Deliberate Practice to Achieve Mastery of Basic Life Support Skills: Exploring the Potential of Objective Structured Clinical Examination (OSCE) As a Learning Tool.

Abstract

Ineffective performance of cardiopulmonary resuscitation (CPR) when needed will cause poor clinical outcomes. Hence more focus should be on the improvisation of CPR training. Various methods of teaching have been used in basic life support (BLS) training. This prospective, single-blinded, quasi-experimental study that evaluated an educational intervention at a tertiary teaching hospital from September 2022 to June 2023. In this study, we aimed to highlight the application of objective structured clinical examination (OSCE) to identify amateur BLS skills and the use of deliberate practice to master that skill. Structured BLS training was provided to 225 participants including nursing staff (n=158), paramedical staff (n=23) and medical students (n=44). A pre-validated OSCE checklist based on the American Heart Association (AHA) 2020 guidelines for cardiopulmonary resuscitation was included for skill-based assessment. The pre and post training OSCE scores of participants were compared. The OSCE was used to identify the skills that needed more practice and the aim was to practice until the score was 100.0% as per the OSCE checklist. A pre and post-test questionnaire with questions covering the theoretical aspects of BLS was administered to all participants. Out of 225 enrolled participants, 177 completed all stages of training. Post training OSCE scores statistically improved in all the participant with (n=79) or without prior (n=98) experience of CPR training. Most forgotten step while demonstrating the BLS was calling for help (33.0%). Immediately after training only 65.0% were able to demonstrate the BLS sequence as recommended by AHA (American Heart Association). Median number of OSCE practice sessions to achieve a 100.0% score was 2 (two) for those with prior training and 4 (four) for first-time trainees. Willingness to give CPR in future emergencies increased from 85.0% to 96.0% among participants after training. The OSCE scores pre and post training improved in both novices and previously trained participants. OSCE can be used as a training tool to check and improve knowledge of BLS.