Practice of Motor Skills in Nursing: CPR

Quantitative Article

Background

The objective of this paper is to select a qualitative research article that is nursing based and that will be useful in future nursing practice.  The article, “Deliberate Practice of Motor Skills in Nursing Education: CPR as Exemplar” by Oermann et al. (2011), explores the effects of strict practice to retain proper skills of cardiopulmonary resuscitation (CPR) among nursing students.  This study investigates the difference in nursing students who have consistent practice of CPR skills and those that only attend an initial CPR training (Oermann et al., 2011).

Research Question and Hypothesis

The authors suggest that CPR skills are quickly lost after the initial training if the skills are not used.  Students who practice CPR six minutes a month for one year will perform better than those who take only the initial training with no follow up practice sessions.  Life-saving and high-use skills need practice to improve their performance and develop expertise (Oermann et al., 2011).

Review of the Literature

This research confirmed prior research that had been taken.  Repetitive practice and feedback will allow students to perform their skills more accurately.  The skills will become automatic and will be done without thinking about them.  The proper feedback will guide the student to perform and adjust their skills until they become consistent (Oermann et al., 2011).

Methods

Internal, External Validity and Research Design

This research article follows a quantitative approach with a randomized control trial.  Six-hundred and six nursing students from 10 different nursing schools in the United States participated in the study (Oermann et al., 2011).  All the students attended an initial CPR training and practiced their CPR skills on a Resusci Anne adult manikin.   The students are then placed in one of two groups which are randomly selected to either the intervention or control group.  The intervention group participates in a short six-minute practice session with a voice advisory manikin (VAM) one time a month for one year. The control group did not receive additional training after the initial CPR class.  All of the participants returned to the nursing school laboratory where they received an envelope which indicated if there were to be reassessed on their skills or continue on in the study.  Each school that participated in the study had site coordinators that implemented the study per protocol.  They did not teach the students directly; they were guided by using the VAM.  Once a student was reassessed, they are no longer needed in the study since the reassessment is considered practicing (Oermann et al., 2011).

Sampling

The intervention group and the control group are predominantly females, with only 16% being males.  The mean age of the nursing students is 28.4 years old. The study states that a few students had previously practiced CPR No other differences were noted between the two groups (Oermann et al., 2011).

Legal-Ethical Issues

The Institutional Review Board of the principal investigator’s university approved the research study.  This study was considered a multi-site study to gain extensive information on a topic that has limited research.  Each student provided written consent to participate. The VAM made the instruction free of bias (Oermann et al., 2011).

Data Collection Methods and Procedures

The intervention group practiced adult CPR for six minutes per month for one year. They performed two minutes of compressions, two minutes of ventilations, followed by two minutes of CPR. The VAM provides feedback at the time of practice. Notifying the students in the compression depth and breaths are adequate.  Data from the reassessment was collected at 3,6,9, and 12 months (Oermann et al., 2011).

Reliability and Validity

The research study follows the American Heart Association (AHA) 2005 guidelines.  Which states the proper depth for compressions and the adequate volume for ventilations.  Using the VAM and no other form of instruction gave the study consistency.  The VAM was able to measure the volume of ventilation and depth of compressions to provide consistency in collecting data from all the universities in the study (Oermann et al., 2011).

Data Analysis

Linear mixed models were used to document both the intervention and control group during the initial BLS training and reassessments.  They were compared at the reassessment time using the student’s baseline from the initial training (Oermann et al., 2011).

Conclusions, Implications, and Recommendations

The research indicated that at the end of the one-year study the control group compressed more times than the control group, but the depth of the compressions was considerably less.  The control group who had practiced six minutes per month with the VAM improvement in their skills.  The reassessment of ventilation skills showed that the intervention group maintained their performance.  Ventilation skills in the control group significantly decreased over the one-year time frame.  Students that practice their CPR skills on VAMs which provide feedback maintained or improved their skills over the 12 months (Oermann et al., 2011).

Application to Nursing Practice

Continuous training on nursing skills will make the skill become automatic.  The study emphasizes the need for continuous education to make motor learning permanent and retained for use in the future.  The study shows that when a skill is new even lapsing a month can diminish your accuracy of the skill. (Oermann et al., 2011).

References

• Oermann, M., Edgren, S., Odom-Maryon, T., Hallmark, B., Hurd, N., Rogers, N., McMolgan, J., Snelson, C., Dowdy, S., Resurreccion, L., Kuerschner, D., LaMar, J., Tennant, M., & Smart, D. (2011). Deliberate practice of motor skills in nursing education: CPR as exemplar. Teaching with Technology, 32,(5), 311-315