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Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training
  1. Andrew R Coggins1,2,
  2. Cameron Nottingham2,
  3. Karen Byth2,
  4. Kevin R Ho2,
  5. Felicia A Aulia1,
  6. Margaret Murphy1,
  7. Amith L Shetty1,2,
  8. Anna Todd3,
  9. Nathan Moore2,4
  1. 1 Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia
  2. 2 Western Clinical School, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Sydney Clinical Skills and Simulation Centre (SCSSC), Royal North Shore Hospital, Saint Leonards, New South Wales, Australia
  4. 4 Simulated Learning Environment for Clinical Training (SiLECT), Westmead Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Andrew R Coggins, Emergency Medicine, NSW Health, Syndey, NSW 2151, Australia; andrew.coggins{at}


Introduction Mechanical cardiopulmonary resuscitation (M-CPR) is increasingly used in the management of cardiac arrest. There are no previously reported randomised studies investigating M-CPR training. This study of newly trained M-CPR providers hypothesised that a brief simulation-based intervention after 4 months would improve M-CPR performance at 6 months.

Methods This study used a simulated ‘in situ’ cardiac arrest model. The M-CPR device used was a proprietary Lund University Cardiac Assist System 3 machine (Physio Control, Redmond, Washington, USA). Standardised baseline training was provided to all participants. Following training, baseline performance was assessed. The primary outcome measure was the time taken to initiate M-CPR and the secondary outcome was performance against a checklist of errors. Participants were then randomised to intervention group (simulation training) or control group (routine clinical use of M-CPR). After 6 months the outcome measures were reassessed. Comparative statistical tests used an intention-to-treat analysis.

Results 112 participants were enrolled. The intervention group (n=60) and control group (n=52) had similar demographic characteristics. At the 6-month assessment, median time to M-CPR initiation was 27.0 s (IQR 22.0–31.0) in the intervention group and 31.0 s (IQR 25.6–46.0) in the control group (p=0.003). The intervention group demonstrated fewer errors compared with controls at 6 months (p<0.001)

Conclusion In this randomised study of approaches to M-CPR training, providers receiving additional simulation-based training had higher retention levels of M-CPR skills. Therefore, when resuscitation skills are newly learnt, provision follow-up training should be an important consideration.

  • education
  • resuscitation, training
  • education, teaching
  • cardiac arrest
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  • Contributors AC, NM, KH, MM and AS conceived and designed the study. AC, CN, FA and KB conducted the data analysis. All authors contributed to the implementation, data acquisition, manuscript preparation and subsequent revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The study protocols were approved by the Westmead Hospital (HREC) Ethics Committee (2016).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data are available by email request from the corresponding author.

  • Patient consent for publication Not required.

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