Influence of pre-course assessment using an emotionally activating stimulus with feedback: a pilot study in teaching...

Cardiopulmonary resuscitation (CPR) mastery continues to challenge medical professionals. The purpose of this study was to determine if an emotional stimulus in combination with peer or expert feedback during pre-course assessment effects future performance in a single rescuer simulated cardiac arrest.

First-year medical students (n=218) without previous medical knowledge were randomly assigned to one of the study groups and asked to take part in a pre-course assessment: Group 1: after applying an emotionally activating stimulus an expert (instructor) gave feedback on CPR performance (Ex). Group 2: after applying the same stimulus feedback was provided by a peer from the same group (Pe); Group 3: standard without feedback (S). Following pre-course assessment, all subjects received a standardized BLS-course, were tested after 1 week and 6 months later using single-rescuer-scenario, and were surveyed using standardized questionnaires (6-point-likert-scales: 1=completely agree, 6=completely disagree).

Participants exposed to stimulus demonstrated superior performance concerning compression depth after 6 months independent of feedback-method (Ex: 65.85% [p=0.0003]; Pe: 57.50% [p=0.0076] vs. 21.43%). The expert- more than the peer-group was emotionally more activated in initial testing, Ex: 3.26 ± 1.35 [p ≤ 0.0001]; Pe: 3.73 ± 1.53 [p=0.0319]; S: 4.25 ± 1.37) and more inspired to think about CPR (Ex: 2.03 ± 1.37 [p=0.0119]; Pe: 2.07 ± 1.14 [p=0.0204]; S: 2.60 ± 1.55). After 6 months this activation effect was still detectable in the expert-group (p=0.0114).

The emotional stimulus approach to BLS-training seems to impact the ability to provide adequate compression depth up to 6 months after training. Furthermore, pre-course assessment helped to keep the participants involved beyond initial training.