title: e-Learning in Advanced Life Support-What factors influence assessment outcome?
abstract: To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect.
  
  
  
  Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed.
  
  
  
  The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome.
  
  
  
  Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs.
authors.affiliation: Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK. Electronic address: cj.thorne@doctors.org.uk.
authors.forename: C J
authors.initials: CJ
authors.lastname: Thorne
authors.affiliation: Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Calderdale & Huddersfield NHS Foundation Trust, Halifax HX3 0PW, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Lockey
authors.affiliation: University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK.
authors.forename: P K
authors.initials: PK
authors.lastname: Kimani
authors.affiliation: Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; Royal College of Physicians, London NW1 4LE, UK.
authors.forename: I
authors.initials: I
authors.lastname: Bullock
authors.affiliation: Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hampshire
authors.affiliation: Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK.
authors.forename: S
authors.initials: S
authors.lastname: Begum-Ali
authors.affiliation: Department of Critical Care Medicine, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; Resuscitation Council (UK), Tavistock House North, Tavistock Square, London WC1H 9HR, UK; University of Warwick, Warwick Medical School, Warwick CV4 7AL, UK.
authors.forename: G D
authors.initials: GD
authors.lastname: Perkins
mesh_terms: D022561:Advanced Cardiac Life Support / Q000193:education*; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011795:Surveys and Questionnaires
keywords: ALS; Advanced Life Support; Assessment; Education; e-Learning