Volume 34, Issue 133 (December 2021)                   IJN 2021, 34(133): 66-81 | Back to browse issues page


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Azadi A, Mosleh S, Alimohammadi N, Tansaz Z, Kheirollahi N. The Effect of Education by Visual Self-assessment on the Operating Room Technician's Knowledge, Self-esteem, and Performance in Advanced Cardiopulmonary Resuscitation. IJN 2021; 34 (133) :66-81
URL: http://ijn.iums.ac.ir/article-1-3316-en.html
1- Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2- Department of Operating Room, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
3- Department of Critical Care Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
4- Department of Nursing, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
5- Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. , n.kheirollahi@nm.mui.ac.ir
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1. Introduction
Cardiopulmonary resuscitation is one of the most important medical emergencies. The positive effect of trained and skilled people on the outcome of resuscitation has already been proven. However, the studies indicate poor performance and insufficient knowledge of operating room technicians in cardiopulmonary resuscitation. Despite the importance of cardiopulmonary resuscitation training, very little attention has been paid to teaching patients' life skills using attractive and appropriate methods. So the current need is not only to increase cardiopulmonary resuscitation training but, more importantly, to increase the quality of training. One way is self-assessment. In the medical profession, the ability of employees to identify their strengths and weaknesses is essential, and proper self-assessment can be effective in developing a person's abilities. Learners also use the rethinking process to gain insight into their performance and identify strengths and abilities, as well as areas that may require further development (weaknesses). This study aimed to investigate the effect of visual self-assessment training on the level of knowledge, self-esteem, and performance of operating room personnel when learning advanced cardiopulmonary resuscitation.
2. Materials and Methods
This quasi-experimental has a pretest-posttest single group design. A total of 32 operating room technicians participated in this study. According to the inclusion criteria, the available method sampling was continued until reaching the specified sample size. The intervention was a cardiopulmonary resuscitation workshop and takes a video from resuscitation operation on the model by each of the participants and then replays the video for self-assessment. The 2-day workshop includes theoretical and practical training, including recognizing life-threatening dysrhythmias, recognizing and using the cardiac shock device, airway management (airway opening maneuvers and artificial respiration by airway and ambo bag), and cardiopulmonary resuscitation training. According to the latest guideline of cardiopulmonary resuscitation (2017), this training was in the form of a lecture and slide show. The resuscitation steps were performed in simulations on a mannequin for cardiopulmonary resuscitation. At the end of the workshop on the second day, each participant was given 3 minutes to perform a short-term scenario about cardiopulmonary resuscitation. All participants' performances were recorded, and then each person's video was shown to him or her on the TV in the resuscitation room. Then, knowledge, self-esteem questionnaire, and self-assessment performance checklist were given to each participant to complete immediately after the intervention. During the resuscitation by the participants, a performance observation checklist was completed for them by the researcher. Then, 8 weeks after the intervention, the participants repeated the above steps by receiving another short scenario and performing 3 minutes of cardiac resuscitation on the mannequin, showing the resuscitation video, and completing the knowledge, self-esteem, and self-assessment questionnaire. The researcher again completed the performance observation checklist for each participant. So the data were collected using a researcher-made questionnaire and Rosenberg self-esteem questionnaire three times (before, immediately, and 8 weeks after the intervention). Also, a self-assessment performance questionnaire and observational performance checklist were completed two times (immediately and 8 weeks after Intervention). This article was extracted from a research project approved by Isfahan University of Medical Sciences, Isfahan City, Iran. During the research process, the ethical principles of the university were observed, including obtaining informed consent from the technicians. The obtained data were analyzed by repeated-measures analysis, Greenhouse-Geisser and Bonferroni post hoc test, and paired t-test in SPSS version 16. 
3. Results
A total of 32 operating room technicians were initially included in the study. One participant was excluded due to obstetric delivery, one due to transfer from a medical center, and 2 due to not participating in the evaluation 8 weeks after the intervention. Finally, data analysis was performed on 28 operating room personnel. Demographic data of participants showed that 89.29% of them were female, 67.86% had a bachelor's degree in operating room, and the mean age of participants was 39.37 years. The differences in the mean score of operating room technicians' knowledge in 3 time points were significant (P<0.001). The pairwise comparison of knowledge index was significant at before-immediately after (P<0.002) and before-8 weeks after the intervention (P<0.05). The comparison of the mean score of operating room technicians' self-esteem in 3 times was significant (P<0.001). Also, the comparison of the mean performance self-assessment score and the mean performance score observed immediately after and 8 weeks later was significant (P<0.001). According to the Bonferroni test results of the knowledge index in pairs at three different time points, the differences between the means of the time points of before and immediately after the intervention and the time points of immediately after and 8 weeks after the intervention were significant (P<0.0001). But, there is no significant difference between the time points of before and 8 weeks after the intervention (P=0.321). Also, according to the results obtained by comparing the self-esteem index in three different times, the differences between the means of the time points before and immediately after the intervention (P=0.002) and the time before and 8 weeks after the intervention was significantly different (P=0.05). However, there was no significant difference between the time points of immediately after and 8 weeks after the intervention (P=1.000). So visual self-assessment had increased the self-esteem of operating room technicians in cardiopulmonary resuscitation, and it remained high 8 weeks later. However, the knowledge index was elevated immediately after the intervention and decreased significantly 8 weeks after the intervention. There was also a significant improvement in functional cardiopulmonary resuscitation.
4. Conclusion
Visual self-assessment method had effectively increased the knowledge, self-esteem, and performance of operating room technicians in the field of cardiopulmonary resuscitation. Especially since their self-esteem and performance will be indelible. The presentation of this method by clinical instructors and diversity in educational affairs are the advantages of using the visual self-assessment training method in clinical education. This method can be helpful if its outputs, such as quality of patient care, will be evaluated. It is suggested that such a study be conducted in other research settings and investigate factors affecting the self-esteem and performance of staff and even their self-efficacy and self-confidence to perform care, especially in emergencies.

