title: Pediatric resuscitation training-instruction all at once or spaced over time?
abstract: OBJECTIVE
  Healthcare providers demonstrate limited retention of knowledge and skills in the months following completion of a resuscitation course. Resuscitation courses are typically taught in a massed format (over 1-2 days) however studies in education psychology have suggested that spacing training may result in improved learning and retention. Our study explored the impact of spaced instruction compared to traditional massed instruction on learner knowledge and pediatric resuscitation skills.
  
  
  METHODS
  Medical students completed a pediatric resuscitation course in either a spaced or massed format. Four weeks following course completion students completed a knowledge exam and blinded observers used expert-developed checklists to assess student performance of three skills (bag-valve mask ventilation (BVMV), intra-osseous insertion (IOI) and chest compressions (CC)).
  
  
  RESULTS
  Forty-five out of 48 students completed the study protocol. Students in both groups had similar scores on the knowledge exam spaced: (37.8±6.1) vs. massed (34.3±7.6)(p<0.09) and overall global rating scale scores for IOI, BVMV and CC; however students in the spaced group also performed critical procedural elements more frequently than those in the massed training group
  
  
  CONCLUSIONS
  Learner knowledge and performance of procedural skills in pediatric resuscitation taught in a spaced format is at least as good as learning in a massed format. Procedures learned in a spaced format may result in better retention of skills when compared to massed training.
authors.affiliation: Royal College Emergency Medicine Residency Program, McGill University, Montreal, QC, Canada; McGill Centre for Medical Education, Montreal, QC, Canada; Department of Emergency Medicine, University of Calgary Faculty of Medicine, Calgary, AB, Canada. Electronic address: catherine.patocka@gmail.com.
authors.forename: Catherine
authors.initials: C
authors.lastname: Patocka
authors.affiliation: Royal College Emergency Medicine Residency Program, McGill University, Montreal, QC, Canada.
authors.forename: Farooq
authors.initials: F
authors.lastname: Khan
authors.affiliation: Department of Pediatrics, McGill University, Montreal, QC, Canada; Pediatric Emergency Medicine, Montreal Children's Hospital-McGill University Health Center, Montreal, QC, Canada.
authors.forename: Alexander Sasha
authors.initials: AS
authors.lastname: Dubrovsky
authors.affiliation: Department of Pediatrics, McGill University, Montreal, QC, Canada; Pediatric Emergency Medicine, Montreal Children's Hospital-McGill University Health Center, Montreal, QC, Canada.
authors.forename: Danny
authors.initials: D
authors.lastname: Brody
authors.affiliation: McGill Centre for Medical Education, Montreal, QC, Canada; Department of Pediatrics, McGill University, Montreal, QC, Canada; Pediatric Emergency Medicine, Montreal Children's Hospital-McGill University Health Center, Montreal, QC, Canada; Arnold and Blema Steinberg Centre for Medical Simulation, Montreal, QC, Canada.
authors.forename: Ilana
authors.initials: I
authors.lastname: Bank
authors.affiliation: McGill Centre for Medical Education, Montreal, QC, Canada; Department of Pediatrics, McGill University, Montreal, QC, Canada; Pediatric Emergency Medicine, Montreal Children's Hospital-McGill University Health Center, Montreal, QC, Canada; Arnold and Blema Steinberg Centre for Medical Simulation, Montreal, QC, Canada; Centre for Medical Education, McGill University, Canada; Royal College of Physicians and Surgeons of Canada, Canada.
authors.forename: Farhan
authors.initials: F
authors.lastname: Bhanji
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002648:Child; D004501:Education, Medical / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies; D013337:Students, Medical; D055815:Young Adult
keywords: Education; Pediatric Resuscitation; Spaced training