CPR TRAINING WITHOUT AN INSTRUCTOR - DEVELOPMENT AND EVALUATION OF A VIDEO SELF-INSTRUCTIONAL SYSTEM FOR EFFECTIVE PERFORMANCE OF CARDIOPULMONARY-RESUSCITATION

Traditional classroom-based instruction of cardiopulmonary resuscitati on (CPR) has failed to achieve desired rates of bystander CPR. Video s elf-instruction (VSI) is a more accessible alternative to traditional classroom instruction (TRAD), and it achieves better CPR skill perform ance. VSI employs a 34-min training tape and an inexpensive manikin. V SI combines simplified and reordered content focusing on the delivery of one-rescuer CPR with the 'practice-as-you-watch' approach of an exe rcise video. Performance of CPR skills immediately following VSI was c ompared to performance immediately following TRAD using an instrumente d manikin, a valid and reliable skill checklist, and an overall compet ency rating. Compared with TRAD subjects, VSI subjects performed more compressions correctly (P < 0.001), more ventilations correctly (P < 0 .001), and more assessment and sequence skills correctly (P < 0.001). TRAD subjects delivered twice as many compressions that were too shall ow, and underinflated the lungs twice as often. VSI subjects were rate d 'competent' or better 80.0% of the time, compared with TRAD subjects , who achieved this rating only 45.1% of the time (P < 0.001). TRAD su bjects were rated to be 'not competent' in performing CPR nearly 10 ti mes more often than VSI subjects (P < 0.001). Subjects 40 years of age and older performed better after VSI than after TRAD. Superior skill performance among subjects exposed to VSI persisted 60 days following training. VSI has the potential to reach individuals unlikely to parti cipate in TRAD classes because of its greater convenience, lower cost, and training in about 0.50 h compared with 3-4 h for TRAD classes. (C ) 1997 Elsevier Science Ireland Ltd.