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Self-motivated learning with gamification improves infant CPR performance, a randomised controlled trial
  1. R J MacKinnon1,2,
  2. R Stoeter3,
  3. C Doherty4,
  4. C Fullwood5,
  5. A Cheng6,
  6. V Nadkarni7,
  7. T Stenfors-Hayes8,
  8. T P Chang9
  1. 1Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  2. 2Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  4. 4Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  5. 5Centre for Biostatistics, Institute of Population Health, University of Manchester, The Manchester Academic Health Sciences Centre and Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, The Manchester Academic Health Science Centre, Manchester, UK
  6. 6Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
  7. 7Department of Anesthesia and Critical Care Medicine and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  8. 8Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
  9. 9Department of Pediatric Emergency Medicine, Childrens Hospital, Los Angeles, California, USA
  1. Correspondence to Professor RJ MacKinnon, Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Hathersage Road, Manchester M13 9WL, UK; ralph.mackinnon{at}cmft.nhs.uk

Abstract

Background Effective paediatric basic life support improves survival and outcomes. Current cardiopulmonary resuscitation (CPR) training involves 4-yearly courses plus annual updates. Skills degrade by 3–6 months. No method has been described to motivate frequent and persistent CPR practice. To achieve this, we explored the use of competition and a leaderboard, as a gamification technique, on a CPR training feedback device, to increase CPR usage and performance.

Objective To assess whether self-motivated CPR training with integrated CPR feedback improves quality of infant CPR over time, in comparison to no refresher CPR training.

Design Randomised controlled trial (RCT) to assess the effect of self-motivated manikin-based learning on infant CPR skills over time.

Setting A UK tertiary children's hospital.

Participants 171 healthcare professionals randomly assigned to self-motivated CPR training (n=90) or no refresher CPR training (n=81) and followed for 26 weeks.

Intervention The intervention comprised 24 h a day access to a CPR training feedback device and anonymous leaderboard. The CPR training feedback device calculated a compression score based on rate, depth, hand position and release and a ventilation score derived from rate and volume.

Main outcome measure The outcome measure was Infant CPR technical skill performance score as defined by the mean of the cardiac compressions and ventilations scores, provided by the CPR training feedback device software. The primary analysis considered change in score from baseline to 6 months.

Results Overall, the control group showed little change in their scores (median 0, IQR −7.00–5.00) from baseline to 6 months, while the intervention group had a slight median increase of 0.50, IQR 0.00–33.50. The two groups were highly significantly different in their changes (p<0.001).

Conclusions A significant effect on CPR performance was demonstrated by access to self-motivated refresher CPR training, a competitive leaderboard and a CPR training feedback device.

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