The Effect of Education by Visual Self-Assessment on the Operating Room Technician’s Knowledge, Self-Esteem and Performance in Advanced Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation is one of the most important medical emergencies and the effect of trained and skilled people on the outcome of resuscitation has been proven to be positive. The results of studies indicate poor performance and insufficient knowledge of operating room technicians in the field of cardiopulmonary resuscitation. Despite the importance of cardiopulmonary resuscitation training, very little attention is still paid to teaching patient life skills with attractive and appropriate methods, so the current need is not only to slightly increase cardiopulmonary resuscitation training, but more importantly, to increase the quality of training. One way is self-assessment. In the medical profession, the ability of employees to identify their strengths and weaknesses is very important, and proper self-assessment can be effective in developing a person's abilities. Learners also use the rethinking process to gain insight into their own performance and identify strengths and abilities, as well as areas that may need further development. The aim of this study was to investigate the effect of visual self-assessment training on the level of knowledge, self-esteem and performance of operating room personnel in field of advanced cardiopulmonary resuscitation.

This Semi-experimental pre-test post-test single group study was performed with participation of 32 operating room technicians. Sampling was continued in an accessible method according to the inclusion criteria reach the specified sample size. The intervention was in the form of a cardiopulmonary resuscitation workshop and takes a video from resuscitation operation on the model by each of the participants and then replaying the video for self-assessment. The two-day workshop includes theoretical and practical training including recognizing life-threatening dysrhythmias, recognizing and using the cardiac shock device, airway management (airway opening maneuvers and artificial respiration by airway and ambo bag), and cardiopulmonary resuscitation training. According to the latest guideline of cardiopulmonary resuscitation 2017, it was in the form of a lecture and slide show and all the resuscitation steps were performed in the form of simulations on a mannequin for cardiopulmonary resuscitation. At the end of the workshop on the second day, each participant was given 3 minutes to perform a short-term scenario about cardiopulmonary resuscitation. From all participant’s performances were recorded a video and after the resuscitation, each person film was shown for himself on the TV in the resuscitation room. Then, knowledge, self-esteem questionnaire and self-assessment performance checklist were given to each participant to complete immediately after the intervention. At the same time, during the resuscitation by the participants, a performance observation checklist was completed for them by the researcher. At 8 weeks after the intervention, the participants repeated the above steps again by receiving another short scenario and performing 3 minutes of cardiac resuscitation on the mannequin and showing the resuscitation video and completing the knowledge, self-esteem and self-assessment questionnaire. At this time, the performance observation checklist was completed again by the researcher. So the data were collected using a researcher-made questionnaire and Rosenberg self-esteem questionnaire in 3 times (before, immediately and 8 weeks after the intervention) and self-assessment performance questionnaire and observational performance checklist in two times (immediately and 8 weeks after Intervention) were collected. This article was extracted from a research project approved by Isfahan University of Medical Sciences. During the research process, the ethical policies of the university were observed, including obtaining informed consent from the nurses. Data were analyzed by SPSS.v16 software and repeated measures analysis, Greenhouse-Geisser and Bonferroni post hoc test and paired t-test were used. 

A total of 32 operating room technicians were included in the study, one participant was excluded due to obstetric delivery, one due to transfer from a medical center and 2 due to not participating in the evaluation 8 weeks after the intervention. Finally, data analysis was performed on 28 operating room personnel participating in the study.  Demographic data of participants showed 89.29% were female, 67.86% had a bachelor's degree in operating room and the mean age of participants was 39.37 years. The comparison of the mean score of operating room technicians knowledge in 3 times was significant (P<0.001). The pairwise comparison of knowledge index was significant at the time (before-immediately after (P<0.002) and before -8 weeks after the intervention (P<0.05)). The comparison of the mean score of operating room technicians self-esteem in 3 times was significant (P<0.001). Also, the comparison of the mean performance self-assessment score and the comparison of the mean performance score observed immediately after and 8 weeks later were significant (P<0.001). According to the results obtained by comparing the knowledge index in pairs at three different times with Bonferroni test, the difference between the means of the times before and immediately after the intervention and the times immediately after and 8 weeks after the intervention was significant (P <0.0001) and there is no significant difference between the time before and 8 weeks after the intervention (P = 0.321). Also, according to the results obtained by comparing the self-esteem index in three different times, the difference between the means of the times before and immediately after the intervention (P = 0.002) and the time before and 8 weeks after the intervention was significantly different (P = 0.05). While there was no significant difference between the times immediately after and 8 weeks after the intervention (P = 1,000). So visual self-assessment has elevated the self-esteem of operating room technicians in cardiopulmonary resuscitation and it kept high until 8 weeks later. While knowledge was high immediately after the intervention and decreased significantly 8 weeks after the intervention. There was also a significant improvement in functional cardiopulmonary resuscitation.

Visual self-assessment method is effective in increasing the knowledge, self-esteem and performance of operating room technicians in the field of cardiopulmonary resuscitation. Especially since their self-esteem and performance will be indelible. The presentation of this method by clinical instructors and diversity in educational affairs are the advantages of using the visual self-assessment training method in clinical education and it can be useful if its outputs such as quality of patient care will be evaluated. It is suggested that such a study be conducted in other research settings and along with investigating of factors affecting the self-esteem and performance of staff and even their self-efficacy and self-confidence to perform care, especially in urgent and stressful care.