Are there any different in retention of BLS and AED skills between younger (15-22 years) and older (>35 years) lifeguards?

TitleAre there any different in retention of BLS and AED skills between younger (15-22 years) and older (>35 years) lifeguards?
Publication TypeConference Paper
Year of Publication2007
Authorsde Vries, W, Bierens, J
Conference NameWorld Conference on Drowning Prevention
Date Published09/2007
PublisherInternational Life Saving Federation
Conference LocationPorto, Portugal
Other Numbers02-28
Abstract

Context: Younger people who are still on school or college have more adequate meta-cognitive skills to learn and construct new knowledge.1 This is an important reason to teach AED skills at a young age. We compared two groups of lifeguards who did an initial training in the use of the AED on the beach with refreshment courses after 3 months and one year. We also assessed the retention. We hypothysed that there was no difference between the two groups.

Methods: Both groups were previous trained in BLS. Before starting the AED-providers course, which included the refreshment of BLS-skills, a pre-assessment was taken to look for any differences between the groups in BLS skills. After this pre-test they received an AED provider course meeting the ILCOR guidelines.2
Retention tests were taken after 3, 6, 12 and 18 months.  Test items can be found in table 1.

Results: Group A consisted of lifeguards between 15 and 22 years old (n=71) and group B consisted of lifeguards older than 35 years old (n=65).

No differences between the groups were found in the pre-test. Directly after the training differences appeared in workspace, check for signs of circulation, hand position for chest compression and CPR integration in favourite for the group of younger lifeguards.  These differences were disappeared after three months, before the received their first refreshment training. Six months after the initial training and three months after the refreshment training differences appears again on workspace.  But there is also a difference in depth of chest compression, which is not disappeared after twelve months. (Table 2)

After 18 months no differences were found between both groups. Non differences were found concerning AED-skills.

Discussion/Implications: Most lifeguards are young people, and it seems that younger people indeed have more effective meta-cognitive skills to learn and construct new knowledge and help them to have a higher retention of BLS skills. But the repetition in the form of refreshment trainings makes these differences extinguish. These repetitions strengthen retrieval and increase retention.

One might argue that the disappearances after 18 months of the differences between both groups are caused by the high retention decrease and that both groups are worse acting. However, calculated retention shows for most topics a high percentage of competent providers. Items with a low percentage are not different from findings from previous studies.2,3,4 (Table 3)

Learning Outcomes
  1. There are better learning effects immediately after the course for younger lifeguards than for older lifeguards. However, both performed well in AED skills.
  2. Different in learning effects can be distinguished with the help of repetition (re-consolidation).
  3. Effective training and re-consolidation lead to good retention of knowledge and skills independent of ages of the learners.
Annexes

Table 1. Items that were subject of the assessment

1

Safety

2

Workspace

3

Shout and shake

4

Check breathing

5

Raise an alarm

6

Rescue breathing

7

Check for signs of circulation

8

Handposition for chest compression

9

Depth of chest compression

10

Ratio ventilation : compression

11

Rhythm of chest compression

12

AED position

13

CPR integration

14

Position of electrodes

15

Clearing during analysis

16

Clearing before shock

17

Shock delivered in time

18

Check for signs of circulation after shock

Table 2. Differences found between both groups that are depending of age

Competent on this item (%)

Younger
Older

Safety
80
60

Workspace
47
77

Shout and shake
69
64

Check breathing
85
86

Raise an alarm
79
77

Rescue breathing
93
88

Check for signs of circulation
50
38

Handposition for chest compression
39
38

Depth of chest compression
62
53

Ratio ventilation : compression
71
50

Rhythm of chest compression
80
72

AED position
80
72

CPR integration
62
53

Position of electrodes
90
87

Clearing during analysis
96
94

Clearing before shock
46
31

Shock delivered in time
40
38

Check for signs of circulation after shock
50
42

Table 3. Percentage competent providers per item­

Post course p-value
Retention after 3 months p-value
Retention after 6 months p-value
Retention after 12 months p-value

Workspace
.05

.05

Check for signs of circulation
.01

Rescue breathing

.01

Hand position for chest compression
.05

Depth of chest compression

.01
.04

CPR integration
.01

References
  1. Anderson, JR. (2000). Cognitive psychology and its implications; Fifth Edition. Worth Publishers, New York.
  2. Berden HJ, Bierens JJ, Willems FF, Hendrick JM, Pijls NH, Knape JT. (1994) Resuscitation skills of lay public after recent training. In: Ann. Emerg. Med.;23:1003-1008.
  3. Chamberlain D, Smith A, Woollard M, et al. (2002) Trials of teaching methods in basic life support (3): Comparison of simulated CPR performance after first training and at 6 months, with a note on the value of re-training. In: Resuscitation;53:179–187.
  4. Usatch BR, Cone DC. (2002) Automated external defibrillator training and skill retention at a ski patrol. In: Prehosp Emerg Care;6:325–329.