Core AHA ECC Educational Concepts
Abbreviations: AHA, American Heart Association; CPR, cardiopulmonary resuscitation; ECC, emergency cardiovascular care.
Simplification Course content should be simplified in both the presentation of the content and the breadth of content to facilitate accomplishment of course objectives.1,2
Consistency Course content and skill demonstrations should be presented in a consistent manner. Video-mediated, practice‑while‑watching instruction is the preferred method for basic psychomotor skill training because it reduces instructor variability that deviates from the intended course agenda.2-5
Contextual Adult learning principles6 should be applied to all ECC courses, with emphasis on creating relevant training scenarios that can be applied practically to the learners’ real‑world setting, such as having hospital-based learners practice CPR on a bed instead of the floor.
Hands-on practice Substantial hands-on practice is needed to meet psychomotor and nontechnical/leadership skill performance objectives.2,3,7-9
Practice to mastery Learners should have opportunities for repetitive performance of key skills coupled with rigorous assessment and informative feedback in a controlled setting.10-13 This deliberate practice should be based on clearly defined objectives14-16 and not time spent, to promote student development toward mastery.17-21
Debriefing The provision of feedback and/or debriefing is a critical component of experiential learning.22 Feedback and debriefing after skills practice and simulations allow learners (and groups of learners) the opportunity to reflect on their performance and to receive structured feedback on how to improve their performance in the future.23
Assessment Assessment of learning in resuscitation courses serves to both ensure achievement of competence and provide the benchmarks that students will strive toward. Assessment also provides the basis for student feedback (assessment for learning). Assessment strategies should evaluate competence and promote learning. Learning objectives24 must be clear and measurable and serve as the basis of evaluation.
Course/program evaluation This is an integral component of resuscitation education, with the appraisal of resuscitation courses including learner, individual instructor, course and program performance.25 Training organizations should use this information to drive the continuous quality improvement process.

References

  1. Nishiyama C, Iwami T, Murakami Y, et al. Effectiveness of simplified 15-min refresher BLS training program: a randomized controlled trial. Resuscitation. 2015;90:56-60.
  2. Lynch B, Einspruch EL, Nichol G, Becker LB, Aufderheide TP, Idris A. Effectiveness of a 30-min CPR self-instruction program for lay responders: a controlled randomized study. Resuscitation. 2005;67(1):31-43.
  3. 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):476-486.
  4. Mancini ME, Cazzell M, Kardong-Edgren S, Cason CL. Improving workplace safety training using a self-directed CPR-AED learning program. AAOHN J. 2009;57(4):159-167.
  5. Roppolo LP, Heymann R, Pepe P, et al. A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: the two-person CPR study. Resuscitation. 2011;82(3):319-325.
  6. Knowles MS, Holton EF III, Swanson RA. The Adult Learner. Woburn, MA: Butterworth-Heinemann; 1998.
  7. Reder S, Cummings P, Quan L. Comparison of three instructional methods for teaching cardiopulmonary resuscitation and use of an automatic external defibrillator to high school students. Resuscitation. 2006;69(3):443-453.
  8. Nishiyama C, Iwami T, Kawamura T, et al. Effectiveness of simplified chest compression-only CPR training program with or without preparatory self-learning video: a randomized controlled trial. Resuscitation. 2009;80(10):1164-1168.
  9. Monsieurs KG, Vogels C, Bossaert LL, et al. Learning effect of a novel interactive basic life support CD: the JUST system. Resuscitation. 2004;62(2):159-165.
  10. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10)(suppl):S70-S81.
  11. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Med Teach. 2013;35(10):e1511-e1530.
  12. Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, et al. Pediatric resident resuscitation skills improve after “rapid cycle deliberate practice” training. Resuscitation. 2014;85(7):945-951.
  13. Cook DA, Hamstra SJ, Brydges R, et al. Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach. 2013;35(1):e867-e898.
  14. Bloom B, Englehart M. Furst E, Hill W, Krathwohl D. Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook I: Cognitive Domain. New York, NY: Longmans; 1956.
  15. Dave RH. Developing and Writing Behavioral Objectives. Tuscon, AZ: Educational Innovators Press; 1970.
  16. Krathwohl DR, Bloom BS. Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook II: Affective Domain. New York, NY: David McKay Co; 1964.
  17. Bloom BS. Mastery Learning. New York, NY: Holt Rinehart & Winston; 1971.
  18. Ericsson K, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100(3):363-406.
  19. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Medical education featuring mastery learning with deliberate practice can lead to better health for individuals and populations. Acad Med. 2011;86(11):e8-e9.
  20. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86(6):706-711.
  21. Roppolo LP, Pepe PE, Campbell L, etal. Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: the American Airlines Study. Resuscitation. 2007;74(2):276-285.
  22. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ. 2014;48(7):657-666.
  23. Cheng A, Rodgers DL, van der Jagt E, Eppich W, O’Donnell J. Evolution of the Pediatric Advanced Life Support course: enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors. Pediatr Crit Care Med. 2012;13(5):589-595.
  24. Mager RF. Preparing Instructional Objectives: A Critical Tool in the Development of Effective Instruction. 3rd ed. Atlanta, GA: Center for Effective Performance; 1997.
  25. Kirkpatrick D, Kirkpatrick J. Implementing the Four Levels: A Practical Guide for the Evaluation of Training Programs. San Francisco, CA: Berrett-Koehler; 2007.