Comparing real-time feedback modalities to support optimal cardiopulmonary resuscitation for undergraduate nursing students: A Quasi-Experimental Cross-Over Simulation Study

Felicity Dick-Smith, Doug Elliott, Roberto Martinez-Maldonado, Tamara Power

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)


Background: Optimal cardiopulmonary resuscitation (CPR) is reliant on a chain of well performed interventions and skills. To investigate whether CPR feedback devices improve performance for nursing students, the effects of three feedback modalities—visual: Laerdal SimPad®; visual-embodied metaphoric: Innosonian Brayden Pro®; and visual-audio: Physio-Control TrueCPR®—was tested. Method: A quasi-experimental cross-over study compared performance metrics of participant exposure to three feedback modalities and standard adult basic life support (BLS) without feedback in a simulated environment. After baseline training, 64 participants performed adult single-rescuer BLS on a manikin for each modality and without feedback for two minutes. Effective chest compressions (correct depth, thoracic recoil, pressure point, rate, no-flow fraction) and ventilation parameters were compared using Friedman and Wilcoxon tests. Results: Superior technical accuracy in CPR skills performance was evident with all feedback modalities when compared with no feedback p = <.05); visual-audio feedback (TrueCPR®) was most effective (p = .005). Participants demonstrated higher technical accuracy in CPR performance (30:2 cycles; chest compression number/rate/depth; chest recoil; pressure point; correct number of ventilations) when compared with no feedback (p = .0001), despite achieving national certification three weeks before data collection. Conclusion: This appears to be the first study to explore the use of feedback modalities during CPR performance in nursing students. These feedback devices can play a major role in improving measurable parameters of BLS and psychomotor skill capability. Modalities varied in their ability to improve performance; visual-audio feedback significantly improved chest compressions, ventilation and cycle performance, whereas visual-graph–based feedback improved flow fraction and ventilations.

Original languageEnglish
Pages (from-to)59-67
Number of pages9
JournalClinical Simulation in Nursing
Publication statusPublished - Jul 2020


  • baccalaureate
  • cardiopulmonary resuscitation
  • education
  • formative feedback
  • nursing
  • simulation training

Cite this