Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

doi:10.5847/wjem.j.1920-8642.2019.02.002

World Journal of Emergency Medicine ›› 2019, Vol. 10 ›› Issue (2): 75-80.doi: 10.5847/wjem.j.1920-8642.2019.02.002

Special Issue: Cardiopulmonary Resuscitation

• Original Articles • Previous Articles Next Articles

Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

Robert D. Willmore¹(), Damjan Veljanoski², Feray Ozdes³, Bethan Stephens⁴, James Mooney⁵, Seamus G. Crumley⁶, Arpan Doshi⁷, Philippa Davies⁷, Shreya Badhrinarayanan⁸, Emily Day⁹, Kristian Tattam¹⁰, April Wilson¹⁰, Nathan Crang¹¹, Lorna Green¹², Craig A. Mounsey¹³, Howell Fu¹³, Joseph Williams¹³, Michelle S. D'souza¹⁴, Dhanya Sebastian¹⁴, Liam A. Mcgiveron¹⁵, Matthew G. Percy¹⁵, James Cohen¹⁶, Imogen J. John¹⁷, Alice Lethbridge¹⁷, Imogen Watkins¹⁸, Omar Amin¹⁹, Mubasher A. Qamar²⁰, John Gerrard Hanrahan²¹, Emily Cramond-Wong²²

¹ Barts Health NHS Trust, London, United Kingdom
² Barts & the London Medical School, Queen Mary University of London, E1 2AT, United Kingdom
³ Norwich Medical School, University of East Anglia, NR4 7TJ, United Kingdom
⁴ Lancaster Medical School, Lancaster University, LA1 4YW, United Kingdom
⁵ School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, BT7 1NN, United Kingdom
⁶ Faculty of Medicine, University of St Andrews, KY16 9AJ, United Kingdom
⁷ Faculty of Medicine, Dentistry and Health, University of Sheffield, S10 2TN, United Kingdom
⁸ Brighton and Sussex University Hospitals NHS Trust, BN2 5BE, United Kingdom
⁹ St George's University of London, SW17 0RE, United Kingdom
¹⁰ University of Liverpool School of Medicine, L3 5PS, United Kingdom
¹¹ University of Exeter medical school, EX4 4QJ, United Kingdom
¹² Faculty of Medicine, University of Southampton, SO17 1BJ, United Kingdom
¹³ Medical Sciences Division, University of Oxford, OX1 3PA, United Kingdom
¹⁴ University of Edinburgh Medical School, EH8 9YL, United Kingdom
¹⁵ Faculty of Medicine, University of Warwick, CV4 7AL, United Kingdom
¹⁶ University College London Medical School, WC1E 6BT, United Kingdom
¹⁷ Cardiff University School of Medicine, CF10 3XQ, United Kingdom
¹⁸ College of Medical and Dental Sciences, University of Birmingham, B15 2TT, United Kingdom
¹⁹ College of Medical, Veterinary and Life Sciences, University of Glasgow, G12 8QQ, United Kingdom
²⁰ Guys, Kings, and St Thomas School of Medicine, King’s College London, WC2R 2LS, United Kingdom
²¹ Faculty of Life Sciences & Medicine, King's College London, WC2R 2LS, United Kingdom
²² Faculty of Health Sciences at the University of Nottingham, NG7 2RD, United Kingdom

Received:2018-12-10 Accepted:2018-08-26 Online:2019-06-15 Published:2019-06-15
Contact: Robert D. Willmore E-mail:robwillmore@doctors.org.uk

Abstract

Abstract:

BACKGROUND: Healthcare professionals have a duty to maintain basic life support (BLS) skills. This study aims to evaluate medical students’ factual knowledge of BLS and the training they receive.
METHODS: A cross-sectional, closed-response questionnaire was distributed to the first- and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent’s previous BLS training, factual knowledge of the BLS algorithm using five multiple choice questions (MCQs), and valuate their desire for further BLS training. Students received 1 point for each correctly identified answer to the 5 MCQ’s.
RESULTS: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent (n=2,999) of students completed a BLS course as part of their undergraduate medical studies. There was a significant difference (P<0.001) in the percentage of the fourth-year students selecting the correct answer in all the MCQ’s compared to the first-year students except in identifying the correct depth of compressions required during CPR (P=0.095). Overall 10.3% (95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ’s on BLS: 9% of the first-year students (n=194) and 12% of the fourth-year students (n=190). On an institutional level the proportion of students answering all MCQ’s correctly ranged from 2% to 54% at different universities. Eighty-one percent of students (n=3,031) wished for more BLS training in their curriculum.
CONCLUSION: Factual knowledge of BLS is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training.

