學術期刊

突破EMS訓練框架，建構EMT教育制度轉化學習

Breakthrough the EMS training framework and construct the transformational learning of the EMT education system

救護技術員訓練已從官方擴及民間，但相同的內容運用在民間場域訓練時卻常發生無法適用，觀察原因來自課程內容、教學手法、場域應用等，從教育學習理論可理解學習分為「經驗學習」及「轉化學習」，以傳統EMT訓練架構延伸至民間教育來說，就非常具轉化或擴增學習內容的空間及必要

隨時代更迭，EMS教育系統植入民間，無論指導員或學員都不侷限官方成員，但對應民間場域時，原有訓練模式又常導致學員受訓後無法完全適用，其原因可能來自課程內容、教學手法、場域應用等，根據教育學習理論解析，人類學習歷程分為「經驗學習」及「轉化學習」，聽從老師傳遞知識與技術、自學等單方面初學屬經驗學習，學員對原本學到的事物，在經歷刺激及挑戰後，重新審視並新形成可適用架構，即稱為「轉化學習」，

轉化學習在運用時可包含(1)使用學員聽得懂的詮釋方法(2)藉學員經驗完成再學習(3)將課程轉換成可運用的項目等多種手法，

轉化、擴充、心法為教學「質變」，重視運用學員過去經驗完成新的知識學習，同時強調深化學習內容並了解學習意義

Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak

Background

Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on bystander cardiopulmonary resuscitation (BCPR) for fear of transmission while breaking social distancing rules. The latest guidelines recommend hands-only cardiopulmonary resuscitation (CPR) and facemask use. However, public willingness in this setup remains unknown.

Methods

A cross-sectional, unrestricted volunteer Internet survey was conducted to assess individuals' attitudes and behaviors toward performing BCPR, pre-existing CPR training, occupational identity, age group, and gender. The raking method for weights and a regression analysis for the predictors of willingness were performed.

Results

Among 1,347 eligible respondents, 822 (61%) had negative attitudes toward performing BCPR. Healthcare providers (HCPs) and those with pre-existing CPR training had fewer negative attitudes (p < 0.001); HCPs and those with pre-existing CPR training and unchanged attitude showed more positive behaviors toward BCPR (p < 0.001). Further, 9.7% of the respondents would absolutely refuse to perform BCPR. In contrast, 16.9% would perform BCPR directly despite the outbreak. Approximately 9.9% would perform it if they were instructed, 23.5%, if they wore facemasks, and 40.1%, if they were to perform hands-only CPR. Interestingly, among the 822 respondents with negative attitudes, over 85% still tended to perform BCPR in the abovementioned situations. The weighted analysis showed similar results. The adjusted predictors for lower negative attitudes toward BCPR were younger age, being a man, and being an HCP; those for more positive behaviors were younger age and being an HCP.

Conclusions

Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on attitudes and behaviors toward BCPR. Younger individuals, men, HCPs, and those with pre-existing CPR training tended to show fewer negative attitudes and behaviors. Meanwhile, most individuals with negative attitudes still expressed positive behaviors under safer measures such as facemask protection, hands-only CPR, and available dispatch instructions.

The Effectiveness of Online-Only Blended Cardiopulmonary Resuscitation Training Static-Group Comparison Study

Background

Basic life support (BLS) education is essential for improving bystander cardiopulmonary resuscitation (CPR) rates, but the imparting of such education faces obstacles during the outbreak of emerging infectious diseases, such as COVID-19. When face-to-face teaching is limited, distance learning-blended learning (BL) or an online-only model-is encouraged. However, evidence regarding the effect of online-only CPR training is scarce, and comparative studies on classroom-based BL (CBL) are lacking. While other strategies have recommended self-directed learning and deliberate practice to enhance CPR education, no previous studies have incorporated all of these instructional methods into a BLS course.

Objective

This study aimed to demonstrate a novel BLS training model-remote practice BL (RBL)-and compare its educational outcomes with those of the conventional CBL model.

Methods

A static-group comparison study was conducted. It included RBL and CBL courses that shared the same paradigm, comprising online lectures, a deliberate practice session with Little Anne quality CPR (QCPR) manikin feedback, and a final assessment session. In the main intervention, the RBL group was required to perform distant self-directed deliberate practice and complete the final assessment via an online video conference. Manikin-rated CPR scores were measured as the primary outcome; the number of retakes of the final examination was the secondary outcome.

Results

A total of 52 and 104 participants from the RBL and CBL groups, respectively, were eligible for data analysis. A comparison of the 2 groups revealed that there were more women in the RBL group than the CBL group (36/52, 69.2% vs 51/104, 49%, respectively; P=.02). After adjustment, there were no significant differences in scores for QCPR release (96.9 vs 96.4, respectively; P=.61), QCPR depth (99.2 vs 99.5, respectively; P=.27), or QCPR rate (94.9 vs 95.5, respectively; P=.83). The RBL group spent more days practicing before the final assessment (12.4 vs 8.9 days, respectively; P<.001) and also had a higher number of retakes (1.4 vs 1.1 times, respectively; P<.001).

Conclusions

We developed a remote practice BL-based method for online-only distant BLS CPR training. In terms of CPR performance, using remote self-directed deliberate practice was not inferior to the conventional classroom-based instructor-led method, although it tended to take more time to achieve the same effect.