title: Real-time visual feedback during training improves laypersons' CPR quality: a randomized controlled manikin study.
abstract: OBJECTIVE
  The chances of surviving an out-of-hospital cardiac arrest depend on early and high-quality cardiopulmonary resuscitation (CPR). Our aim is to verify whether the use of feedback devices during laypersons' CPR training improves chest compression quality.
  
  
  METHODS
  Laypersons totalling 450 participating in Basic Life Support and Automated External Defibrillation (BLS/AED) courses were randomly divided into three groups: group No Feedback (NF) attended a course without any feedback, group Short Feedback (SF) a course with 1-minute training with real-time visual feedback, and group Long Feedback (LF) a course with 10-minute training with real-time visual feedback. At the end of each course, we recorded 1 minute of compression-only CPR. The primary end point was the difference in the percentage of compressions performed with correct depth.
  
  
  RESULTS
  There was a significant improvement in the percentage of compressions with correct depth in the groups receiving feedback compared to the other (NF v. LF, p=0.022; NF v. SF, p=0.005). This improvement was also present in the percentage of compressions with a complete chest recoil (71.7% in NF, 86.6% in SF, and 88.8% in LF; p<0.001), compressions with the correct hand position (93.2% in NF, 98.2% in SF, and 99.3% in LF; p<0.001), and in the Total CPR Score (79.4% in NF, 90.2% in SF, and 92.5% in LF; p<0.001). There were no significant differences for all of the parameters between group SF and group LF.
  
  
  CONCLUSIONS
  Real-time visual feedback improves laypersons' CPR quality, and we suggest its use in every BLS/AED course for laypersons because it can help achieve the goals emphasized by the International Liaison Committee on Resuscitation recommendations.
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Enrico
authors.identifier: http://orcid.org/0000-0002-6360-224X
authors.initials: E
authors.lastname: Baldi
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cornara
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Contri
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Epis
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Fina
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Zelaschi
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Dossena
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Fichtner
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Tonani
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Di Maggio
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Zambaiti
authors.affiliation: *Pavia nel Cuore,IRC-Comunità Training Center,Pavia,Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Somaschini
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D056228:Feedback, Sensory / Q000502:physiology*; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008348:Manikins; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D019984:Quality Indicators, Health Care; D013997:Time Factors
keywords: cardiac arrest; cardiopulmonary resuscitation; education; feedback devices; first responders; laypersons; training