Alanna R. Rowley and Dr. Sheri P. Palmer, College of Nursing
Much focus has been placed on studying cardiopulmonary resuscitation (CPR) retention among nurses, but little has been done to understand the retention of emergency care/first-aid knowledge among undergraduate nursing students. Even though nursing students are educated in basic emergency care and first-aid throughout school, it “does not guarantee that [they] will be competent when faced with an emergency” (Berckes, 1984). The Berckes study (1984) shows that after only three months there was a three percent decrease in emergency care knowledge/first-aid retention. This finding was statistically significant but not drastic. Since recertification requirements range from one to two years, it was necessary broaden this study to include students whose most recent emergency care/first-aid course was one to two years ago.
This research study compared the retention rates and confidence levels among students who took training courses 0-26 months previous to the study. IRB approval was obtained prior to distributing the survey. We surveyed 108 undergraduate nursing students in semesters one, three and five in BYU’s five semester nursing program. The survey included demographic questions, previous CPR and first-aid certifications, and the 50 question Berckes Emergency Care Knowledge Test (BECKT) and was given during, or immediately following, the students’ classes. The BECKT test included questions on both first-aid and CPR knowledge. The survey was designed to answer four questions: first, if the nursing school curriculum had an effect on emergency care retention; second, if more recently certified students scored better than students certified less recently; third, if working in the medical field affected emergency care retention; fourth, if students confidence in their emergency care skills matched their knowledge. The results of the surveys are as follows.
Average scores for each semester were computed, and then compared. There was a significant increase (p = 0.019) in average score among 5th semester students (40.889) compared to 1st semester students (38.806). However, average overall scores showed a non-significant difference between semesters 1 and 3 (p = 0.113) and 3 and 5 (p = 0.385). Even though this was not significant, average scores consistently increased in every semester, suggesting that nursing education helps students to retain emergency care/first-aid knowledge. This also suggests emergency care knowledge increases throughout the entire nursing education, evidenced by the non-significant increases between 1 and 3 and 3 and 5. More research should be done to determine what aspect of learning creates this increased retention, be it repetition of knowledge, increased critical thinking skills, or simply increased confidence.
Demographic data obtained showed when the students’ most recent certifications in both first aid and CPR were obtained. All students were currently certified, as it is a requirement in the nursing program. Individual CPR scores and individual first-aid scores, showed no relationship between how recently students were certified and their score (p = 0.7911 and p = 0.8113). However, average overall scores (includes both CPR and first-aid questions) significantly increased (p = 0.042) in students who were most recently certified (3-8 months) compared to those with the second oldest certification (15-20 months). No other groups (0-2 months, 9-14 months, or 21-26 months) had any significant differences. More research should be done with a larger sample to discover if there is a difference. Results could have been affected by nursing education as well.
In light of other measured variables, there was no significant relationship among those students currently working in the medical field and those not currently working in the medical field and retention. Working in the medical field for greater than one year appeared to have no affect on increased retention. This study did not separate data for emergency medical technicians (EMTs), certified nurse’s assistants (CNAs) and licensed practical nurses (LPNs). Each of these medical professions utilizes a varying level of emergency care knowledge on the job. I would expect EMTs to have more up to date emergency care knowledge than CNAs because they use it all the time. In future studies, it would be a good idea to separate out the different professions to find out if any one profession helps to increase emergency care/first-aid knowledge. We simply did not have a large enough population of working students to separate the groups.
Student confidence was increased relative to increased scores (p = 0.058). Although not significant, it is interesting to see that, for the most part, students’ confidence levels match their knowledge levels. CPR confidence was significant (p = 0.0189): as confidence increased by 1 (out of a scale of 5), individual CPR scores increased by 0.215 (out of 6). Also, first-aid confidence was significant (p = 0.001): as confidence increased by 1 (out of a scale of 5), individual first-aid scores increased by 1 (out of 44). It appears that nursing students are appropriately confident about their knowledge.
Although more research should be done on the topic, it appears that attending nursing school significantly and positively affects retention of emergency care knowledge and confidence. It also appears that receiving nursing education helped students maintain up-to-date basic emergency care knowledge. Future studies may focus on the possibility of decreasing certification standards for nursing students to save time, money, and energy. Studies may also focus on certain medical experience to compare differences in retention among the different professions.
If I could do the study again, I would probably include all the semesters to get a bigger sample. It would also be ideal to give a pre-certification test, a post-certification test (immediately after certifying), and a retention test (a defined period of time following the certification). This would be a much better predictor of retention. Instead, we did a general study of what students know. Despite the simplicity of the study, it appears BYU nursing students have a pretty decent grasp of emergency care/first-aid knowledge. Perhaps, in the future, we can decrease certification requirements for nursing students, as they get the information in their classes anyway. I was happy to see that these future nurses retained knowledge, continued learning throughout their nursing training, and had appropriate confidence levels.
References
- Burckes, M. E. (1982). The Burckes emergency care knowledge test. Journal of American College Health Association, 30(4), 185-186
- Burckes, M. E., Shao, K. P. P. (1984). Retention of emergency care knowledge. Journal of School Health, 54(9), 355-357