Learning Models of Group Lecturing and Small Group Cardiopulmonary Resuscitation Training - Essay Example

CPR Training Principles of Teaching and Learning Word count: 4079 s0977251 Critically reflect on the process of becoming a member of your profession in relation to the literature, and describe how you might apply the lessons learned to your own teaching Introduction Cardiopulmonary resuscitation (CPR) training is one of the most essential aspects of health care delivery. For health professionals and experts involved in emergency and trauma care, the process of learning about CPR is a complex and difficult process to master. For new learners, CPR training is an even more overwhelming and challenging learning process. In the educational setting, CPR training is often incorporated as part of major health courses like nursing and medicine. In these instances, CPR training is often carried out in a large university set-up. Other health professionals undergoing more specific and non-university based training (for example, paramedics) are more likely to undertake their training sessions in smaller groups. However, the above practices may not always apply as university lectures and can often be broken down into smaller practical group trainings; and smaller training sessions for paramedics can be carried out in a large university type lecture. There are differences, as well as advantages and disadvantages of these different methods of CPR training. This paper shall seek to compare and contrast teaching and learning models between large group lecturing in university and small group practical CPR training. It shall cite literature which would help establish the best ways of ensuring adequate CPR training among new learners. This paper is being undertaken in order to comprehensively discuss CPR training and the different tools needed in order to ensure adequate training in the actual practice. Discussion CPR training methods have been traditionally handled by instructors starting with lectures on theory, and then followed by a demonstration, and ending with the manikin practice (Paradis, Halperin, & Kern, 2007, p. 1259). Changes in this traditional method were later introduced and a shift to the video-instruction format was seen in the mid-1980s. In this video format, the students were shown videos on the standardized information about CPR and they were guided by their instructor in the process of learning (Paradis, Halperin, & Kern, 2007, p. 1259). The watch-then-practice method was later introduced to students in the late 1990s and this method saw the playing of the video for the students and later the students practising or applying what they saw in the videos to the manikins. The video instruction methods became popular from the 1990s onwards and they helped to standardize the CPR training process (Paradis, Halperin, & Kern, 2007, p. 1259). Jevon (2010, p. 300) discusses that there are four key teaching methods in CPR training, and these methods are: lectures, skills stations, cardiac arrest scenarios, and discussion groups. Lectures are important in emphasizing important points in the CPR training process and help to explain the theories and concepts behind the different steps which are being taken in the conduct of CPRs (Jevon, 2010, p. 300). Lectures are crucial in allowing moments of discussion and clarification between the lecturers and the learner. In order to achieve effectiveness in this teaching method, the lecturer has to speak with clarity and with precision; he also has to make eye contact with the students in order to stress and highlight the importance of the lecture (Jevon, 2010, p. 300). The lecture type is however meant to complement the practical stations; it is not meant to replace the practical teaching and training through the mannequins (Jevon, 2010, p. 300). CPR training involves the process of learning different skills in order to make up the entire CPR training process. Skills stations “provide an opportunity to learn a skill and debate relevant issues” (Jevon, 2010, p. 300). These skills stations are to be undertaken in small groups and are meant to add to the existing and the previous knowledge of students. When taken as a whole, all the skills make up the necessary training in order to ensure that the student would be capable of successfully carrying out the procedure. In applying this method in a more practical context, the instructor would first demonstrate the skill in the way it is usually undertaken without any commentary (Jevon, 2010, p. 300). This allows the student to observe and take in the overall look and overall process of the procedure. The instructor would then repeat the procedure – this time with commentary and with explanations on each step in the procedure (Jevon, 2010, p. 301). The next step would be for the instructor to repeat the procedure, this time with the student commentating and explaining the procedure (Jevon, 2010, p. 301). This would ensure that the student knows why each part of the procedure is being undertaken. Finally, the student would demonstrate the skill and also provide the commentary (Jevon, 2010, p. 301). The instructor then observes the student and determines if the latter understood and has properly demonstrated the skill. The simulated cardiac arrest scenario is a team process which places the entire CPR process into a more practical context. It follows the process of learning the skills involved in CPR, such as bag/mask/valve ventilation, chest compressions, and defibrillation (Jevon, et.al., 2004, p. 159). All the skills learned in skills training are now placed on a more practical context. This part of the CPR training helps to assess the effectiveness of a team or a member of the team in CPR; it also allows team members to practice their skills and to work with each other in managing cardiac arrests; it helps to make the connection between theory and practice; and it increases the efficiency and credibility of the CPR team (Jevon, et.al., 2004, p. 159). Finally, the discussion group method is the last teaching method in CPR training. It is the process of connecting, asking questions, and gaining information about the entire CPR process. It also helps define the overall outcome of the session and to facilitate the learning process and to discuss the different views of other members of the team, the students, and the