A Comparative Study to Assess the Effectiveness of Self-Instructional Module versus Demonstration Method of Teaching Cardiopulmonary Resuscitation among Nursing Students
Deepthy James1, Rao Vatsala2
1IKDRC College of Nursing, IKDRC-ITS Premises, Medicity, Asarwa Ahmedabad.
2Divisional Railway Hospital, Sabarmati, Ahmedabad.
*Corresponding Author Email: deepthy.thomas@ymail.com
ABSTRACT:
A study was carried out with the primary aim to compare the effectiveness of Self Instructional Module (hereafter referred as SIM) and Demonstration method of teaching on Cardiopulmonary resuscitation (hereafter referred as CPR). The other objectives were to assess the knowledge and practice of nursing students after administration of SIM on CPR and to assess the knowledge and practice of nursing students after administration of demonstration method of teaching on CPR. The study used quasi experimental approach with posttest only design and was conducted in selected Nursing Colleges in Ahmedabad, Gujarat state. 30 samples from one Nursing College were selected in the demonstration group and 30 samples from another Nursing College were selected in the SIM group with simple random sampling technique. In view of the nature of the problem and the accomplishment of the objective, a demonstration plan on CPR and a SIM on CPR was planned and prepared respectively. The assessment of the knowledge was done with the help of structured knowledge questionnaire and an observational checklist was developed to assess the practice of the students. Both the tools were reliable and were validated by the experts. The mean posttest knowledge score and practice score of demonstration group were 27.43 and 13.4 respectively while for SIM group they were 21.6 and 8.83 respectively. Comparison of the posttest knowledge and practice scores between demonstration and SIM groups were tested using unpaired ‘t’ test and it was found significant at 0.05 level. It was revealed that demonstration is more effective method of teaching CPR as compared to that of SIM.
KEYWORDS: Demonstration, SIM, Knowledge, Practice, Cardiopulmonary Resuscitation.
INTRODUCTION:
A teaching method consists of the principles and methods used in teaching. Common teaching methods may include presentations, demonstrations, self-study modules or combinations thereof. The choice of method of teaching to be used for the most part depends on the knowledge or ability that's being taught, and it should even be influenced by the ability and enthusiasm of the students.1
CPR is a procedure of emergency that is performed in an effort to maintain intact brain function manually till more measures are taken to revive spontaneous blood circulation and breathing in a person in a cardiac arrest situation2. The ability of health care personnel to identify and respond quickly to life-threatening situations is very important to the survival of victims4. As a nurse in many cardiac arrest situations, he or she acts as a first responder. It is even more important to know how to resuscitate and be familiar with resuscitation devices, medications, and procedures 3. As a result, hospitals need to have a well-qualified and experienced nursing professional and modern medical tools and equipment to provide cardiac resuscitation rescue treatment 5.
In order to make competent future nursing professionals, the researchers found it desirable to assess the knowledge and practice in CPR technique among the degree students and also to update the knowledge and to bring improvement in their skills and to identify that which method of teaching CPR: SIM method or demonstration method is comparatively more effective way to learn CPR and to practice CPR.
MATERIAL AND METHODS:
A quasi-experimental research approach with posttest only design was applied for the study.
|
GROUP |
Pre Test |
Treatment |
Post Test |
|
Demonstration group |
- |
X1 |
O1 |
|
SIM group |
- |
X2 |
O2 |
Keys:
X1: Administration of demonstration plan to one group (Demonstration plan of 60 minutes was administered covering both knowledge and practice aspect of CPR)
X2: Administration of SIM to another group (SIM containing the similar content of both knowledge and practice aspect of CPR was administered)
O1: Post-test to assess the knowledge and practice of demonstration group
O2: Post-test to assess the knowledge and practice of SIM group
The sample size for the study consisted of 60 samples, 30 in demonstration group which were from one college and 30 in SIM group which were from another college. These samples were selected on the basis of simple random sampling technique with lottery method. Nursing students who were studying in the 2nd year of the selected colleges and those who were available during the study period were included under the study.