Key words: Emergency Medicine, Basic life support, Medical education, Resuscitation

Robert D. Willmore, Damjan Veljanoski, Feray Ozdes, Bethan Stephens, James Mooney, Seamus G. Crumley, Arpan Doshi, Philippa Davies, Shreya Badhrinarayanan, Emily Day, Kristian Tattam, April Wilson, Nathan Crang, Lorna Green, Craig A. Mounsey, Howell Fu, Joseph Williams, Michelle S. D'souza, Dhanya Sebastian, Liam A. Mcgiveron, Matthew G. Percy, James Cohen, Imogen J. John, Alice Lethbridge, Imogen Watkins, Omar Amin, Mubasher A. Qamar, John Gerrard Hanrahan, Emily Cramond-Wong. Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?[J]. World Journal of Emergency Medicine, 2019, 10(2): 75-80.

Figures/Tables 4

Figure 1.

Table 1

Table 2

Figure 2.

References 20

1	Daya MR, Schmicker RH, Zive DM, Rea TD, Nichol G, Buick JE, et al. Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC). Resuscitation. 2015; 91:108-15. doi: 10.1016/j.resuscitation.2015.02.003 pmid: 25676321
2	WHO. Fact Sheet: 310 - The 10 leading causes of death in the world, 2014.
3	Yasunaga H, Horiguchi H, Tanabe S, Akahane M, Ogawa T, Koike S, et al. Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study. Crit Care. 2010; 14(6):R199.
4	Leary M, Buckler DG, Ikeda DJ, Saraiva DA, Berg RA, Nadkarni VM, et al. The association of layperson characteristics with the quality of simulated cardiopulmonary resuscitation performance. World J Emerg Med. 2017; 8(1):12-8.
5	(UK) RC. Quality standards for cardiopulmonary resuscitation. Secondary Quality standards for cardiopulmonary resuscitation November 2013. .
6	Council GM. Tomorrow’s Doctors Online. 2009. http://www.gmc-uk.org/static/documents/content/Tomorrows_Doctors_1214.pdf (accessed 1st October 2016).
7	Gabbott D, Smith G, Mitchell S, Colquhoun M, Nolan J, Soar J, et al. Cardiopulmonary resuscitation standards for clinical practice and training in the UK. Resuscitation. 2005; 64(1):13-9. doi: 10.1016/j.resuscitation.2004.11.001 pmid: 15629550
8	Kelley K, Clark B, Brown V, Sitzia J. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003; 15(3):261-6.
9	Almesned A, Almeman A, Alakhtar AM, AlAboudi AA, Alotaibi AZ, Al-Ghasham YA, et al. Basic life support knowledge of healthcare students and professionals in the Qassim University. Int J Health Sci (Qassim). 2014; 8(2):141-50.
10	Kila T, Yockopua S. Knowledge of cardiopulmonary resuscitation among doctors at the Port Moresby General Hospital. P N G Med J. 2012; 55(1-4):76-87. pmid: 25338477
11	Roshana S, Kh B, Rm P, Mw S. Basic life support: knowledge and attitude of medical/paramedical professionals. World J Emerg Med. 2012; 3(2):141-5.
12	Abbas A, Bukhari SI, Ahmad F. Knowledge of first aid and basic life support amongst medical students: a comparison between trained and un-trained students. J Pak Med Assoc. 2011; 61(6):613-6. pmid: 22204227
13	Council GM. Clinical placements for medical students. GMC-UK.org: GMC, 2009: 6.
14	Brown TB, Dias JA, Saini D, Shah RC, Cofield SS, Terndrup TE, et al. Relationship between knowledge of cardiopulmonary resuscitation guidelines and performance. Resuscitation. 2006; 69(2):253-61. pmid: 16563601
15	Somaraj V, Shenoy RP, Panchmal GS, Jodalli PS, Sonde L, Karkal R. Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India. World J Emerg Med. 2017; 8(2):131-5.
16	Freund Y, Duchateau FX, Baker EC, Goulet H, Carreira S, Schmidt M, et al. Self-perception of knowledge and confidence in performing basic life support among medical students. Eur J Emerg Med. 2013; 20(3):193-6. pmid: 22735507
17	Idris AH, Guffey D, Pepe PE, Brown SP, Brooks SC, Callaway CW, et al. Chestcompression rates and survival following out-of-hospital cardiac arrest. Crit Care Med. 2015; 43(4):840-8.
18	Chojnacki P, Ilieva R, Kołodziej A, Królikowska A, Lipka J, Ruta J. Knowledge of BLS and AED resuscitation algorithm amongst medical students--preliminary results. Anestezjol Intens Ter. 2011; 43(1):29-32. pmid: 21786527
19	Reddy S, Doshi D, Reddy P, Kulkarni S, Reddy S. Awareness of basic life support among staff and students in a dental school. J Contemp Dent Pract. 2013; 14(3):511-7.
20	Suzuki A, Kurosawa A, Sasakawa T, Tampo A, Yasuda S, Iwasaki H. OSCE improves medical student’s BLSknowledge, but its long-term memory is not well maintained. Masui. 2006; 55(11):1423-7. pmid: 17131900

