If you pay attention to the latest developments in CPR mannequins, the clear trend is to provide feedback on performance, particularly chest compression depth and rate. While the latest versions are mostly electronic – with the most sophisticated connected to apps and to telepresent instructors online – the concept isn’t new. For example, probably the best-known CPR training feedback device is the traditional “click” correct compression depth indicator that has been in mannequins for decades. Sophisticated or simple, like any tool used by anyone for anything, optimal use maximizes how effectively and efficiently it helps you.
In instructional terms, a CPR mannequin is a simulator. Simulators and simulations are hugely important because they allow participants to practice and learn techniques they cannot practice at all, or as effectively, in the real world. They allow participants to make and learn from mistakes without the consequences of a real mistake. And, to accelerate and/or improve learning, simulators can provide feedback that doesn’t exist in real circumstances. For moderately complex procedures like CPR that have both broad and more refined motor and thinking skills, such feedback is generally withheld from the student to start, then provided, and then withdrawn.
Sequence and Position Development — No Mannequin Feedback
Have Emergency First Response® participants learn the basics to begin – correct sequences and positioning. They should know and attempt the correct compression depth and rate, the number of breaths, etc. but don’t worry too much about those as long as participants are trying to do them correctly. Instead, focus on the correct sequences, steps and positioning until they show reasonable basic mastery. The idea is to give them basics to build upon. Worrying about compression depth while still unsure about where to push in the first place can task load, slow learning and undermine confidence. The only feedback should be from you, like: “Look toward the chest when you listen so you can watch it,” “Good, you remembered hand position.” “Excellent compression position.” “Remember, 30 compressions first.” “Great job. Do it again, and this time let’s add call for help first,” etc. This usually doesn’t take a lot of time because you’re not worrying about technique yet.
Technique Development — Mannequin Feedback On
Once participants have sequencing and positioning down, congratulate them (important – it signals transition to the next stage), then tell them that now they’re going to focus on developing technique. Turn on (or have participants turn on/access) feedback, whether that’s the mechanical clicker or an electric visual, an audible indicator, app or other form. Explain that this will help them refine their compression depth, compression release (recoil) and rate (and more or less, as appropriate for the device), and then have them practice, adjusting their depth/speed etc. as they go. For aspects not supported by feedback, coach as you always have: “a little faster,” “a bit deeper – more . . . more . . . there you go,” etc.
Confidence Development — Withdraw Feedback
Your participants know real patients won’t have clickers and lights, so it is important to remove these not only so you can confirm mastery, but also so they can be confident in their skills. Although you could simply cut the feedback off, a gradual withdrawal is usually better for reaching mastery and developing confidence. After participants show consistently proper depth, rate, etc., tell them that you want them to transition to CPR without the artificial feedback, so it will be like a real patient. Have them turn off feedback (or stop looking at it, or ignore it, if that’s reasonable), practice a few cycles (with you watching) and then turn it back on for a cycle to see if they’re hitting the correct depth, etc. If not, let them control feedback as they refine their skills, turning it off and on but using it less and less (you may have to provide some prompting in this direction) until they’re demonstrating proper depth/rate/breaths etc. with no “non real world” feedback. Congratulate them for having learned basic CPR.
1. Don’t overcorrect – it undermines learning and confidence. Feedback devices can be very precise, but don’t get caught up on unimportant details when the performance would adequately do the job. So, if one compression is a little too shallow among 30 in one cycle, say nothing. And during technique development, you shouldn’t need to say anything about feedback the mannequin gives them anyway.
2. Step in gently to help speed feedback withdrawal. Instead of going back to full feedback, use your coaching. With feedback off, a simple “I think you’re getting a little shallow” or “Hold that pace” may be all a student who’s drifting away from desired performance needs to hear to get back on track.
3. The mannequin is not the instructor – you are. Feedback mannequins can help participants with technique, but that’s only part of what it takes to develop an Emergency Responder who will help if it’s ever called for. To this end, your “that’s perfect” means more than 30 green “correct depth” compression lights in a row. “Just a little faster and you’re there” does more to reassure and encourage a learner to reach mastery than does a mannequin’s incessant “you’re too slow” chirp.
For more information on feedback CPR mannequins, check out this 2019 article here.
Emergency First Response, cpr, EFR, feedback mannequins, mannequinsPADI Pros