Formal permission was obtained from the Principals of nursing colleges for collecting data and then the samples were approached individually. After discussing the objectives of the study, consent for participation in study was obtained.
Researchers have prepared a structured knowledge questionnaire and an observational checklist to assess the knowledge and the practice of students on CPR respectively. Structured knowledge questionnaire focused on purposes, chain of survival and steps of CPR. It had 36 multiple choice questions. Observational checklist focused on the procedure of CPR checking scene safety, assessment and activation, Cycle-1 of CPR, Cycle-2 of CPR, 2- rescuer CPR and evaluation and recording. It had total 20 items.
The tool for the data collection included a structured knowledge questionnaire, an observational checklist, demonstration lesson plan and SIM were validated by experts and checked their reliability by carrying out initial try out on 12 students of other nursing college which was not included in the main study.
Both descriptive and inferential statistics were used for analysis. The data was analyzed by using frequency distribution, percentage, mean, mean difference and standard deviation. Unpaired ‘t’ test was used to compare the effectiveness of demonstration and SIM methods of teaching cardiopulmonary resuscitation and comparison was done of the result between both the groups.
RESULTS:
Knowledge score of nursing students on CPR:
The knowledge score was divided as good, average and poor based on their score. In demonstration group, none of the samples yielded poor score, while 05(16.67%) scored average score and 25(83.33%) scored good score. In SIM group, 01(3.34%) sample scored poor, 22(73.33%) scored average and 7(23.33%) of the samples scored good.
Table 1: Area-wise mean and mean percentage of Demonstration group and SIM group of knowledge scores of students on CPR.
(n=30 for Demonstration group) (n=30 for SIM group) [N=60]
|
SN |
Content Area |
Max Score |
Posttest Score of Demonstration Group |
Posttest Score of SIM Group |
||
|
Mean |
Mean Percentage |
Mean |
Mean Percentage |
|||
|
1 |
Introduction |
2 |
1.8 |
90% |
1.94 |
97% |
|
2 |
Purpose |
1 |
0.97 |
97% |
0.74 |
74% |
|
3 |
Chain of survival |
2 |
0.73 |
36.5% |
0.6 |
30% |
|
4 |
Steps of CPR |
31 |
23.93 |
77.19% |
18.33 |
59.12% |
|
Total |
36 |
27.43 |
|
21.6 |
|
|
Comparison of knowledge of nursing students’ post test scores on CPR in both groups
The result of the study revealed that comparison of the post test scores between Demonstration group and SIM group at 0.05 level of significance was tcal=6.12. At 58 degree of freedom the tabulated value was 2. So ttab=2 < tcal=6.12, the null hypothesis was rejected.
This revealed that there was a significant difference between demonstration group and SIM group and so demonstration is more effective as compared to SIM for imparting knowledge regarding CPR.
Table 2: Standard error, unpaired ‘t’ value of knowledge scores of CPR between Demonstration group and SIM group
(n=30 for Demonstration group)
(n=30 for SIM group) [N=60]
|
Posttest Score |
Unpaired t- Test |
|||
|
Standard Error |
tcal value |
df |
ttab value |
|
|
0.94 |
6.12 |
58 |
2 |
|
Practice score of nursing students on CPR:
The practice score was divided as good and poor based on their score. In demonstration group, 06(20%) of the samples had a poor score while 24(80%) samples scored good. In SIM group, 20(66.66%) samples scored poor and 10(33.33%) scored good.
Table 3: Area-wise mean and mean percentage of Demonstration group and SIM group of practice scores of students on CPR.
