Resus Today Autumn 2021

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FEATURE THE OPPORTUNITIES OF BLS SELF-DIRECTED LEARNING (SDL) IN A POST COVID WORLD Brayden Online supporting self-directed learning RESUSCITATION TODAY - AUTUMN 2021 The recent Covid-19 pandemic and the resulting backlog of Basic Life Support (BLS) training is reportedly putting increasing pressure on training departments that are struggling to meet their BLS certification compliance targets. This article looks at the Brayden Online system and how through close collaboration with resuscitation educators and instructors, Self Directed Learning (SDL) BLS training is now enabling high quality training and assessment for a high throughput of trainees that is both cost and time efficient. Self-directed learning is not a new pedagogical approach in healthcare education having successfully been employed in a wide variety of training programs across multiple clinical disciplines and related curricula 1,2 . However, the teaching of Basic Life Support through SDL has presented some unique challenges to the clinical community 3 . It has been suggested that theoretical eLearning programs combined with practical CPR skills training have not yet convincingly proven to be consistent quality training experiences, whilst subscription costs and reduced management controls for the instructor in some systems have also been seen as prohibitive factors. Commenting on the issues of integrating SDL systems into BLS training, Kevin Mackie, Lead for Education at Resuscitation Council UK said, ‘We have steered away from SDL training through sole use of eLearning because the muscle memory of practicing CPR skills on a manikin is actually much more important than knowing the theory. The approach we are looking at here is blended learning, which must include a practical, hands-on component 4,5,6 . Instructors can direct their trainees to extensive eLearning resources to cover BLS theory; resources which are now highly engaging and immersive e.g. Healthcare Education England, E-Learning for Healthcare (eLFH). Once completed, trainees can then practice on a manikin at a time convenient to them. A good SDL system gives the student easy to interpret, real-time feedback on their performance allowing them to make instant improvements to the quality of their CPR 7,8 . They can then progress to an assessment that provides full debrief metrics, if successful, this sends a certificate direct to their email and the organisation’s LMS (Learning Management System) - all in one simple, streamlined process.’ Objective versus subjective assessment ‘One of the challenges of previous SDL systems has been the averaging out of metrics, which gave trainees anomalous scores across the different systems’, continued Mackie. ‘Working with Brayden on this aspect of the system, we know the metrics have been inputted by UK and Global professionals, where every single element of CPR has been looked at and weighted accordingly – it’s the professional standard of expected performance 9 .’ ‘Objective and repeatable assessment is I feel pivotal to ensure consistent, high standards of CPR from all healthcare staff required to initiate BLS in cardiac arrests. Recent research 10 found that subjective assessment has been shown to be inconsistent when compared with objective assessment. Resuscitation trainers will be all too familiar with the pressures of progressing large cohorts of BLS trainees in classroom settings, where time and logistical constraints have meant that some have been passed as ‘good enough’ rather than attaining the higher standards we would all wish. The 24/7, high frequency, low fidelity nature of this system’s set up, enabling trainees to practice as their own schedules allow to reach the standards we set, then be assessed and certified accordingly, makes a compelling case for SDL BLS training, not just as a solution for present training challenges in Covid times but as the standard training approach for the future 11 .’ Integration and instructor autonomy within a hospital’s Learning Management System (LMS) – The Genk Experience Sylvain Haekens, Head of Training and Development at Ziekenhuis Oost-Limburg, Genk in Belgium looked at SDL BLS training solutions six years ago with two primary needs in mind; a system that could be integrated into the hospital’s new LMS and a training program that could provide objective assessment to ensure high standards of CPR across the hospital. ‘The hospital has approximately 4,000 employees and my department is responsible for all education and development programs for both doctors and nurses. I am constantly looking at opportunities to maximise both cost and time efficiencies in our programs, while maintaining the highest standards in both educational delivery and outcomes,’ said Haekens. ‘The Brayden Online system caught my attention because it had the 6
FEATURE operational flexibility I needed. The hospital’s LMS system organises the scheduling of our trainees, who go to our CPR room where they can learn or refresh their skills on the Brayden manikins (adult and/ or infant), take the assessment and a certificate is automatically sent to their emails at the same time as updating our LMS system. Our hospital LMS system also automatically sends staff renewal invites within the time period we set. This automatic processing of staff records through the integration of the Brayden Online system has significantly reduced the administrative workload of our BLS training program saving the department both time and money. This has allowed us to divert resources to our more instructor intensive ALS programs. When the parameters change for CPR performance, we can of course update those markers on the Brayden system, but otherwise, our BLS program virtually runs itself and ensures demonstrable high standards of CPR competence at both an individual and organisational level.’ Introducing SDL has reduced the need for us to do face to face teaching. The system has been easy to use and the staff like the SDL method of practicing and taking their test. It has freed my staff up for other things such as our ILS and ALS courses, which are also down on compliance. We are a large NHS Hospital Trust with up to 9,000 staff. Since introducing Brayden Online, we have recovered our compliance rating of 85% far quicker than we could have done with our face-to-face program. At the height of Covid we had dropped down to 62%, so the Brayden Online system has been really beneficial.’ Catching up to pre-covid levels of BLS compliance through self-assessment The St. George’s Teaching Hospital NHS Foundation Trust experience Jeannie Walls, Lead Resuscitation Officer at St. George’s Hospital highlighted the significant impact of the pandemic on BLS compliance targets in hospitals across the country. ‘We had a huge reduction in compliance over Covid due to having to stop face-to-face sessions during the peak wave periods. When we could resume, our class sizes were reduced drastically in order to enable social distancing and our training team was reduced by half with staff sent to work in the ITU. We had to find other solutions. We decided on compression only CPR to reduce the risk of having two people working so closely together. In a hospital setting, the most important BLS learning objective is early hands-on compressions as full resuscitation support will never be more than three minutes away. We introduced the eLFH Level 2 online module, so staff could cover the theoretical learning before attending the practical sessions in our self-assessment pod on the Brayden Online manikin system. Staff were noticeably more fully prepared prior to their online self-assessment. Greater efficiencies in BLS training that go beyond the classroom The District General Hospital Experience – Darent Valley Hospital Rob Morrison, Resuscitation Officer at Darent Valley Hospital cited similar challenges to St. George’s and comments on how quickly he has been able to embed SDL into the hospital’s BLS training program. ‘It was the Covid situation that triggered the shift in our training. I was not convinced about this type of training before, and it took me to use the system to become convinced. I was told I had to stop mandatory training for three months, which resulted in a significant backlog. I was really struggling but Brayden’s SDL system has resolved most of my problems for BLS. It’s easy- to- use and so the staff have been very receptive to it. We now use the Brayden Online system for infant and paediatric CPR certification as well as adult 12 . I can quickly identify RESUSCITATION TODAY - AUTUMN 2021 7
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Page 3 and 4: CONTENTS CONTENTS Resuscitation Tod
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Page 19: NEWS How to tackle the nursing cris

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