Effect of in situ coaching on cardiopulmonary resuscitation quality: a multicenter randomized simulation study.
Resuscitation plus · 2026-05-01 · Randomised trial
Abstract
BACKGROUND: A previous manikin-based simulation study among healthcare professionals developed a cardiopulmonary resuscitation (CPR) coaching method that significantly improved CPR quality compared with real-time audiovisual feedback provided by a defibrillator monitor. This study aimed to determine whether these findings could be replicated in a larger, multicenter trial involving first responders. METHODS: We conducted a multicenter, block-randomized trial among French firefighters. Participants were randomized into three groups (n = 36 each): CPR coaching, defibrillator monitor or control. Each participant performed three 2-min external chest compression sequences on an adult cardiac arrest simulator, which measured CPR quality, compression rate, chest recoil, and depth. RESULTS: A total of 108 participants were enrolled across two centers; one participant withdrew. In the second external chest compression sequence, the CPR coaching group achieved significantly higher CPR quality than the defibrillator monitor group (median 99% [interquartile range (IQR) 99-100] vs 99% [78-99]; p = 0.0022). This difference persisted in the third sequence (p = 0.0017). Compared with the control group, CPR quality in the CPR coaching group was significantly improved in both sequences (p < 0.001), whereas the defibrillator monitor group did not show a significant difference versus control. CONCLUSION: The study confirmed the findings of our previous study with healthcare professionals, demonstrating the superiority of CPR coaching over defibrillator monitor feedback for improving CPR quality in a simulation-based setting with lay rescuers.