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VOLUME 1 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Feasibility of Hybrid Training for Basic and Advanced Cardiac Life Support during COVID-19 Pandemic

CC Vinil Kumar, Viju Wilben, Arjun Alva, Vimal Bharadwaj, Ratan Guptha, TS Srinath, Poonam Malhotra, Alexander Thomas

Keywords : Cardiac life support, Cardiopulmonary resuscitation, Hybrid training, Lifesaving skills, Online training, Resuscitation, Training during pandemic

Citation Information : Kumar CV, Wilben V, Alva A, Bharadwaj V, Guptha R, Srinath T, Malhotra P, Thomas A. Feasibility of Hybrid Training for Basic and Advanced Cardiac Life Support during COVID-19 Pandemic. 2022; 1 (2):104-109.

DOI: 10.5005/jp-journals-10089-0025

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: The coronavirus disease of 2019 (COVID-19) pandemic in the years 2020 and 2021 disrupted the professional life of healthcare providers in the most unprecedented manner. Notwithstanding this, COVID-19 substantially diminished the platform for the dissemination of knowledge and skills due to restrictions and limited training opportunities. The need for recruitment of healthcare providers to meet the growing demands owing to the pandemic has caused a huge gap in demand and delivery of quality care, especially in basic and advanced cardiac life support skills (BLS/ACLS). In the wake of the pandemic, education, training, seminars, and even medical conferences have found a novel approach to sharing knowledge by utilizing e-learning modules. Technological advancement and studies have proved that e-learning is non-inferior to face-to-face education. However, it would be illogical to conduct certain types of training, such as cardiac life support, fully through online modules since this sort of training demands a considerable amount of time in hands-on sessions. We aimed to investigate the feasibility and effectiveness of training and imparting skills in BLS/ACLS using a combination of online and offline “hybrid technique” education and thereby minimizing exposure to a potentially infectious environment. Materials and methods: The schedule of the hybrid National Cardiac Life Support (NCLS) was structured as a 2-day training program, the 1st day as an “online” virtual learning module and the 2nd day as “on-site” for hands-on training. All the didactic sessions of NCLS were dealt with online on day 1 using PowerPoint presentations through the Teams Microsoft platform, teaching materials, and ingeniously framed training videos as per standard guidelines. This day 1 session lasted for a total of 5 hours, which was interactive with the active participation of the participants. Day 2 consisted of on-site “hands-on” training with manikins with the best possible COVID-19 precautions. Instructors monitored one-one skill impartment with correct techniques of high-quality cardiopulmonary resuscitation (CPR). The duration of training on day 2 was 7 hours, followed by an assessment. The assessment consisted of two sessions, namely, theory and skill assessments for BLS and ACLS. During the assessment, all the necessary COVID-19 precautions were taken into consideration. To complete the NCLS program successfully, candidates must score a minimum of 80% in the assessment, failing which, the candidates are subjected to remediation or reappearing for the test. Upon successful completion of the training, the candidates are certified in NCLS with a validity of 2 years. Results: A total of 11 hybrid NCLS training programs were conducted over a period of 18 months with a total of 276 trainees. The overall rating of the hybrid NCLS based on the analysis of feedback, was good/outstanding by 97% of attendees, which was similar to the feedback obtained from the traditional pre-COVID-19 standard NCLS program. To perform meaningful statistical analysis, 11 standard NCLS programs were chosen in a random manner (computer generated), and these programs were compared to 11 hybrid NCLS programs. The pre-COVID-19 standard NCLS classroom training trained 3,078 healthcare providers through 127 courses from its inception (October 2016) till the onset of the COVID-19 pandemic, whereas 276 candidates were trained through 11 hybrid NCLS programs. Conclusion: A standard and structured cardiac arrest resuscitation training program which is tailor-made to the Indian scenario by incorporating evidence obtained from universal/local research shall undoubtedly uplift the quality of resuscitation during the pandemic. Most importantly, training with precautions against infection is a paramount consideration during a pandemic. If online learning technology can play a role here, it is incumbent upon all of us to explore its full potential.

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