Basic life support skills training in a first year medical curriculum:: six years' experience with two cognitive-constructivist designs

Rationale: Although the Basic Life Support (BLS) ability of a medical student is a crucial competence, poor BLS training programs have been documented worldwide. Better training designs are needed. This study aims to share detailed descriptions and the test results of two cognitive - constructivist training models for the BLS skills in the first year of medical curriculum. Method: A BLS skills training module was implemented in the first year curriculum in the course of 6 years ( 1997 - 2003). The content was derived from the European Resuscitation Council Guidelines. Initially, a competence-based model was used and was upgraded to a cognitive apprenticeship model in 2000. The main performance-content type that was expected at the end of the course was: competent application of BLS procedures on manikins and peers at an OSCE as well as 60% achievement in a test consisting of 25 MCQ items. A retrospective cohort survey design using exam results and a self-completed anonymous student ratings' questionnaire were used in order to test models. Results: Training time for individual students varied from 21 to 29 hours. One thousand seven hundred and sixty students were trained. Fail rates were very low (1.0 - 2.2%). The students were highly satisfied with the module during the 6 years. Conclusion: In the first year of the medical curriculum, a competence-based or cognitive apprenticeship model using cognitive-constructivist designs of skills training with 9 hours theoretical and 12 - 20 hours long practical sessions took place in groups of 12 - 17 students; medical students reached a degree of competence to sufficiently perform BLS skills on the manikins and their peers. The cognitive - constructivist designs for skills training are associated with high student satisfaction. However, the lack of controls limits the extrapolation of this conclusion.