Animation and interactivity facilitate acquisition of pediatric life support skills: a randomized controlled trial using virtual patients versus video instruction

Ronny Lehmann; Thomas Lutz; Astrid Helling-Bakki; Sebastian Kummer; Sören Huwendiek; Hans Martin Bosse

doi:10.1186/s12909-018-1442-5

Animation and interactivity facilitate acquisition of pediatric life support skills: a randomized controlled trial using virtual patients versus video instruction

BMC Med Educ. 2019 Jan 5;19(1):7. doi: 10.1186/s12909-018-1442-5.

Authors

Ronny Lehmann¹, Thomas Lutz², Astrid Helling-Bakki², Sebastian Kummer³, Sören Huwendiek⁴, Hans Martin Bosse³

Affiliations

¹ Department of General Pediatrics, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany. ronny.lehmann@med.uni-heidelberg.de.
² Department of General Pediatrics, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
³ Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
⁴ University of Bern, Medical Faculty, Institute for Medical Education, Mittelstrasse 43, 3012, Bern, Switzerland.

Abstract

Background: Several promising studies suggest a positive impact of interactive and media-enriched e-learning resources such as virtual patients (VP) on skill acquisition in pediatric basic life support (PBLS). This study investigates which immanent VP components account for this effect.

Methods: N = 103 medical students in their 5th year were assigned to one of three groups: a video group prepared with self-instructional videos on PBLS (N = 37); an animation-enriched VP group with VP containing interactive questions (N = 35), static and animated media, and a static VP group with VP containing interactive questions and only static media (N = 31). Subsequent PBLS demonstrations were video-documented and scored for adherence to guideline-based algorithm, temporal demands (such as correct pace of rescue breaths and chest compressions), and quality of procedural steps (e.g., correct head positioning), as well as overall competency by two group-blinded, independent pediatricians.

Results: Groups did not differ with regard to adherence to correct algorithm (88.7 ± 10.3, 93.3 ± 6.7 and 90.3 ± 10.5, respectively). Self-instruction with animated media - through videos or animation-enriched VP - resulted in a better adherence to temporal demands, as compared with training with static VP (64.5 ± 26.3 and 50.7 ± 25.7, respectively, vs. 23.8 ± 21.0). Procedural quality by the video group was slightly inferior compared with the animation-enriched VP group (79.5 ± 12.3 vs. 82.0 ± 11.9), and distinct inferior in overall 'competent' ratings (43.2% vs. 65.7%). The static VP group performed considerably most poorly of all three groups (temporal adherence 73.2 ± 11.9 and 19.4% 'competent' ratings).

Conclusions: VP can feasibly enhance PBLS skill acquisition. Thoughtful design of animations and interactivity of the VP further improves such skill acquisition, both in quality of performance and in adherence to temporal demands.

Keywords: Blended learning; Pediatric basic life support; Performance rating; Video instruction; Virtual patients.

Publication types

Randomized Controlled Trial

MeSH terms

Cardiopulmonary Resuscitation / education*
Clinical Competence
Computer-Assisted Instruction / methods*
Female
Humans
Male
Manikins*
Patient Simulation
Pediatrics / education*
Students, Medical*
Video Recording / methods