The effect of a team-based blended simulation training program on cardiopulmonary resuscitation on healthcare professionals' perception, performance, and costs: a mixed-method study.

Background: The quality of Cardio Pulmonary Resuscitation (CPR) and Automated External Defibrillations (AED) treatment provided by individual practitioners is the most important factor in surviving an in-hospital cardiac arrest (IHCA); therefore, healthcare professionals (HCPs) require sufficient resuscitation competency. This study aimed to analyze the effects of a blended team-based CPR and AED simulation training (riAniMO program) on HCPs performance, satisfaction and perception on transferability, and costs.

Methods: The riAniMO is based on a multimedia training program with video lessons and a virtual CPR resuscitation simulation, and a team-based CPR and AED simulation. The study utilized a mixed-method design. The quantitative phase involved a retrospective cohort study with a comparison group to assess the impact of the riAniMO. Meanwhile, the qualitative phase involved four focus groups (FGs) to investigate the viewpoints of professionals on the strengths and limitations of the riAniMO. We compared the 845 HCPs who participated in the BLSD (Basic Life Support- early Defibrillation) re-training program with ERC (European Resuscitation Council) approach and the 1,167 who participated in the riAniMO re-training program. BLSD re-training took place between January and December 2019 and riAniMO re-training took place between January and December 2022.

Results: From quantitative analysis, a slight increase in the number of HCPs satisfied with retraining in the riAniMO group compared to the BLSD group was found. However, the percentage of HCPs certified decreased by 9% in the riAniMo group (90.2%) compared to the BLSD group (99.2%). The RiAniMO approach resulted in cost savings by training 322 more healthcare providers and saving € 61.7 per participant. From the FG analysis, five themes emerged: 1) Realism in Learning: Experimenting in your own operating context and using your own devices; 2) Strength of the working group and multidisciplinarity; 3) Improved perception of training burden; 4) Facilitator as consultant and guide, which provides real-time situational feedback; 5) Transparency on evaluations and certifications for the simulations.

Conclusions: The riAniMO approach maintained high standards in terms of HCPs' satisfaction and performance and seemed to be cost-saving. Further studies are necessary to verify the long-term effectiveness of training methods for team-based CPR and AED simulation.