4.1 Problems with traditional cardiopulmonary resuscitation courses
4.1.1 Disconnect between theory and practice
At present, medical education is a sequential process from theory to practice. Understanding the theoretical courses is very difficult for students lacking clinical practical experience. This situation is not uncommon in the continuing education of medical students after graduation. Junior doctors often encounter difficulty connecting theory with the clinic, and senior doctors face challenges in returning to theory with their habitual thinking.
Kolb proposed an experiential learning model in the 1980s. It consists of four parts: practical experience, feedback observation, abstract concepts, and active attempts. The four parts are looped repeatedly to improve learners’ theoretical and practical abilities. The essence of this model is to combine theory with practice through repeated cycles. The necessary condition is the learner’s active observation, thinking, and experimentation. In a short period of 2 class hours (90 minutes), how to guide medical students without a basis in clinical practice to think actively is a difficult point for educators. In the course of CPR, we are faced with how to make students feel the images of clinical CPR in their minds and how to match these images with the required high-quality CPR techniques and various numbers.
4.1.2 Disconnect between teaching and learning
In traditional colleges and universities, teachers usually teach classes and midterm and final assessments, and the communication between teachers and students is very minimal. Especially in the teaching of various clinical subjects, teachers come from major hospitals, and each teacher is only responsible for his own theme. After the lecture, communication with the students is rare. Re-intersection occurs after the final assessment, and the teaching method is adjusted according to the answer; this is undoubtedly the disconnect between teaching and learning.
When teaching a large class with more than 100 people, how should attention be paid to the learning effect of the students, and how is feedback on the teaching effect made from the perspective of the students, that is, how to determine whether the students understand or not, this is a knowledge. When teaching CPR courses, students would be interested in actual clinical cases. Clinical cases can be used as a point of interest to guide students in obtaining a deeper understanding of how and why each step of CPR should be carried out, that is, let students know what is and why.
4.1.3 Disconnect between professional teaching and medical humanities
In teaching professional theory courses, following the text and simply discussing theoretical knowledge is easy. Everyone knows that ideological and political elements are an effective support for professional theory. Medical humanities teaches us to keep abreast of the latest educational theories and teaching concepts at all times, and always keep a clear head to deal with several problems that may arise during practice. For the education of students, the situation should be used, and students should be taught in accordance with their aptitude. Our education should be adjusted at any time to adapt to every student, rather than training students suitable for education.
The CPR course itself covers medical humanities elements. For patients who have died clinically, how we can actively rescue the individual while respecting the individual requires an in-depth discussion. The unity of knowledge and action is the starting point and goal of medical humanities. In the knowledge–action relationship, “knowledge” is the premise of “action,” and “action” is the purpose of “knowledge.” Without “knowing” but “doing,” “doing” will lose its direction and easily go astray, but only “knowing” without “doing” will lose its meaning. CPR is not only a way to save people but also a decision made when facing life. Each point of CPR is very important. Any disconnection or slack in the link will bring the price of blood. How to guide students to look at life reasonably in the short teaching time requires teachers to think deeply.
4.2 Teaching innovation of CPR course
Based on the thinking in the above teaching, combined with the close connection between the CPR course itself and clinical practice, we consider that based on the traditional teaching mode and content, we should be student centered and guided by teaching goals, apply heuristic teaching mode, introduce clinical practice cases, incorporate medical humanities elements, apply basic knowledge of medical physics and pathophysiology, and teach students how to understand the action essentials in the teaching content and assist various digital memories in CPR. The goal is to make students familiar with the course of CPR and achieve to know what it is and why it is so.
The results of this research show that after teaching innovation, students’ usual grades and final grades are improved compared with traditional teaching. The teaching innovation of the CPR course improves the grades of the CPR course, enables students to apply learning methods to the overall curriculum of emergency medicine, and enhances the overall course of emergency medicine.
The teaching model of BOPPPS is applied and according to the teaching goals; students are gradually guided and mobilized to think actively, fundamentally understand the methods and connotations of CPR, and incorporate ideological elements.
