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Evaluating the effectiveness of life-support courses

A review of the literature

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Tijdschrift voor Kindergeneeskunde

Summary

Aim: Life-support courses (LSCs) are widely advocated, very popular and increasing in number but their effectiveness has been little studied. This paper presents a qualitative review of the evaluation literature of LSCs over the last fifteen years.

Method: Kirkpatrick’s hierarchy of the effect of educational interventions was applied as a framework to summarize the available literature. This hierarchy distinguishes four effect levels: (I) reactions in the learners, (II) learned knowledge and skills, (III) transfer: observed change in actual behaviour and (IV) outcome effects in patient care as a result of behavioural change. Publications on the evaluation of LSCs for doctors were reviewed and the results were categorized in this framework.

Results: Most literature was qualitative in nature, and did not permit quantitative conclusions on effects. On level I (reaction) generally positive results are reported. A learning effect (level II) is often found, but the retention of acquired skills has been less well studied and seems to be generally poor. Studies on transfer or behavioural change (level III) show mixed results. The effect of LSCs on patient outcome has not adequately been studied.

Conclusion: While life-support courses are probably a necessary and valued approach to the acquisition of life-support skills in doctors, enhancement of the long term retention of those skills needs further attention. Educational research tools must be developed to investigate better behavioural change leading to improved patient outcome, which can be considered the most important effects of LSCs.

Samenvatting

Korte bijscholingen op het gebied van spoedeisende geneeskunde zijn in de afgelopen decennia onder de generieke naam life-support cursussen (LSC’s) in Nederland toenemend aanbevolen en populair geworden. Hun effectiviteit is echter weinig onderzocht. In dit artikel wordt een evaluatie van LSC’s voor artsen gepresenteerd. Het model van Kirkpatrick wordt als raamwerk gebruikt om de literatuur te rangschikken onder de niveaus van reactie, leren, gedragsverandering in de praktijk (transfer) en resultaat hiervan in de patiëntenzorg. Het merendeel van de literatuur heeft een kwalitatief karakter en kwantitatieve conclusies zijn daarom niet mogelijk. LSC’s leiden in het algemeen tot een positieve reactie onder de deelnemers. Leren vindt vaak plaats, maar het retentie- interval blijkt dikwijls heel kort. Onderzoek naar gedragsverandering laat wisselende resultaten zien. Het effect van LSC’s op de kwaliteit van de patiëntenzorg is vooralsnog inadequaat onderzocht. Geconcludeerd kan worden dat LSC’s een noodzakelijke en hooggewaardeerde methode vormen om kennis en vaardigheden te verwerven in de spoedeisende geneeskunde. Meer aandacht dient echter besteed te worden aan het probleem van retentie op de langere termijn. Er moeten betere onderzoeksinstrumenten ontwikkeld worden om de effecten van LSC’s op gedragsverandering en patiëntenzorg in kaart te brengen. Het is uiteindelijk op deze niveaus dat de maatschappelijke waarde van deze cursussen zichtbaar moet worden.

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    N. M. Turner

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  1. N. M. Turner
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  2. Th. J. ten Cate
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Correspondence to N. M. Turner.

Additional information

Dr. N.M. Turner, Consultant Paediatric Anaesthesiologist, Department of Perioperative Care and Emergency Medicine, Wihelmina Children’s Hospital, prof. dr. Th.J. ten Cate, Professor of Medical Education and Director of the Centre for Research and Development of Education, University Medical Centre, Utrecht.

Address for correspondence: Nigel Turner, Divisie DP&S, Afdeling Pelikaan, Wilhelmina Kinderziekenhuis, UMC Utrecht, Postbus 85090, 3508 AB Utrecht,

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Turner, N.M., ten Cate, T.J. Evaluating the effectiveness of life-support courses. KIND 76, 304–310 (2008). https://doi.org/10.1007/BF03078224

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