title: Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial.
abstract: BACKGROUND
  E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches.
  
  
  OBJECTIVE
  This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment.
  
  
  METHODS
  A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements.
  
  
  RESULTS
  Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group.
  
  
  CONCLUSIONS
  Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.
authors.affiliation: Center for Pediatrics and Adolescent Medicine, Department of General Pediatrics, University Hospital Heidelberg, Heidelberg, Germany. ronny.lehmann@med.uni-heidelberg.de.
authors.forename: Ronny
authors.identifier: http://orcid.org/0000-0003-0976-4384
authors.initials: R
authors.lastname: Lehmann
authors.forename: Christiane
authors.identifier: http://orcid.org/0000-0003-2908-4714
authors.initials: C
authors.lastname: Thiessen
authors.forename: Barbara
authors.identifier: http://orcid.org/0000-0002-7428-2499
authors.initials: B
authors.lastname: Frick
authors.forename: Hans Martin
authors.identifier: http://orcid.org/0000-0001-7888-9434
authors.initials: HM
authors.lastname: Bosse
authors.forename: Christoph
authors.identifier: http://orcid.org/0000-0003-2839-178X
authors.initials: C
authors.lastname: Nikendei
authors.forename: Georg Friedrich
authors.identifier: http://orcid.org/0000-0002-6593-896X
authors.initials: GF
authors.lastname: Hoffmann
authors.forename: Burkhard
authors.identifier: http://orcid.org/0000-0002-6598-6910
authors.initials: B
authors.lastname: Tönshoff
authors.forename: Sören
authors.identifier: http://orcid.org/0000-0001-6116-9633
authors.initials: S
authors.lastname: Huwendiek
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education*; D013337:Students, Medical; D055815:Young Adult
keywords: blended learning; pediatric basic life support; performance; simulation; virtual patients