Self-motivated learning with gamification improves infant CPR performance, a randomised controlled trial

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.

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.

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

A UK tertiary children's hospital.

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

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.

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.

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).

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.