Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: High-quality cardiopulmonary resuscitation (CPR) is essential to improve survival in cases of cardiac arrest. However, skill acquisition based solely on instructor observation has proven to be limited. In this context, real-time feedback devices emerge as promising tools to optimize CPR training.
Objective: In this study our goal was to evaluate the effect of using a real-time feedback device on the quality of CPR performed by medical students at a public university in Colombia.

Methods: This was an experimental study with fourth-year medical students, randomly assigned to two groups. Both groups received the same initial theoretical and practical training in basic CPR. Subsequently, the intervention group practiced with a real-time feedback device, while the control group trained without technological feedback. The primary outcome measure was the target of chest compressions, simultaneously meeting both a rate of 100-120 compressions/minute and a depth of 5-6 cm (maximum value: 100%), as well as ventilations delivered within the 500-600 mL volume range. Secondary outcomes included isolated data on compression depth and rate during two simulated scenarios: hands-only CPR for two minutes and five cycles of 30 chest compressions and two ventilations.

Results: Of 106 eligible participants, 98 (92.5%) completed the test (46 intervention / 52 control). Regarding the primary outcome, the intervention group showed significantly higher compliance with the compression target compared to the control group (median values: intervention group 31% vs control group 0%, P < .001). In the hands-only CPR test, the intervention group achieved a higher compression target (72% [40.7-81] vs 3.4% [0-40]; P < .05) and better depth control (5.5 cm [5-5.6] vs 6 cm [5.6-6.1]); P < .05], with no differences in rate (P = .71). In the test with cycles of 30 chest compressions and two ventilations, the intervention group performed better, with a higher compression target (73% [5-83] vs 0.5% [0-19]), P< .05) and better depth control (5.5 cm [5-5.8] vs 6 cm [5.9-6.1], P < .05). No significant differences were observed in ventilation. Both groups had a median target completion of 0% with tidal volumes (intervention group, 265 mL; control group, 291 mL), accounting for failure at well below the recommended 500-600 mL.

Conclusion: Real-time feedback significantly improved chest compression quality in medical students, although ventilation difficulties persisted. Future research is needed to assess long-term skill retention and clinical application.