instructors on CPR training (Jevon et.al., 2004, p. 159). Lectures in large groups (university setting) In considering the above key methods in CPR training, it is important to note that the lecture and the practical part of the training is a necessary part of CPR training. The lecture method is one of the primary and most fundamental methods of learning and training (Training and Development 2007). In the school level, the lecture method is said to be one of the more effective methods of teaching. In this method of instruction, the lecturer or the instructor plays a major or a central role and the students play a more passive role (Ahmed, 2009 p. 103). In the CPR training, lectures help lay out the subject matter and the theories behind the CPR process. In the large group university set-up, lectures provide basic information to the students. The lectures are the most effective ways of providing an overview of the subject matter and in a large setting, as in the university setting, lectures are considered to be a major challenge (Jones, n.d, p. 69). Lecturing in large classes requires skills which only some staff members may have mastered. Other staff members and lecturers may not be as effective or as comfortable in delivering lessons and lectures in large classes. Lectures always require clear objectives, clear overhead slides, a well-paced delivery, adequate and appropriate handouts which provide detailed information and diagrams for the subject matter (Jones, n.d, p. 69). Lectures are easier to access for students and the ability of students to participate in lectures and to ask questions during lectures has become an important feature and advantage of lectures (Jones, n.d, p. 69). In CPR training however, the lecture process alone is considered to be an inadequate training method. It has to be coordinated and has to be complemented by the more practical skills training method. For large groups in the university setting, CPR training can sometimes be ineffective because it may be more difficult to gain feedback from the students, and to ensure comprehension of the theories and the information imparted (Bach, Haynes, & Smith, 2007, p. 126). In the large group set-up of universities, CPR training sometimes still needs to be broken up into smaller, more manageable groups. Some lecturers also need to break up their lectures into shorter sessions in order to allow for moments when the students can give their feedback and can ask their questions (Bach, Haynes, & Smith, 2007, p. 126). Some activities in between the lectures can also help improve the delivery of the subject matter and to successfully implement effective CPR training. CPR training in the large group university setting is usually done with the proper logistical arrangements in advance (Felder, 1997). Such arrangements help ensure that the process of learning would not rely on straight lecturing and would still take advantage of smaller groups or teams in the in-class and out of class work (Felder, 1997). Eventually, it would be possible for learners to still feel the benefit of smaller classes. Moreover, the satisfaction of the lecturer would still be significant because the effectiveness of teaching would be intact (Felder, 1997). Larger group lectures in CPR trainings are effective to some point, however, when broken down into smaller groups and into shorter sessions, it is possible to achieve maximum effectiveness. Small group practical CPR training Small group practical training sessions can also be applied to CPR training. Small group training sessions are considered by trainers and lecturers to be more enjoyable and to be a more effective means of teaching and of learning. It also requires a great amount of interest, enthusiasm, and active participation from students (Esisi, 2010). With smaller groups, lecturers and trainers are able to spend more time with their students. With more time spent together with the lecturers and with other students, the small group set-up can get more comfortable and familiar for the learners (Esisi, 2010). Moreover, when ground rules are established for each small group session, the learning process can become faster and more efficient. Small groups can be facilitated by the lecturer and facilitator by clarifying the different roles that each of them plays in the group. The interaction in the small group training practice is not meant to be a mini-lecture (Esisi, 2010). In the practical CPR training, the smaller groups help facilitate a comfortable and familiar setting for students and instructors. The small group practical training in CPR seems to be the more effective method in CPR training because it is more manageable and more hands-on for the learners. However, as earlier mentioned by Jevon, the small practical groups or the practical skills trainings, including the cardiac arrest simulations, are meant to complement the lectures. There would be no other way to lay down the foundation of CPR, except through lectures; and through the group trainings, it is possible to apply the different theories. In a study by Rehberg, Gazzillo, & Middlemas (2009, p. 98), the authors were able to establish the importance of practical training programs. Their study sought to compare whether computer-based CPR training is comparable to traditional classroom training. Their study was a quantitative design and it covered 64 undergraduate freshmen who had to undergo training under the two methods of CPR training (Rehberg, Gazzillo, & Middlemas, 2009, p. 98). After the two instruction methods were applied on the respondents, a skill performance evaluation was carried out on them. The study was able to reveal that computer-based CPR training can also be as effective as traditional classroom CPR training based on the knowledge outcomes of the students or trainees (Rehberg, Gazzillo, & Middlemas, 2009, p. 98). However, in terms of ensuring a quality CPR training, the computer-based training is not as effective as the traditional CPR training (Rehberg, Gazzillo, & Middlemas, 2009, p. 98). Through this study, it can be implied that a more hands on and a more tactile process of learning can ensure quality CPR training. In terms of knowledge imparted, both the computer-based and the traditional classroom instruction process are effective methods of teaching, but in terms of practical knowledge, the traditional