Ethical Considerations
Compliance with ethical guidelines

The study was approved by the Research Ethics Committee of Isfahan University of Medical Sciences (Code: IR.MUI.RESEARCH.REC.1398.390). All ethical principles are considered in this article. The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information. They were free to leave the study whenever they wished, and if desired, the research results would be available to them.

Funding
This study was supprted by the Isfahan University of Medical Sciences (No.: 198087). 

Authors' contributions
Conceptualization and methodology: Amir Azadi and Narges Khairollahi; Research, study and implementation: Nasrollah Ali Mohammadi, Amir Azadi, Zarrin Tansaz and Narges Khairollahi; Editing and finalizing: Sorour Mosleh.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
We want to thank the Operating Room Technicians for their help.


References
  1. Raeisi M, Saberinia A, Dolatabadi AA, Kashani P. The relationship between emergency medical services staff knowledge of basic life support indicators. J Pharm Res Int. 2019; 31(6):1-6. [DOI:10.9734/jpri/2019/v31i630323]
  2. Raeisi H, Torabi zadeh, K, Makoulati N. [Studying the effect of CPR knowledge and skill retention reeducation course on nursing students (Persian)]. J Rescue Relief. 2012; 4(1):11-20. http://jorar.ir/article-1-110-en.html.
  3. Zahedmehr A, Daram Z, totonchi M. [The effect of education by video self-assessment on nurses’ knowledge and performance in cardiopulmonary resuscitation (Persian)]. Iran J Cardiovas Nurs. 2016; 4(4):32-9. http://journal.icns.org.ir/article-1-303-en.html.
  4. Freund Y, Duchateau FX, Baker EC, Goulet H, Carreira S, Schmidt M, et al. Self-perception of knowledge and confidence in performing basic life support among medical students. Eur J Emerg Med. 2013; 20(3):193-6. [DOI:10.1097/MEJ.0b013e328355fd59] [PMID]
  5. Mohsenpour M, Imani Z, Abdolkarimi M. [The effect of cardiopulmonary resuscitation training on the knowledge of nursing staff and members of the cardiopulmonary resuscitation team of a hospital in Kerman province (Persian). J Qual Res Health Sci. 2010; 9(1-2):1-7. https://www.sid.ir/fa/Journal/ViewPaper.aspx?ID=249701
  6. Berry WR. Cardiac resuscitation in the operating room: Reflections on how we can do better. Can J Anaesth. 2012; 59(6):522-6. [DOI:10.1007/s12630-012-9697-5] [PMID]
  7. Gabbard KL, Smith-Steinert RM. Advanced cardiac life support simulation for nurse anesthetists and student nurse anesthetists. Clin Simul Nurs. 2021; 50:P65-73. [DOI:10.1016/j.ecns.2020.06.006]
  8. Safdari R, Charkhsaz N, Montaseri M, Montaseri N. [Survey the effect of CPR simulation training software on the satisfaction of operating room and medical emergency students in Tehran University of Medical Sciences (Persian)]. J Nurs Educ. 2017; 5(6):1-10. [DOI:10.21859/jne-05061]
  9. Corrêa TD, Vuda M, Blaser AR, Takala J, Djafarzadeh S, Dünser MW, et al. Effect of treatment delay on disease severity and need for resuscitation in porcine fecal peritonitis. Crit Care Med. 2012; 40(10):2841-9. [DOI:10.1097/CCM.0b013e31825b916b] [PMID]
  10. Campbell D, Clark PC. An initiative using simulation to aid in retention of advanced cardiac life support knowledge and skills in an emergency department nurse residency program. Dimens Crit Care Nurs. 2020; 39(1):33-8. [DOI:10.1097/DCC.0000000000000394] [PMID]
  11. Goette A, Auricchio A, Boriani G, Braunschweig F, Terradellas JB, Burri H, et al. EHRA White Paper: Knowledge gaps in arrhythmia management-status 2019. Europace. 2019; 21(7):993-4. [DOI:10.1093/europace/euz055] [PMID]
