학습곡선-누적합 분석을 이용한 흉부압박의 능숙도 평가 (Evaluation of Proficiency in Chest Compression by Learning Curve- Cumulative Sum Analysis)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 21권 / 3호 / 293 ~ 298페이지
· 저자명 : 서강열, 안지윤, 안희철, 조준휘, 손유동

초록

Purpose: Chest compression is the corner stone of resuscitation.
As a result, many studies insist on the importance of retention of skill performance. But there are weak points.
First, a unique characteristic of skill is ignored, “the more practice, the better outcome”. Second, no one knows when they have a proficiency in a skill. Learning curve-CUSUM analysis is a good tool to evaluate each trainee’s performance.
Hence, we designed this study to evaluate each trainee’s proficiency in performing chest compression using LC-CUSUM analysis.
Methods: Four medical students were enrolled. We asked them to perform chest compression for two minutes per day without any intervention over six weeks. Data included the depth and rate of chest compression. Eventually, all trainees performed chest compression at least 30 times.
We plotted the LC-CUSUM curve according to the results of attempts, successes or failures.
Results: According to median values of the depth and rate of chest compression through the 30th attempt, trainees had performances within the acceptable range, 40~49 mm (for depth) and 100~105 beats per minutes (for rate) of chest compression. Nonetheless, LC-CUSUM analysis indicated that two trainees no longer were proficient throughout, and even though the rest of them were once proficient, they appear to have lost that proficiency regarding depth of chest compression. LC-CUSUM analysis of rate of compression showed that all trainees had proficiency during the early phase.
Conclusion: We propose that instructors can evaluate their trainees’ proficiency easily, based on LC-CUSUM analysis.

영어초록

Purpose: Chest compression is the corner stone of resuscitation.
As a result, many studies insist on the importance of retention of skill performance. But there are weak points.
First, a unique characteristic of skill is ignored, “the more practice, the better outcome”. Second, no one knows when they have a proficiency in a skill. Learning curve-CUSUM analysis is a good tool to evaluate each trainee’s performance.
Hence, we designed this study to evaluate each trainee’s proficiency in performing chest compression using LC-CUSUM analysis.
Methods: Four medical students were enrolled. We asked them to perform chest compression for two minutes per day without any intervention over six weeks. Data included the depth and rate of chest compression. Eventually, all trainees performed chest compression at least 30 times.
We plotted the LC-CUSUM curve according to the results of attempts, successes or failures.
Results: According to median values of the depth and rate of chest compression through the 30th attempt, trainees had performances within the acceptable range, 40~49 mm (for depth) and 100~105 beats per minutes (for rate) of chest compression. Nonetheless, LC-CUSUM analysis indicated that two trainees no longer were proficient throughout, and even though the rest of them were once proficient, they appear to have lost that proficiency regarding depth of chest compression. LC-CUSUM analysis of rate of compression showed that all trainees had proficiency during the early phase.
Conclusion: We propose that instructors can evaluate their trainees’ proficiency easily, based on LC-CUSUM analysis.

참고자료

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