classroom setting is still more effective. Koons, Evans, and Hill (1976, p. 18) sought to evaluate house staff training in CPR. This study was able to emphasize that smaller workshops are more effective in rendering instruction. The study cited the audiovisual instructional program which was developed in order to teach CPR to new interns and house staff (Koons, Evans, & Hill, 1976, p. 18). The program supported the standards set forth in CPR training and was conceptualized for use in a large or small group instruction. In order to ensure adequate individual instruction, projectors and computerized student response systems were used in order to impart audiovisual instruction to large groups. Small group workshops gave the students the chance to demonstrate CPR and to also be instructed by the trainers and instructors (Koons, Evans, & Hill, 1976, p. 18). Through audiovisual materials, small group instruction was improved and after the training process, the house staff training was rated as “excellent” or “good” by the trainees and the trained personnel (Koons, Evans, Hill, 1976, p. 18). From this study, it can be implied that although both large and small groups can be used in the CPR training process, it is still important for the CPR training process to reach each member of the group on an individual basis. The projectors and additional audiovisual instruction for the large groups help ensure that each student receives individual instruction. In smaller groups, the trainees now have a chance to demonstrate CPR skills as shown to them by the trained personnel. These methods of teaching, in the end, complement each other and guarantee that the trainees would be able to apply what they would learn in the more practical context. Small group practical CPR training is different from large group lecturing in the sense that all members of the class or the group can potentially have the chance to participate in the discussions (Adprima, 2010). Students can also become more comfortable in small groups and they can also easily reach a consensus in that setting. The purposes of these small groups need to be thought of well in order to prevent their activities from being sidetracked (Adprima, 2010). Facilitators in the small group setting therefore need to prepare their specific tasks and questions for the members of the group to answer. In the practical setting, small groups provide opportunities for learners to assume roles and to appreciate other people’s perspective on a particular task (Adprima, 2010). The small groups give a chance to learners to practice their skills and explore solutions to issues in the learning process. It is important for instructors and trainers to give focused instructions for the learners in order to ensure that they receive adequate instruction and are able to repeat such instructions confidently in the more practical context. The importance of practical and tactile learning in the CPR training was highlighted in a study by Done and Parr (2001, p. 287) where they assessed an “educational package for medical student BLS skills which placed the responsibility of skill acquisition with the learner”. The education package was based on hardcopy and online data, as well as an audio-video tape illustrating BLS, and access to manikins in a Skills Centre program (Done & Parr, 2001, p. 287). The learners were later assessed and based on the assessment of two independent observers using the BLS sheet; 47 of the students exhibited competence in BLS on their first assessment; three were assessed as competent after they were given self-directed learning; and one needed guidance from a personal tutor before successfully passing the assessment (Done & Parr, 2001, p. 287). The study concluded that self-directed learning is an important method in CPR training and when students do not successfully master their skills in the Skills Centre, they tend to fail in their BLS assessment. This study once again highlights the importance of a practical and tactile experience in CPR training. Skills needed in order to successfully learn CPR is largely based on the acquired skills which can be gained in a small group practical setting. It is also important to note that an interactive educational and training session can help improve the participation of learners. In a paper by Davis, et.al., (2008, p. 867), the authors were able to emphasize such point. Their study sought to evaluate and interpret the effect of formal CME interventions on the performance of physicians and on health outcomes. In the process of research and review, they were able to establish that the more interactive sessions among learners were also able to improve the participation of participants and to provide them with opportunities to implement change in their professional practice (Davis, et.al., 2008, p. 867). These results imply that in order to be effective in any learning activity, especially in the medical field, a more practical and interactive model has to be followed and applied by the learners and the teachers. Through such process, the participants would be able to come up with ways in order to later improve their practice. The process of acquiring skills in any learning process in a more comfortable and less-pressured set-up helps to ensure improved patient outcomes. For medical professionals, their limited skills in the practical set-up can cause problems in the delivery of care (House & House, 2001, p. 1440). Setting up a practical skills workshop for novice medical professionals was made part of this research in order to help the professionals learn and apply basic medical skills. Their study covered a surgical camp with eight teaching stations and ten mock trauma scenarios. The study revealed that the retreat was able to assist in improving and focusing the skills of the health professionals – away from the pressures of a formal classroom. The learners were able to master the relevant skills they would need in the practice and to still enjoy the experience as learners (House & House, 2001, p. 1440). This study implies that a relaxed and comfortable learning environment – seen in the small group practical set-up can help ensure the success of the CPR training process. CPR training is also far more effective in a small group practical format and cannot be substituted for distance education practices. A study by