  12. Perkins GD, Olasveengen TM, Maconochie I, Soar J, Wyllie J, Greif R, et al. European resuscitation council guidelines for resuscitation: 2017 update. Resuscitation. 2018; 123:43-50. [DOI:10.1016/j.resuscitation.2017.12.007] [PMID]
  13. Vandervelden S, Sabbe M, Dewolf P. Prolonged CPR. Trends Anaesth Crit Care. 2016; 9:13-9. [DOI:10.1016/j.tacc.2016.05.007]
  14. Nagaraju R, Chikkegowda LK. Selfie: A rising culture. Assessment of selfitis and its relation with self-esteem among medical and nursing students: A cross-sectional study. National J Community Med. 2019; 10(5):285-9. http://www.njcmindia.org/home/abstrct/1364/
  15. Tramèr L, Becker C, Schumacher C, Beck K, Tschan F, Semmer NK, et al. Association of self-esteem, personality, stress and gender with performance of a resuscitation team: A simulation-based study. PLoS One. 2020; 15(5):e0233155. [DOI:10.1371/journal.pone.0233155] [PMID] [PMCID]
  16. Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, et al. Part 14: education: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015; 132(18_suppl2):S561-73. [DOI:10.1161/CIR.0000000000000268] [PMID]
  17. Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Acad Med. 2014; 89(3):387-92. [DOI:10.1097/ACM.0000000000000130] [PMID]
  18. Parajulee S, Selvaraj V. Knowledge of nurses towards cardiopulmonary resuscitation in a tertiary care teaching hospital in Nepal. J Clin Diagn Res. 2011; 5(8):1585-8. https://www.jcdr.net/article_abstract.asp?issn=0973-709x&year=2011&volume=5&issue=8&page=1585&issn=0973-709x&id=1720
  19. Godarzi M, Sarhangy F, Mokhtari Nouri J, Seyed Amouzegar Zavareh S M. [The effectiveness of neonatal cardiopulmonary resuscitation training by educare method on nurses and midwives’ knowledge and performance (Persian). J Crit Care Nurse. 2018; 11(4):35-43. http://jccnursing.com/article-1-440-en.html
  20. Dorri S, Hakimi H. [The effect of mastery learning model for suction and oxygen therapy skills in nursing students (Persian)]. Res Med Educ. 2017; 9(4):10-9. [DOI:10.29252/rme.9.4.19]
  21. Javaheri Arasteh A, Najafi Ghezeljeh T, Haghani S. [Effects of peer-assisted education on the knowledge and performance of nursing students in basic cardiopulmonary resuscitation (Persian)]. Iran Nurs. 2018; 31(115):6-19. [DOI:10.29252/ijn.31.115.6]
  22. Hashemi S, Valiei S, Makarem MK, Ariaie Nejad B. [Effect of training cardiopulmonary cerebral resuscitation management on nurses’ knowledge (Persian)]. Iran J Cardiovasc Nurs. 2014; 3(1):42-9. https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=285790
  23. Källestedt ML, Berglund A, Herlitz J, Leppert J, Enlund M. The impact of CPR and AED training on healthcare professionals’ self-perceived attitudes to performing resuscitation. Scand J Trauma Resusc Emerg Med. 2012; 20:26. [DOI:10.1186/1757-7241-20-26] [PMID] [PMCID]
  24. Falahinia G, Daneshgari M, Borzou S R, Moghimbeigi A, Sokoti T. [Comparing the effects of CPR teaching using two methods, practical with model and film, on the knowledge and performance of aid groups in Hamadan, Iran (Persian)]. Avicenna J Nurs Midwifery Care. 2016; 24(1):9-15. [DOI:10.20286/nmj-24012]
  25. Omidifar N, Yamani N, Changiz T. [The efficacy of new method of cardiopulmonary resuscitation training in promoting knowledge and skills of 4th year medical students (Persian)]. Iran J Med Edu. 2008; 8(19):23-30. https://www.sid.ir/en/journal/ViewPaper.aspx?id=125126
