The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial.


Journal

Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173

Informations de publication

Date de publication:
05 2019
Historique:
received: 22 11 2018
revised: 11 02 2019
accepted: 18 02 2019
pubmed: 5 4 2019
medline: 28 7 2020
entrez: 5 4 2019
Statut: ppublish

Résumé

Little is known about how best to motivate healthcare professionals to engage in frequent cardiopulmonary resuscitation (CPR) refresher skills practice. A competitive leaderboard for simulated CPR can encourage self-directed practice on a small scale. The study aimed to determine if a large-scale, multi-center leaderboard improved simulated CPR practice frequency and CPR performance among healthcare professionals. This was a multi-national, randomized cross-over study among 17 sites using a competitive online leaderboard to improve simulated practice frequency and CPR performance. All sites placed a Laerdal® ResusciAnne or ResusciBaby QCPR manikin in 1 or more clinical units - emergency department, ICU, etc. - in easy reach for 8 months. These simulators provide visual feedback during 2-minute compressions-only CPR and a performance score. Sites were randomly assigned to the intervention for the first 4-months or the second 4-months. Following any CPR practice by a healthcare professional, participants uploaded scores and an optional 'selfie' photo to the leaderboard. During the intervention phase, the leaderboard displayed ranked scores and high scores earned digital badges. The leaderboard did not display control phase participants. Outcomes included CPR practice frequency and mean compression score, using non-parametric statistics for analyses. Nine-hundred nineteen participants completed 1850 simulated CPR episodes. Exposure to the leaderboard yielded 1.94 episodes per person compared to 2.14 during the control phase (p = 0.99). Mean CPR performance participants did not differ between phases: 90.7 vs. 89.3 (p = 0.19). A competitive leaderboard was not associated with an increase in self-directed simulated CPR practice or improved performance.

Sections du résumé

BACKGROUND
Little is known about how best to motivate healthcare professionals to engage in frequent cardiopulmonary resuscitation (CPR) refresher skills practice. A competitive leaderboard for simulated CPR can encourage self-directed practice on a small scale. The study aimed to determine if a large-scale, multi-center leaderboard improved simulated CPR practice frequency and CPR performance among healthcare professionals.
METHODS
This was a multi-national, randomized cross-over study among 17 sites using a competitive online leaderboard to improve simulated practice frequency and CPR performance. All sites placed a Laerdal® ResusciAnne or ResusciBaby QCPR manikin in 1 or more clinical units - emergency department, ICU, etc. - in easy reach for 8 months. These simulators provide visual feedback during 2-minute compressions-only CPR and a performance score. Sites were randomly assigned to the intervention for the first 4-months or the second 4-months. Following any CPR practice by a healthcare professional, participants uploaded scores and an optional 'selfie' photo to the leaderboard. During the intervention phase, the leaderboard displayed ranked scores and high scores earned digital badges. The leaderboard did not display control phase participants. Outcomes included CPR practice frequency and mean compression score, using non-parametric statistics for analyses.
RESULTS
Nine-hundred nineteen participants completed 1850 simulated CPR episodes. Exposure to the leaderboard yielded 1.94 episodes per person compared to 2.14 during the control phase (p = 0.99). Mean CPR performance participants did not differ between phases: 90.7 vs. 89.3 (p = 0.19).
CONCLUSION
A competitive leaderboard was not associated with an increase in self-directed simulated CPR practice or improved performance.

Identifiants

pubmed: 30946919
pii: S0300-9572(19)30100-5
doi: 10.1016/j.resuscitation.2019.02.050
pii:
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

273-281

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Auteurs

Todd P Chang (TP)

Division of Emergency Medicine & Transport, Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, United States. Electronic address: dr.toddchang@gmail.com.

Tia Raymond (T)

Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, TX, United States.

Maya Dewan (M)

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

Ralph MacKinnon (R)

Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Manchester, United Kingdom.

Travis Whitfill (T)

Departments of Pediatrics and Emergency Medicine, Yale University School, Division of Medicine, New Haven CT, United States.

Ilana Harwayne-Gidansky (I)

Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stony Brook Children's Hospital, Stony Brook, NY, United States.

Cara Doughty (C)

Department of Pediatrics, Section of Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Karin Frisell (K)

Anestesikliniken Mälarsjukhuset, Eskilstuna, Sweden.

David Kessler (D)

Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, United States.

Heather Wolfe (H)

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.

Marc Auerbach (M)

Departments of Pediatrics and Emergency Medicine, Yale University School, Division of Medicine, New Haven CT, United States.

Chrystal Rutledge (C)

Division of Pediatric Critical Care, University of Alabama at Birmingham, Birmingham, AL, United States.

Diana Mitchell (D)

Department of Pediatrics, Section of Critical Care Medicine, Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States.

Priti Jani (P)

Department of Pediatrics, Section of Critical Care Medicine, Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States.

Catharine M Walsh (CM)

Department of Paediatrics, the Research and Learning Institutes, Hospital for Sick Children, University of Toronto, Toronto, Canada.

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