Makinen (2006, p. 327) was conducted in order to assess the applicability of distance learning in teaching CPR. The study covered 56 nurses involved in geriatric hospitals and these respondents were divided into three groups. The first group underwent the internet-based CPR course, the second was given the traditional small group CPR course, and the third was not given any specific training in CPR (Makinen, 2006, p. 327). The observed examination was conducted after 2 weeks. The study revealed that nurses who underwent the traditional small group course performed better as compared to those who underwent the internet-based course and those who did not undergo any training at all (Makinen, 2006, p. 327). In effect, the studies revealed that the traditional small-group training in CPR learning is superior to distance learning and the latter should not be made to replace the former. From this study, it can be further implied again that smaller groups are more effective means of teaching and learning, especially in areas where practical applications and skills have to be carried out. The process of group training was highlighted in the study by Henry (1997, p. vii). His study was carried out in order to establish the difference between subject-reported team effectiveness scores and group satisfaction among those who took part in the group training and those who did not. Their study covered about 47 female college students enrolled in First Aid CPR classes. In the process of research, the study revealed that both teams believed that they were effective in the way they carried out the intervention. The intervention group however was more confident in its team membership and its progress in the intervention. Those who did not go through the group training process had better skills in the problem-solving process and were able to give responses in relation to conflict management (Henry, 1996, p. vii). In other words, the author was able to highlight the importance of providing group training in learning CPR. It was able to emphasize group training can help ensure group development and can assist such groups in successfully going through the different tasks which have to be completed (Henry, 1996, p. vii). Once again, the importance of groups in the teaching and learning process in CPR training has been emphasized in this research. Cummins and Hazinski (2000, p. 1) discussed the different changes introduced in the International ECC and CPR guidelines and in relation to teaching and training, the authors were quick to criticize the lecture based approach to teaching and learning CPR. The authors pointed out that in order to acquire CPR skills, a hands-on approach must be applied and too much lecture time only serves to reduce skills practice time of students (Cummins & Hazinski, 2000, p. 1). The authors have come to accept the use of video-based techniques in learning CPR because they provide means for the learners to “practise as they watch” and to “watch and then practice”; and this technique seems to be also the more effective technique for lay rescuers (Cummins & Hazinski, 2000, p. 1). The authors also emphasize that the education training programs being implemented for CPR training needs approval and pilot-testing in order to ensure their overall effectiveness. In the current trends in CPR instruction, it is important to note that video-instruction methods are also fast becoming a preferred means of teaching CPR. In a study Todd, et.al., (1997, p. 564), the authors conducted a randomized study in order to establish whether or not video self-instruction (VSI) in CPR training is more effective than the traditional method prescribed by the American Heart Association. The authors covered incoming freshman medical students who were assigned randomly to the two methods of receiving CPR instruction. After about six months of training, the subjects were tested based on their ability to perform CPR (Todd, et.al., 1997, p. 564). The study revealed that the VSI-trained students had a better overall performance as compared to those undergoing traditional trainings. The VSI method proved to be effective in providing CPR training and provided a simple and inexpensive option to the traditional method of CPR training (Todd, et.al., 1997, p. 564). In effect, this study was able to provide another alternative to CPR training—one that shows much promise for the patients and the general health practice. Conclusion This study compared and contrasted the large group university lectures versus the small practical group training in CPR training. There are different types of CPR training and these types include lectures, skills stations, simulated cardiac arrest scenarios, and discussion groups. The two methods discussed in this paper include the lectures and the skills groups which can also include the simulated arrest scenarios. The lectures in large university setting can prove to be a major challenge to teachers and to learners. However, it is beneficial in the sense that it gives the learners a chance to gain theoretical information about CPR and to discuss issues with the lecturer. Large groups are however more difficult to manage and more difficult to control. Breaking up the large group into smaller ones and into shorter sessions can help improve the efficacy of the teaching process in this set-up. Based on the wealth of studies gained for this study, support for small group practical training seems to be more forthcoming. Studies reveal that small groups are more effective because they are more manageable, more interactive, and more comfortable for learners and teachers. These practical groups also help each learner in advancing skills which they would need in applying CPR. The small practical groups help to focus each learner and also help the teachers in imparting the necessary skills and knowledge to the learner. Based on information gained above, applying the lectures in a smaller group and later undertaking practical applications and demonstrations of knowledge and skills gained is the most effective means of CPR training. It is best to combine these two methods of teaching in order to achieve the best results in CPR training, and in breaking down the large groups seen in the universities, an ideal learning scenario for CPR training can also be achieved. 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