Resuscitation training in developing countries: a systematic review.
OBJECTIVE
To evaluate whether the inclusion of any specific resuscitation training educational strategy in developing countries improves outcomes.


METHODS
As part of the International Liaison Committee on Resuscitation evidence evaluation process, a systematic review of the literature was conducted. The Cochrane database of systematic reviews; Medline; Google Scholar and EmBASE were searched using multiple search strategies.


RESULTS
Forty-four papers were relevant to review, including 38 studies that provided support for the use of resuscitation training programs in developing countries. All studies that examined self-efficacy (15 studies) and student satisfaction (8 studies) reported improvement. There was no consistent testing method for educational outcomes across studies and few studies examined both educational outcomes and patient outcome (1 of 15 self-efficacy, 0 of 18 cognitive knowledge, 0 of 8 psychomotor skills, 0 of 5 simulated operational performance). Fourteen of 15 studies that examined patient survival were either newborn or trauma resuscitation, 1 adult resuscitation, and none were in pediatric resuscitation. Increased patient survival after resuscitation training was variable, with an absolute risk reduction that ranged from 0% to 34%.


CONCLUSIONS
Resuscitation training in developing countries was well received and viewed as valuable training by the students and local counterparts. Important student, training environment characteristics, educational outcomes and patient outcomes were inconsistently defined and reported. Institution of training in trauma and newborn resuscitation in developing countries has significantly reduced mortality, but this has not been demonstrated with other training programs.
Meaney
Peter A
PA
Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA, USA. meaney@email.chop.edu
Topjian
Alexis A
AA
Chandler
Heather K
HK
Botha
Martin
M
Soar
Jasmeet
J
Berg
Robert A
RA
Nadkarni
Vinay M
VM
D002983:Clinical Competence; D003906:Developing Countries; D004501:Education, Medical / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D012151:Resuscitation / Q000193:education*