Basic life support is effectively taught in groups of three, five and eight medical students: a prospective, randomized study

BACKGROUND Resuscitation is a life-saving measure usually instructed in simulation sessions. Small-group teaching is effective. However, feasible group sizes for resuscitation classes are unknown. We investigated the impact of different group sizes on the outcome of resuscitation training. METHODS Medical students (n = 74) were randomized to courses with three, five or eight participants per tutor. The course duration was adjusted according to the group size, so that there was a time slot of 6 minutes hands-on time for every student. All participants performed an objective structured clinical examination before and after training. The teaching sessions were videotaped and resuscitation quality was scored using a checklist while we measured the chest compression parameters with a manikin. In addition, we recorded hands-on-time, questions to the tutor and unrelated conversation. RESULTS Results are displayed as median (IQR). Checklist pass rates and scores were comparable between the groups of three, five and eight students per tutor in the post-test (93%, 100% and 100%). Groups of eight students asked fewer questions (0.5 (0.0 - 1.0) vs. 3.0 (2.0 - 4.0), p < .001), had less hands-on time (2:16 min (1:15 - 4:55 min) vs. 4:07 min (2:54 - 5:52 min), p = .02), conducted more unrelated conversations (17.0 ± 5.1 and 2.9 ± 1.7, p < 0.001) and had lower self-assessments than groups of three students per tutor (7.0 (6.1 - 9.0) and 8.2 (7.2 - 9.0), p = .03). CONCLUSIONS Resuscitation checklist scores and pass rates after training were comparable in groups of three, five or eight medical students, although smaller groups had advantages in teaching interventions and hands-on time. Our results suggest that teaching BLS skills is effective in groups up to eight medical students, but smaller groups yielded more intense teaching conditions, which might be crucial for more complex skills or less advanced students.