Parameters	The first-year students	The fourth-year students	All students
Responses	2,160	1,572	3,732
Response rate	48%	38%	43%
Completed BLS training external to curriculum	69% (n=1,481)	67% (n=1,046)	68% (n=2,527)
Mean duration of external BLS training (days)	2.38 (95% CI 2.37 to 2.39)	2.57 (95% CI 2.46 to 2.68)	2.46 (95% CI 2.39 to 2.53)
Competed BLS training as part of medical school curriculum	68% (n=1,463)	98% (n=1,536)	80% (n=2,999)
Worked in a clinical enviroment in the previous 2 months to survey	71% (n=1,541)	98% (n=1,540)	83% (n=3,081)
Mean number of university BLS courses taken	0.68 (95% CI 0.48 to 0.88)	1.77 (95% CI 1.72 to 1.82)	1.14 (95% CI 1.11 to 1.17)

Parameters	The first-year students	The fourth-year students	χ(1)	All students
Mean MCQ Score	2.70 (95% CI 2.64 to 2.76)	3.35 (95% CI 3.30 to 3.40)	297.036 P<0.001	2.97 (95% CI 2.93 to 3.01)
Correctly answered questions
Assess airway first	48% (n=1,026)	69% (n=1,086)	172.545 P<0.001	57% (n=2,112)
Number of compressions	80% (n=1,726)	88% (n=1,387)	45.568 P<0.001	83% (n=3,113)
Number of ventilations	80% (n=1,727)	97% (n=1,526)	238.364 P<0.001	87% (n=3,253)
Compressions : ventilations ratio	73% (n=1,584)	87% (n=1,366)	101.039 P<0.001	79% (n=2,950)
Rate of compressions	40% (n=871)	57% (n=889)	96.153 P<0.001	47% (n=1,760)
Depth of compressions	22% (n=472)	24% (n=380)	2.782 P=0.095	22% (n=852)
All MCQ’s correct	9% (n=194)	12% (n=190)	9.503 P=0.002	10% (n=384)

