Gamified CPR Training for Cardiac Arrest

Overseen By Lorrel Toft, MD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Nevada, Reno

Disqualifiers: Previous CPR training, Physical injury, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to identify the most effective ways to teach CPR to students, focusing on training frequency, duration, and optimal tools. It will compare various CPR training methods, including traditional classes and gamified sessions, and test different manikin types, ranging from high-tech to improvised objects. Participants will engage in training sessions and complete questionnaires to help researchers assess skill retention and attitudes toward CPR. Students at participating schools who have not previously received CPR training and can physically perform CPR are ideal candidates for this trial. As an unphased trial, this study provides a unique opportunity for students to contribute to research that could enhance CPR training methods for future generations.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether participants need to stop taking their current medications. However, since the trial involves CPR training for students, it is unlikely that medication changes are required.

What prior data suggests that this gamified CPR training is safe?

Research has shown that gamified CPR training is safe and easy to handle. In a study with 97 first-year medical students, this training improved their retention of CPR skills, with no safety issues reported. Another study found that participants valued the interactive elements of gamified learning for understanding CPR. No negative effects were reported from using this training method. These findings suggest that gamified CPR training is both effective and safe for educational use. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to improve CPR training. Unlike traditional methods, which often rely on standard manikins with limited feedback, this trial includes gamified training to make learning more engaging and effective. By using serious games and prototypes like the "No-Head Manikin," the trial aims to enhance the quality of CPR compressions through realistic simulations. Additionally, it evaluates cost-effective alternatives, such as improvised materials, making CPR training more accessible. This trial could revolutionize CPR education by combining technology, affordability, and effectiveness.

What evidence suggests that this trial's training methods could be effective for CPR skill retention?

Research has shown that using games to teach CPR can greatly enhance how well people learn and retain these skills. In this trial, participants in the "High-Frequency, Blended Training" and "Annual Serious Game Training" arms will undergo game-based CPR training. One study found that first-year medical students who used a 3-D CPR game retained their skills better after three months. Early studies also found that learning through games, either alone or before traditional training, improves CPR training outcomes. This method makes learning more engaging, helping people retain their skills and maintain a positive attitude about CPR. The evidence suggests that games are an effective way to teach and sustain these crucial life-saving skills. ^{1 2 3 6 7}

Who Is on the Research Team?

Lorrel Toft, MD

Principal Investigator

University of Nevada, Reno

Are You a Good Fit for This Trial?

This clinical trial is for 8th and 9th grade students enrolled in Health Class at participating schools. It's not for those who've had previous CPR training (though they can still learn CPR), or if the student or parent opts out, or if there's a physical injury preventing them from performing CPR.

Inclusion Criteria

I am an 8th or 9th grader enrolled in Health Class at a participating school.

Exclusion Criteria

I or my parent have chosen not to participate.

You have received CPR training before.

I have a physical injury that stops me from performing CPR.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Training

Participants receive CPR training using either the standard method or the gamified CPR experience

1 day

1 visit (in-person)

Immediate Post-Training Assessment

Participants perform 2 minutes of chest compressions and complete post-training questionnaires

1 day

1 visit (in-person)

Follow-up

Participants are monitored for CPR skill retention and attitudes through skills testing and questionnaires

4-6 months

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Gamified CPR Training

Trial Overview The study is testing whether an interactive game-based system improves CPR skills and attitudes towards providing it, especially addressing barriers faced by women and minorities. Students will be compared based on standard classroom training versus this novel gamified approach.

How Is the Trial Designed?

Group I: Every 2 year standard CPR training Active Control 1 Intervention

Receives two 60-minute instructor-led CPR trainings: once in 9th grade and again in 11th grade

Group II: Annual Standard CPR training Active Control 1 Intervention

Receives a 60-minute instructor-led CPR training each year for three years.

Group III: High-Frequency, Blended Training Active Control 1 Intervention

Starts with a 30-minute serious game-based session, followed by 10-minute refreshers every semester for four years (8 total sessions).

Group IV: Annual Serious Game Training Active Control 1 Intervention

Receives a 30-minute serious game-based training session once per year for three years.

Group V: Control Active Control 1 Intervention

No CPR training

Group VI: Standard High-fidelity Manikin Active Control 1 Intervention

Uses a commercially available torso manikin with realistic chest mechanics and feedback. Serves as the gold standard comparator for CPR training.

Group VII: Low-Fidelity Manikin Active Control 1 Intervention

Uses a basic inflatable torso manikin with minimal feedback or resistance. Represents a low-cost, commonly used alternative in schools and communities.

Group VIII: No-Head Manikin (Prototype) Active Control 1 Intervention

Uses a custom-built spring-based device with a silicone topper and realistic force-displacement properties that closely mimic the human chest. Tests whether an affordable, biomechanically accurate prototype can improve compression quality.

Group IX: Non-Traditional Object Active Control 1 Intervention

Uses improvised materials (e.g., toilet paper rolls) to simulate chest compressions. Evaluates the feasibility and effectiveness of ultra-low-cost CPR practice tools

Who Is Running the Clinical Trial?

University of Nevada, Reno

Lead Sponsor

Trials

34

Recruited

20,200+

Published Research Related to This Trial

A randomized control trial with 97 freshman medical students showed that using a 3-D CPR game significantly improved CPR skill retention after 3 months compared to traditional training methods.

The game was also found to be highly usable, with average scores between 3.99 and 4.05 on a 5-point scale, indicating that it is both effective and user-friendly for teaching CPR skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

3D CPR Game Can Improve CPR Skill Retention. Li, J., Xu, Y., Xu, Y., et al.[2019]

Pediatric residents often lack sufficient training and experience in performing primary surveys for critically ill patients, leading to delays and incomplete evaluations during emergencies.

