title: Teaching basic life support with an automated external defibrillator using the two-stage or the four-stage teaching technique.
abstract: BACKGROUND
  Laypersons often hesitate to perform basic life support (BLS) and use an automated external defibrillator (AED) because of self-perceived lack of knowledge and skills. Training may reduce the barrier to intervene. Reduced training time and costs may allow training of more laypersons. The aim of this study was to compare BLS/AED skills' acquisition and self-evaluated BLS/AED skills after instructor-led training with a two-stage versus a four-stage teaching technique.
  
  
  METHODS
  Laypersons were randomized to either two-stage or four-stage teaching technique courses. Immediately after training, the participants were tested in a simulated cardiac arrest scenario to assess their BLS/AED skills. Skills were assessed using the European Resuscitation Council BLS/AED assessment form. The primary endpoint was passing the test (17 of 17 skills adequately performed). A prespecified noninferiority margin of 20% was used.
  
  
  RESULTS
  The two-stage teaching technique (n=72, pass rate 57%) was noninferior to the four-stage technique (n=70, pass rate 59%), with a difference in pass rates of -2%; 95% confidence interval: -18 to 15%. Neither were there significant differences between the two-stage and four-stage groups in the chest compression rate (114±12 vs. 115±14/min), chest compression depth (47±9 vs. 48±9 mm) and number of sufficient rescue breaths between compression cycles (1.7±0.5 vs. 1.6±0.7). In both groups, all participants believed that their training had improved their skills.
  
  
  CONCLUSIONS
  Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.
authors.affiliation: Research Center for Emergency Medicine.|Departments of Emergency.
authors.forename: Katrine
authors.initials: K
authors.lastname: Bjørnshave
authors.affiliation: Research Center for Emergency Medicine.
authors.forename: Lise Q
authors.initials: LQ
authors.lastname: Krogh
authors.affiliation: Research Center for Emergency Medicine.|Respiratory Diseases and Allergy.
authors.forename: Svend B
authors.initials: SB
authors.lastname: Hansen
authors.affiliation: Research Center for Emergency Medicine.
authors.forename: Mette A
authors.initials: MA
authors.lastname: Nebsbjerg
authors.affiliation: Cardiology, Aarhus University Hospital.|Institute of Clinical Medicine, Aarhus University, Aarhus.
authors.forename: Troels
authors.initials: T
authors.lastname: Thim
authors.affiliation: Research Center for Emergency Medicine.|Institute of Clinical Medicine, Aarhus University, Aarhus.|Department of Internal Medicine, Regional Hospital of Randers, Randers, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Løfgren
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods; D003150:Community Health Workers / Q000193:education; D047548:Defibrillators / Q000706:statistics & numerical data*; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006266:Health Education / Q000379:methods*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D013647:Task Performance and Analysis