title: Effects of two retraining strategies on nursing students' acquisition and retention of BLS/AED skills: A cluster randomised trial.
abstract: OBJECTIVE
  To determine and compare the effects of two different retraining strategies on nursing students' acquisition and retention of BLS/AED skills.
  
  
  METHODS
  Nursing students (N = 177) from two European universities were randomly assigned to either an instructor-directed (IDG) or a student-directed (SDG) 4-h retraining session in BLS/AED. A multiple-choice questionnaire, the Cardiff Test, Laerdal SkillReporter(®) software and a self-efficacy scale were used to assess students' overall competency (knowledge, psychomotor skills and self-efficacy) in BLS/AED at pre-test, post-test and 3-month retention-test. GEE, chi-squared and McNemar tests were performed to examine statistical differences amongst groups across time.
  
  
  RESULTS
  There was a significant increase in the proportion of students who achieved competency for all variables measuring knowledge, psychomotor skills and self-efficacy between pre-test and post-test in both groups (all p-values<0.05). However, at post-test, significantly more students in the SDG achieved overall BLS/AED competency when compared to IDG. In terms of retention at 3 months, success rates of students within the IDG deteriorated significantly for all variables except ≥ 70% of chest compressions with correct hand position (p-value = 0.12). Conversely, the proportion of students who achieved competency within the SDG only decreased significantly in 'mean no flow-time ≤ 5s' (p-value = 0.02). Furthermore, differences between groups' success rates at retention-test also proved to be significantly different for all variables measured (all p-values < 0.05).
  
  
  CONCLUSIONS
  This study demonstrated that using a student-directed strategy to retrain BLS/AED skills has resulted in a higher proportion of nursing students achieving and retaining competency in BLS/AED at three months when compared to an instructor-directed strategy.
authors.affiliation: Associate Lecturer in Clinical Skills. Adult, Child and Midwifery Department. School of Health and Education. Middlesex University. Hendon Campus. The Burroughs, NW4 4BT, London, United Kingdom. Electronic address: J.Hernandez-Padilla@mdx.ac.uk.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Hernández-Padilla
authors.affiliation: Senior Lecturer in Resuscitation. Adult, Child and Midwifery Department. School of Health and Education. Middlesex University. Postal address: The Burroughs, NW4 4BT, Hendon, London, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Suthers
authors.affiliation: Senior Lecturer. Nursing, Physiotherapy and Medicine Department. Faculty of Education Sciences, Nursing and Physiotherapy. University of Almeria. Spain. Postal address: Universidad de Almería. Edificio de Ciencias de la Salud. Carretera de Sacramento s/n. Almería. CP: 04120. Spain; Associate Researcher. Faculty of Health Sciences. Universidad Autónoma de Chile. Temuco, Chile.
authors.forename: José
authors.initials: J
authors.lastname: Granero-Molina
authors.affiliation: Senior Lecturer. Nursing, Physiotherapy and Medicine Department. Faculty of Education Sciences, Nursing and Physiotherapy. University of Almeria. Spain. Postal address: Universidad de Almería. Edificio de Ciencias de la Salud. Carretera de Sacramento s/n. Almería. CP: 04120. Spain; Associate Researcher. Faculty of Health Sciences. Universidad Autónoma de Chile. Temuco, Chile.
authors.forename: Cayetano
authors.initials: C
authors.lastname: Fernández-Sola
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000295:instrumentation / Q000379:methods; D003194:Computer-Assisted Instruction / Q000379:methods*; D047548:Defibrillators; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017145:Models, Educational; D020380:Needs Assessment; D015402:Nursing Education Research; D011597:Psychomotor Performance; D020377:Self Efficacy; D013030:Spain; D013338:Students, Nursing / Q000523:psychology; D013647:Task Performance and Analysis; D006113:United Kingdom
keywords: Automated external defibrillator; BLS; CPR; Knowledge; Motor skills; Nursing students; Self-efficacy; Teaching methods