Implementing gamification techniques with a low-fidelity paper doll model simulation aims to standardize and enhance training for pediatric residents, potentially improving their performance in real-life resuscitations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gamification of a Low-Fidelity Paper Doll to Teach Primary Survey to Pediatric Residents. Thomas, AA., Yoshida, H., Keilman, AE., et al.[2023]

The study outlines a comprehensive approach to integrating gaming into a level 'A' cardiopulmonary resuscitation (CPR) course, which includes needs assessment, planning, implementation, and evaluation phases.

Using gaming as an interactive teaching method can enhance the learning experience for instructors and participants in the Heartsaver CPR course, potentially improving engagement and retention of critical life-saving skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Playing games with cardiopulmonary resuscitation. Martin, R., Coleman, S.[2004]

A study involving 162 healthcare professionals found that a web-based Neonatal Resuscitation Game did not significantly improve the retention of knowledge and skills in neonatal resuscitation compared to a control group without access to the game.

Despite some participants using the game voluntarily, there was no notable difference in knowledge and skill retention between those who played the game and those who did not, indicating that the game's current format may not be effective for enhancing learning outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of web-based game in neonatal resuscitation - is it effective? Yeo, CL., Ho, SKY., Tagamolila, VC., et al.[2021]

The serious game Relive significantly improved CPR skills among high school students, with chest compression depth increasing from 31mm at baseline to 47mm during the retention phase, and compression rate rising from 95 to 131 compressions per minute, indicating effective training.

Seventy-three percent of students showed improved CPR knowledge, and the game was well-received, with participants finding it easy to use and providing effective feedback, suggesting it is a valuable educational tool for teaching CPR.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Kids (learn how to) save lives in the school with the serious game Relive. Semeraro, F., Frisoli, A., Loconsole, C., et al.[2018]

The augmented reality (AR) CPR training system (CPReality) was found to be feasible and effective for healthcare providers, with participants achieving high-quality chest compressions (CC) that met guideline recommendations.

Participants reported high satisfaction with the AR training experience, with 98% finding the visual feedback helpful and 94% expressing willingness to use the system for future CPR training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers. Balian, S., McGovern, SK., Abella, BS., et al.[2022]

The LISSA serious game significantly improved learning acquisition scores in CPR training among 109 nursing students compared to traditional teaching methods, with statistical analysis showing significant differences (p<0.05).

Students who used LISSA performed better in executing the main steps of the CPR protocol, indicating that the game effectively enhances practical skills in emergency situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a serious game to complement CPR instruction in a nurse faculty. Boada, I., Rodriguez-Benitez, A., Garcia-Gonzalez, JM., et al.[2015]

A randomized controlled trial involving 171 healthcare professionals showed that self-motivated CPR training with a feedback device and competitive leaderboard significantly improved infant CPR skills over 26 weeks compared to no refresher training.

Participants in the intervention group had a notable increase in their CPR performance scores, while the control group showed little to no improvement, highlighting the effectiveness of gamification techniques in maintaining CPR skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-motivated learning with gamification improves infant CPR performance, a randomised controlled trial. MacKinnon, RJ., Stoeter, R., Doherty, C., et al.[2022]

An immersive 'escape room' experience was created for 130 incoming intern physicians to enhance their ability to identify and report patient safety hazards, which are critical in preventing medical errors.

Post-activity surveys indicated that the interns found the experience engaging and it positively changed their perception of patient safety threats, suggesting that this innovative approach could improve reporting behaviors in the future.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Finding the 'QR' to Patient Safety: Applying Gamification to Incorporate Patient Safety Priorities Through a Simulated 'Escape Room' Experience. Zhang, XC., Diemer, G., Lee, H., et al.[2020]

Gamification (GAM) training for CPR significantly improved the quality of CPR performance among 489 secondary school students compared to traditional (TC) and visual feedback (VFC) methods, with GAM achieving an average score of 89.56%.

A higher percentage of students trained with GAM (93.4%) met the recommended compression depth of >50 mm, indicating that gamification is an effective teaching method for Basic Life Support (BLS) in younger individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Let the kids play: gamification as a CPR training methodology in secondary school students. A quasi-experimental manikin simulation study. Otero-Agra, M., Barcala-Furelos, R., Besada-Saavedra, I., et al.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11043884/

Gamified learning for resuscitation education: A systematic ... Some preliminary studies have found that gamified learning results in improved knowledge and skill during CPR training, either alone or used as pre-training.

2. games.jmir.org games.jmir.org/2024/1/e52990/

Systematic Review With Meta-Analysis of Randomized ... This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies.

3. withpower.com withpower.com/trial/phase-out-of-hospital-cardiac-arrest-2024-b8781

Gamified CPR Training for Cardiac Arrest A randomized control trial with 97 freshman medical students showed that using a 3-D CPR game significantly improved CPR skill retention after 3 months compared ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0260691724001734

Effects of gamification in advanced life support training for ... We hypothesized that gamified learning would improve educational outcomes in in-hospital cardiac arrest response training, but the effectiveness may vary ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10879970/

The Effects of Serious Games on Cardiopulmonary ... This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies.

6. jmir.org jmir.org/2021/7/e22920/

Resuscitating Cardiopulmonary Resuscitation Training in a ... In our study, the vast majority of respondents agreed that the interactive gameplay elements were useful in understanding how to perform CPR and ...

7. scispace.com scispace.com/pdf/gamifying-autonomous-cpr-training-8howirh73z.pdf

Gamifying Autonomous CPR Training The main objective of this thesis was to design and evaluate a gamified approach for CPR training. To this end, a first study aimed to review the literature ...