TY  - JOUR
T1  - Managing Safety in Teaching Clinical Skills: Investigating Framing Errors in Cardiopulmonary Resuscitation Training through a Multi-Arm Randomized Controlled Equivalence Study
A1  - Carla Sa-Couto
A1  - Pedro Sa-Couto
A1  - Abel Nicolau
A1  - Marc Lazarovici
A1  - Christoffer Ericsson
A1  - Pedro Vieira-Marques
A1  - Ingrid Bispo
JF  - Bulletin of Pioneering Researches of Medical and Clinical Science
JO  - Bull Pioneer Res Med Clin Sci
SN  - 3006-2659
Y1  - 2025
VL  - 4
IS  - 2
DO  - 10.51847/nybbkEFwd7
SP  - 18
EP  - 29
N2  - Cardiopulmonary resuscitation (CPR) is a critical skill in clinical settings, where mistakes can occur and potentially have serious consequences. Common approaches to handling errors include error management (EM) and error avoidance (EA), but their impact on medical performance outcomes is not fully understood. This study examined the effect of framing errors on the outcomes of basic life support (BLS) training for healthcare students. In an equivalence trial with 430 first-year students from medicine, dentistry, physiotherapy, and midwifery, participants completed BLS training. They were assigned to one of three groups: (1) instructions encouraging a positive view of mistakes (EM), (2) instructions emphasizing error prevention (EA), or (3) no specific guidance (Control). CPR performance was evaluated using a manikin measuring compression depth (CD) and compression rate (CR), while self-confidence was assessed via questionnaire. Equivalence margins and sample size were determined based on prior BLS studies, using two-sided 95% confidence intervals to evaluate equivalence. For compression depth, the results indicated equivalence across groups, with a tendency for EM to outperform both EA (a 23.3% point difference; 95% CI = 11.4%–34.2%) and the control (a 23.4% point difference; 95% CI = 11.5%–34.2%). EA and control showed significant equivalence (0.1%-point difference; 95% CI = 11.6%–11.7%). All groups demonstrated equivalence regarding compression rate and self-confidence. Error management did not impair CPR performance. Considering evidence of EM’s long-term benefits for patient safety and its equivalence to EA in short-term outcomes, EM emerges as a promising strategy for medical education. Incorporating error-framing awareness and training in error-handling strategies may enhance safety management in healthcare training and practice. Framing errors positively in CPR training shows promise for improving medical education and supporting safety management in healthcare.
UR  - https://bprmcs.com/article/managing-safety-in-teaching-clinical-skills-investigating-framing-errors-in-cardiopulmonary-resusci-2xv53hpk693zbs3
ER  -