[1]	Janett Kreutziger, Philip Puchner, Stefan Schmid, Wolfgang Mayer, Harald Prossliner, Wolfgang Lederer. Accuracy of training blood volume quantification using a visual estimation tool [J]. World Journal of Emergency Medicine, 2021, 12(3): 174-178.
[2]	Alexei Birkun, Fatima Trunkwala, Adhish Gautam, Miriam Okoroanyanwu, Adesokan Oyewumi. Availability of basic life support courses for the general populations in India, Nigeria and the United Kingdom: An internet-based analysis [J]. World Journal of Emergency Medicine, 2020, 11(3): 133-139.
[3]	Jung Wan Kim, Jin Woong Lee, Seung Ryu, Jung Soo Park, InSool Yoo, Yong Chul Cho, Hong Joon Ahn. Changes in peak inspiratory flow rate and peak airway pressure with endotracheal tube size during chest compression [J]. World Journal of Emergency Medicine, 2020, 11(2): 97-101.
[4]	Samantha Shwe, Lauren Witchey, Shadi Lahham, Ethan Kunstadt, Inna Shniter, John C. Fox. Retrospective analysis of eFAST ultrasounds performed on trauma activations at an academic level-1 trauma center [J]. World Journal of Emergency Medicine, 2020, 11(1): 12-17.
[5]	Elaine Situ-LaCasse, Helpees Guirguis, Lucas Friedman, Asad E. Patanwala, Seth E. Cohen, Srikar Adhikari. Can emergency physicians perform extended compression ultrasound for the diagnosis of lower extremity deep vein thrombosis? [J]. World Journal of Emergency Medicine, 2019, 10(4): 205-209.
[6]	Ye-cheng Liu, Yan-meng Qi, Hui Zhang, Joseph Walline, Hua-dong Zhu. A survey of ventilation strategies during cardiopulmonary resuscitation [J]. World Journal of Emergency Medicine, 2019, 10(4): 222-227.
[7]	Sagar Shah, Steven Tohmasi, Emily Frisch, Amanda Anderson, Roy Almog, Shadi Lahham, Roland Bingisser, John C. Fox. A comparison of simulation versus didactics for teaching ultrasound to Swiss medical students [J]. World Journal of Emergency Medicine, 2019, 10(3): 169-176.
[8]	Israel Olatunji Gabriel, Joel O. Aluko. Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students [J]. World Journal of Emergency Medicine, 2019, 10(2): 81-87.
[9]	Amairah Fahad Aloushan, Faisal Abdullah Almoaiqel, Raid Naysh Alghamdi, Fatmah Ismail Alnahari, Abdulaziz Fahad Aldosari, Nazish Masud, Nawfal Abdullah Aljerian. Assessment of knowledge, attitude and practice regarding oxygen therapy at emergency departments in Riyadh in 2017: A cross-sectional study [J]. World Journal of Emergency Medicine, 2019, 10(2): 88-93.
[10]	Genevieve Mazza, Carina Mireles Romo, Marlene Torres, Ali Duffens, Annasha Vyas, Katherine Moran, Joshua Livingston, Savannah Gonzales, Shadi Lahham, Inna Shniter, Maxwell Thompson, John Christian Fox. Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama [J]. World Journal of Emergency Medicine, 2019, 10(1): 46-50.
[11]	Rakesh Gupta, Isaac Siemens, Sam Campbell. The use of outcome feedback by emergency medicine physicians: Results of a physician survey [J]. World Journal of Emergency Medicine, 2019, 10(1): 14-18.
[12]	Karun Shrestha, Prakriti Subedi, Oshna Pandey, Likhita Shakya, Kailash Chhetri, Darlene R. House. Estimating the weight of children in Nepal by Broselow, PAWPER XL and Mercy method [J]. World Journal of Emergency Medicine, 2018, 9(4): 276-281.
[13]	Shervin Farahmand, Masoume Vafaeian, Elnaz Vahidi, Atefeh Abdollahi, Shahram Bagheri-Hariri, Ahmad Reza Dehpour. Comparison of exogenous melatonin versus placebo on sleep efficiency in emergency medicine residents working night shifts: A randomized trial [J]. World Journal of Emergency Medicine, 2018, 9(4): 282-287.
[14]	Alexei Birkun, Yekaterina Kosova. Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea [J]. World Journal of Emergency Medicine, 2018, 9(4): 237-248.
[15]	Alexei Birkun, Maksim Glotov, Herman Franklin Ndjamen, Esther Alaiye, Temidara Adeleke, Sergey Samarin. Pre-recorded instructional audio vs. dispatchers’ conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study [J]. World Journal of Emergency Medicine, 2018, 9(3): 165-171.

Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 20

Related Articles 15

Recommended Articles

Comments