  26. Rahmati H, Yaghoubinia F, Zare Mehrabady R. Comparing the effect of lecture-based training and basic life support training package on cardiopulmonary resuscitation knowledge and skill of teachers. Health Scope. 2017; 6(3):e15165. [DOI:10.5812/jhealthscope.15165]
  27. Nejad Shamsi P, Zaker-Jafari HR, Basirat M, Zaker-Jafari A. [Self-assessment of senior dental students about acquired skills based on the educational program (Persian)]. Res Med Educ. 2017; 9(3):73-8. [DOI:10.29252/rme.9.3.79]
  28. Abedini Z, Jafar Begloo E, Raeisi M, Dadkhah Tehrani T. [Effectiveness of reflection in clinical education: Nursing students’ perspective (Persian)]. Iran J Nurs. 2011; 24(71):74-82. http://ijn.iums.ac.ir/article-1-1004-en.html
  29. Aghajani M, Nasrabadi T, Ebrahimi Abyaneh E. [The effect of BLS training through video feedback on the performance of non-professional saviors (Persian)]. Anesthesiol Pain. 2018; 8(4):84-92. http://jap.iums.ac.ir/article-1-5359-en.html
  30. Cheng A, Overly F, Kessler D, Nadkarni VM, Lin Y, Doan Q, et al. Perception of CPR quality: Influence of CPR feedback, just-in-time CPR training and provider role. Resuscitation. 2015; 87:44-50. [DOI:10.1016/j.resuscitation.2014.11.015] [PMID]
  31. Sadeghzadeh S, Zareii Zavaraki E, Moghaddas A, Mahoori A, Mehryar H. [The impact of cardiopulmonary resuscitation simulation software on the knowledege and performance of senior medical students (Persian)]. Nurs Midwifery J. 2017; 15(9). http://unmf.umsu.ac.ir/article-1-3283-fa.html
  32. Rosenberg M. Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy Measures package. 1965; 61(52):18. [DOI:10.1037/t01038-000]
  33. Rosenberg M. Society and the adolescent self-image. New Jersey: Princeton university press; 2015. https://www.google.com/books/edition/Society_and_the_Adolescent_Self_Image/YR3WCgAAQBAJ?hl=en&gbpv=0
  34. Joshanloo M and Ghaedi G. [Reinvestigation of the reliability and validity of the rosenberg self-esteem scale in Iran (Persian)]. Daneshvar Raftar. 2008; 15:49-56. http://cpap.shahed.ac.ir/article_2612.html?lang=en
  35. Clement ND, Lovat T. Neuroscience and education: Issues and challenges for curriculum. Curriculum Inq. 2012; 42(4):534-57. [DOI:10.1111/j.1467-873X.2012.00602.x]
  36. Larrison AL. Mind, brain and education as a framework for curricular reform [PhD dissertation]. California: University of California; 2013. https://escholarship.org/uc/item/0v779550
  37. Ahmadian M, Khami MR, Ahamdi AE, Razeghi S, Yazdani R. Effectiveness of two interactive educational methods to teach tobacco cessation counseling for senior dental students. Eur J Dent. 2017; 11(3):287-92. [DOI:10.4103/ejd.ejd_352_16] [PMID] [PMCID]
  38. Blewer AL, Leary M, Esposito EC, Gonzalez M, Riegel B, Bobrow BJ, et al. Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: A hospital-based randomized controlled trial. Crit Care Med. 2012; 40(3):787-92. [DOI:10.1097/CCM.0b013e318236f2ca] [PMID] [PMCID]
  39. Roh YS, Issenberg SB. Association of cardiopulmonary resuscitation psychomotor skills with knowledge and self-efficacy in nursing students. Int J Nurs Pract. 2014; 20(6):674-9. [DOI:10.1111/ijn.12212] [PMID]
  40. Roh YS, Lee WS, Chung HS, Park YM. The effects of simulation-based resuscitation training on nurses’ self-efficacy and satisfaction. Nurse Educ Today. 2013; 33(2):123-8. [DOI:10.1016/j.nedt.2011.11.008] [PMID]
Type of Study: Research | Subject: nursing
Received: 2021/09/6 | Accepted: 2021/12/2 | Published: 2022/01/1

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