(n=30 for Demonstration group) (n=30 for SIM group) [N=60]
|
SN |
Content Area |
Max Score |
Posttest Score of Demonstration Group |
Posttest Score of SIM Group |
||
|
Mean |
Mean Percentage |
Mean |
Mean Percentage |
|||
|
1 |
Checking scene safety |
1 |
0.8 |
80% |
0.23 |
23% |
|
2 |
Assessment and activation |
5 |
3.63 |
72.6% |
3.43 |
68.6% |
|
3 |
Cycle-1 of CPR |
9 |
6.16 |
68.44% |
4.33 |
48.11% |
|
4 |
Cycle-2 of CPR |
2 |
0.9 |
43% |
0.27 |
13.5% |
|
5 |
2-Rescuer CPR |
1 |
0.73 |
73% |
0.06 |
6% |
|
6 |
Evaluation and Recording |
2 |
1.2 |
60% |
0.5 |
25% |
|
Total |
20 |
13.4 |
|
8.83 |
|
|
Comparison of practice of nursing students’ post test scores on CPR in both groups:
The result of the study revealed that comparison of the post test scores between Demonstration group and SIM group at 0.05 level of significance was tcal= 5.14. At 58 degree of freedom the tabulated value was 2. So ttab=2 < tcal= 5.14, the null hypothesis was rejected.
Table 2: Standard error, unpaired ‘t’ value of practice scores of CPR between Demonstration group and SIM group
(n=30 for Demonstration group)
(n=30 for SIM group) [N=60]
|
Posttest Score |
Unpaired t- Test |
|||
|
Standard Error |
tcal value |
df |
ttab value |
|
|
0.88 |
5.14 |
58 |
2 |
|
This revealed that there was a significant difference between demonstration group and SIM group and so demonstration is more effective as compared to SIM for practice regarding CPR.
DISCUSSION:
The present study can be supported with a similar study where in the researcher had adopted a quasi-experimental study, with a pretest posttest design, to compare the effect of two teaching methods on knowledge and skill acquisition in basic cardiac life support, among nursing personnel working in Midwestern acute care teaching hospital, USA. 40 samples were selected using convenience sampling technique and were randomly allotted to the group demonstration and self-study module. A knowledge questionnaire consisting of 20 multiple choice questions was used to assess knowledge and a one person adult cardiopulmonary resuscitation evaluation instrument was used to assess the skills. The study revealed that the mean difference in the post test knowledge scores in between the two groups was statistically significant (p>0.5). The demonstration group had a posttest mean of 18.7 and the self-study group had a posttest mean of 12.4. There was also a significant difference in the acquisition of skills from pretest to post test. The demonstration group should the least amount of errors on 40 posttest with an adjusted mean of 4.92 as compared to self-study group’s adjusted mean of 11.52 (p<.05). It was concluded that demonstration was more effective as compared to self-study.6
CONCLUSION:
There was a significant difference in the knowledge and practice scores of Demonstration Group and Self Instructional Module Group. It was concluded that Demonstration is more effective as compared to Self-Instructional Module for teaching cardiopulmonary resuscitation.
DECLARATIONS:
Ethics approval and consent to Participate:
Ethical clearance was obtained from ethical committee of IKDRC college of Nursing and after gaining permission from the selected colleges data collection commenced.
COMPETING INTERESTS:
The authors declare that they have no competing interests.
REFERENCES:
1. Gatto JT. A Different Kind of Teacher: Solving the Crisis of American Schooling. 1st ed. Berkeley Hills Books, California. 2000.
2. Lewis, Heitkemper et al; Medical Surgical Nursing Assessment and Management of Clinical Problem. Elsevier Publishers. 7th ed: pp no: 1845-1849.
3. Krupesh. N, Advanced Cardiac Life Support, Prisms Nursing Practice. 2006 Vol 1 (3) 98-103.
4. Roshan Ramly, Fadhli Yusoff, Zainal A Omar, Survey on First Aid and Cardio pulmonary Resuscitation Among Health personnel. American Heart Association, Heart Saver Manual. 2005; volume 4:187-191.
5. Davies, N and Gould, D. Updating Cardiac Resuscitation skills: a study to examine the efficacy of self-instruction on nursing professionals’ competence. Journal of Clinical Nursing. 2011.
6. Patricia A. Merrill, et al. 2007. Grand Valley State University Scholar Works. doi:https://scholarworks.gvsu
Received on 20.02.2021 Modified on 18.07.2021
Accepted on 21.09.2021 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2022; 12(1):33-36.
DOI: 10.52711/2349-2996.2022.00006