For students who have not yet entered clinical work, the CPR video is used as the basis for their perceptual understanding of CPR. The video covers the basic life support part of CPR. Through actual cases, the patient’s performance in cardiac arrest, the reaction of the first witness, the method and steps of CPR, the application of defibrillator, and team cooperation are demonstrated for students to have an intuitive, perceptual understanding of CPR. Moreover, students are taught that the current situation of CPR is not optimistic, and its success rate is still very low. It requires everyone in society to contribute their own strength and use the knowledge they have learned to save lives.
The purpose of learning CPR, including course goals and goals of CPR, is clarified. Course objectives include mastering the diagnosis of cardiac arrest, CPR methods, procedures, and indications of successful resuscitation; familiarizing with the concepts of resuscitation complications, clinical death, and biological death; understanding the mechanism of CPR, the treatment of airway foreign body obstruction, and defibrillators; and guiding students to self-learn arrhythmia and post CPR management procedures, and CPR guideline update[15–19]. The goals of CPR are divided into primary goals and ultimate goals. The primary goal is to restore spontaneous circulation, and the ultimate goal is to recover and return to society.
The pre-class test is not limited to the form. For large classes with limited time, the pretest part is not limited to the pre-course, but the interactive questioning method is used before each learning stage or key knowledge point is taught, which is helpful to understand the students. The basic cognition level can also allow students to think and listen to the class with questions, which is helpful to the understanding and application of knowledge in the future. For example, in the introduction, “What are the factors that can lead to cardiac arrest?” A seed can be planted in the students’ hearts, they learn with this question, and wait until the answer is revealed, which can deepen their memory of knowledge points.
18.104.22.168 Participatory learning
Participatory learning methods, heuristic teaching, and in-depth layer by layer are applied to inspire students to use the knowledge they have learned to explore the connotation of CPR, guide students to find answers, and cultivate good learning and thinking methods. For example, the step of “chest compression” in CPR introduces pathophysiology to explain the mechanism and connotation of chest compression; the step “opening the airway” guides students to try their own airway opening and closing states to understand what the step is; the step “ventilation” introduces Poiseuille’s law in fluid mechanics to explain the time and connotation required for ventilation based on the opening of the airway. In letting students be the implementers of the courses, not just the trainees, students are acquire a deep understanding of the knowledge points, which is conducive to their future operation of skills courses and ultimately, clinical practice.
22.214.171.124 Post assessment
After the course, students are assessed based on their knowledge, and the teaching methods are adjusted according to the test results. During the short teaching period, applicants take a small test in class, set up questions for students according to the key questions of the syllabus, set up open questions appropriately, and are encouraged to think independently.
Finally, the course as a whole is summarized, the teaching focus is reiterated, students are guided to review the main points of the course, the learning content is expanded, and students are provided space for self-study. The guiding process is carried out by asking questions, guiding students to review the entire course by themselves and find blind spots again. Summary is a very important part of the course, which helps students obtain a clearer understanding of the course as a whole.
4.2.2 PAL teaching methods
The PAL teaching method is adopted[12, 20], the coat of teachers is taken off, CPR-related knowledge is discussed with students in the attitude of pioneer partners in the same field, students are encouraged to raise objections, and practical clinical issues are discussed with one another, which will help deepen the understanding and memory of knowledge points.
For example, when teaching the ECG performance during cardiac arrest, the ECG evolution of cardiac arrest cases seen in the clinic are shared with the students. Students can participate in the discussion and learn what they need as if they were talking. Bringing in such a situation makes students have a firmer grasp of knowledge points.
4.2.3 Medical humanities methods
Medical humanities brings more space to teachers and students. While teaching theoretical knowledge, more attention is paid to thoughts and thinking. As the saying goes, “With copper as a mirror, you can straighten your clothes; with ancient times as a mirror, you can know the rise and fall; and with people as a mirror, you can understand gains and losses.” Professional theoretical knowledge is to give fish to people, whereas the education we need is to teach people how to fish.
The course of CPR has its own medical humanities characteristics, ranging from the ethics of resuscitation to the idea of “preventing disease” in Chinese medicine, the understanding of pathophysiology-oriented CPR mechanism, and the dialectical materialism of individualized medicine. As medical teachers, we should lead the students on the correct path from the perspective of humanity and morality.