Comparison of instructor-led automated external defibrillation training and three alternative DVD-based training methods.

Abstract

Self-directed BLS-training, using a personal training manikin with video has been shown to be as effective as instructor-led training. This has not previously been investigated for AED-training. This prospective, randomized study with a non-inferiority design compared traditional instructor-led training with three DVD-based AED-training methods (2.5min DVD without practice; 4.5min DVD with manikin practice; 9min DVD with manikin practice and scenario training). After DVD BLS-training, 396 participants were assigned to one of the four AED-training methods by randomization stratified for age. Participants were tested immediately after the training (post-test) and 2 months later (retention-test) using modified Cardiff criteria. The primary endpoint was the percentage of providers scoring 70% or higher on testing. The secondary endpoints were the mean scores and differences per item per age group. Comparison non-inferiority could not be accepted for the post-test or retention-test. Relative risk (RR) and 95% confidence interval (CI) of passing for DVD without practice, with manikin practice and with manikin practice and scenario training compared to instructor-led training were 0.36 (0.25-0.53), 0.35 (0.24-0.51), 0.55 (0.38-0.79), respectively for the post-test, and 0.82 (0.68-0.97), 0.82 (0.68-0.97), and 0.84 (0.70-1.00), respectively for the retention-test. The performance of participants in all DVD-based training groups was significantly higher on the retention-test than on the post-test. Those receiving scenario training scored higher on the post-test compared to the other DVD-training groups (p<0.001). DVD-based AED-training without scenario is not recommended. Scenario training is a useful addition, but instructor-facilitated training remains the best method.