Elsevier

Resuscitation

Volume 112, March 2017, Pages 17-21
Resuscitation

Simulation and education
The effect of a specialized content knowledge workshop on teaching and learning Basic Life Support in elementary school: A cluster randomized controlled trial

https://doi.org/10.1016/j.resuscitation.2016.11.023Get rights and content

Abstract

Background

Research investigating the effect of specialised content knowledge (SCK) on teaching and learning Basic Life Support (BLS) is lacking.

Purpose

To investigate the effect of a specialised content knowledge workshop on teaching behaviour, lesson context and student learning of BLS. Specialised content knowledge comprises knowledge of content progressions, skill analysis, and how to correct common errors.

Methods

A cluster randomized controlled trial. Ten elementary teachers from three schools were assigned to a common content knowledge (n = 4) and specialized content knowledge condition (n = 6). Common content knowledge teachers received a 50-min BLS workshop focused on learning BLS. Next to learning BLS, specialised content knowledge teachers also practised the teaching of BLS focussing on skill progressions, skill analysis and how to correct common errors children would likely make. Teachers then taught one BLS lesson and their behaviour together with lesson context was collected through direct observation. BLS performance of 203 children (mean age: 11.3 years) was individually assessed immediately after the lesson.

Results

Students taught by specialised content knowledge teachers spent more time practising BLS (57% vs 30%), were less engaged in cognitive activities (29% vs 55%) and achieved a significantly higher BLS performance (62% vs 57%) compared to students taught by common content knowledge teachers, P < .05. Specialised content knowledge teachers on average gave more feedback (31 vs 19).

Discussion and conclusion

This study demonstrates that a 50-min workshop with a focus on specialised content knowledge impacted teachers’ in-class behaviour, which in turn significantly improved students’ BLS performance.

Introduction

Early bystander cardiopulmonary resuscitation (CPR) can double or quadruple survival from cardiac arrest.1, 2, 3 Because of this important outcome, Basic Life Support (BLS) courses are now widely implemented in companies, hospitals, coaching settings, schools and in lay organizations. To meet the growing demand for BLS education, many researchers have developed and reported upon innovative instructional models and tools to learn BLS and CPR. Examples of such educational innovations are the use of medical students for teaching BLS at schools,4 task cards or iPads as instructional tools within reciprocal peer learning,5, 6, 7 smartphone BLS training,8 training lay classroom teachers for delivering BLS,9 and learning in pairs.10 Although some instructional models and tools have educational potential, instructors might not implement these effectively following training or professional development. Research with teachers has shown that when returning to their school, the content of professional development they received was poorly taught.11, 12 To our knowledge, experimental research investigating BLS instructors’ effectiveness following training is lacking.

Educational researchers have discriminated between two types of content knowledge for teaching.13, 14 Common content knowledge (CK) is knowledge that is needed to effectively perform an activity. In BLS it refers to knowledge of technical criteria for effective BLS performance (e.g., according to the ERC guidelines) and knowledge of the available BLS procedures (e.g., in case of drowning). On the other hand, specialized CK consists of knowing which errors students will likely make and how to correct these, and the knowledge of task progressions to teach BLS. These task progressions refer to the knowledge an instructor needs to sequence the teaching of BLS in order to achieve proficiency with trainees. For example, since they are not able to perform this skill themselves, trainees with a low body weight could be learned to put a victim in the recovery position using help from a bystander before they perform it alone. While both BLS providers and instructors should possess common CK, specialised CK is the exclusive domain of the instructor. It is often assumed that “in order to teach BLS, one must be able to perform it well (i.e., common CK).” Although the latter is probably true, it is arguably not sufficient to be an effective instructor. Research in the psychomotor domain has demonstrated that an increase in specialised CK substantially alters teachers’ in-class behaviour in terms of task presentation (i.e., verbal behaviour and demonstrations) which significantly improves student learning.15, 16

In this study we sought to investigate the effect of a specialised CK versus common CK professional development workshop for teachers. It is hypothesized that the BLS workshop focused on specialised CK will lead to improved teacher behaviour compared to a workshop focused on common CK. We also hypothesize that as a function of this improved teacher behaviour, student BLS performance will be higher. Since students are in classes in schools, we used a cluster randomized design.

Section snippets

Participants and setting

A cluster randomized controlled trial was set up to investigate the effect of a specialised CK versus common CK professional development workshop for teachers on their behaviour and student learning. Thirty-five primary schools in Flanders, Belgium were contacted to participate in this study. Schools could enroll only if BLS was not part of the curriculum. Six schools volunteered to participate and three were chosen and randomly assigned to a common CK (n = 2) or specialised CK (n = 1) group.

Results

Intrarater reliability for teacher behaviour and lesson context data as measured by Cohen’s kappa was .95 and .91 for observer A and B respectively. Interrater reliability averaged between .81 and 1 based on 33% of the total sample as recommended by behavioural research.20 No significant difference was found between common CK and specialised CK teachers based on their BLS assessment after the workshop, F(1, 9) = 43.12, P = .41. In total, 203 children (98 girls and 105 boys) constituting 10 intact

Discussion

It was hypothesized that a BLS workshop focused on specialised CK would lead to different teacher behaviour compared to a common CK workshop. Results showed that specialised CK teachers’ verbal behaviour was substantially different compared to that of their counterparts. While common CK teachers placed children in pairs and provided them with iPad’s, specialised CK teachers explained students how peer learning works and how they should collaborate. Those teachers practiced the implementation of

Conclusion

This study demonstrated that the content of a professional CK workshop matters. Knowing how to perform BLS is not the same as knowing how to teach BLS. A professional development workshop as short as 60 min was able to affect teachers’ behaviour, and in turn children’s BLS performance. Instructor training and professional development focusing on specialised CK seems crucial for increasing effectiveness.

Conflict of interest statement

None.

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    A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2016.11.023.

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