Web of Science, CINAHL, Cochrane DSR, DARE, ACP Journal Club, and CCTR was conducted (January 1, 1950 to August 21, 2008) for studies reporting OHCA of presumed cardiac etiology in adults. Data were extracted from 79 studies involving 142 740 patients. The pooled survival rate to hospital admission was 23.8% (95% CI, 21.1 to 26.6) and to hospital discharge was 7.6% (95% CI, 6.7 to 8.4). Stratified by baseline rates, survival to hospital discharge was more likely among those: witnessed by a bystander (6.4% to 13.5%), witnessed by EMS (4.9% to 18.2%), who received bystander CPR (3.9% to 16.1%), were found in ventricular fibrillation/ventricular tachycardia (14.8% to 23.0%), or achieved return of spontaneous circulation (15.5% to 33.6%). Although 53% (95% CI, 45.0% to 59.9%) of events were witnessed by a bystander, only 32% (95% CI, 26.7% to 37.8%) received bystander CPR. The number needed to treat to save 1 life ranged from 16 to 23 for EMS-witnessed arrests, 17 to 71 for bystander-witnessed, and 24 to 36 for those receiving bystander CPR, depending on baseline survival rates. The aggregate survival rate of OHCA (7.6%) has not significantly changed in almost 3 decades. Overall survival from OHCA has been stable for almost 30 years, as have the strong associations between key predictors and survival. Because most OHCA events are witnessed, efforts to improve survival should focus on prompt delivery of interventions of known effectiveness by those who witness the event.
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                Author and article information

                Journal
                GMS J Med Educ
                GMS J Med Educ
                GMS J Med Educ
                GMS Journal for Medical Education
                German Medical Science GMS Publishing House
                2366-5017
                15 September 2022
                2022
                : 39
                : 4
                : Doc45
                Affiliations
                [1 ]Universiti Sains Malaysia, School of Medical Sciences, Kelantan, Malaysia
                [2 ]Universiti Malaysia Sabah, Faculty of Medicine and Health Sciences, Sabah, Malaysia
                [3 ]Hospital Universiti Sains Malaysia, Kelantan, Malaysia
                Author notes
                *To whom correspondence should be addressed: Ariff Arithra Abdullah, Universiti Sains Malaysia, School of Medical Sciences, MY-16150 Kota Bharu, Kelantan, Malaysia, E-mail: arithra@ 123456usm.my
                Article
                zma001566 Doc45 urn:nbn:de:0183-zma0015662
                10.3205/zma001566
                9585410
                36310890
                0f97359b-6fee-41ef-b797-b6a9632fc794
                Copyright © 2022 Marcus et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

                History
                : 18 May 2021
                : 05 July 2022
                : 16 March 2022
                Categories
                Article

                cardiopulmonary resuscitation,basic life support,teaching materials,clinical skills,medical education

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