REVIEW PROTOCOL

Educational technologies on basic life support for adolescents: scoping review protocol

Phellype Kayyaã da Luz1, Raylane da Silva Machado1, Rouslanny Kelly Cipriano de Oliveira1, Nelson Miguel Galindo Neto2, Maria do Céu Mendes Pinto Marques3, Nelito Lopes Barros1, Elaine Maria Leite Rangel Andrade1

1Universidade Federal do Piauí, Teresina, PI, Brazil

2Federal Institute of Pernambuco, Pesqueira, PE, Brazil

3Evora University, Evora, PT, Portugal

ABSTRACT

Objective: to map the productions about educational technologies built to teach basic life support for adolescents. Method: Scope review protocol conducted based on the Joanna Briggs Institute methodology. Findings will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist extension. The protocol is in the Open Science Framework. The guiding question was elaborated based on the PCC acronym: Population (adolescents), Concept (educational technologies) and Context (basic life support). Three databases will be used via Virtual Health Library and four databases via the Journal Portal of the Coordination for the Improvement of Higher Education Personnel. Two independent reviewers will select the articles using the EndNote® and Rayyan® programs, obeying eligibility criteria. Google Scholar and references from primary studies will be consulted as additional strategies. The results will be presented in tables, flowchart and narrative discussion.

Descriptors: Cardiopulmonary Resuscitation; Educational Technology; Adolescent.

INTRODUCTION

Guidelines from the American Hearth Association (AHA) and the European Society for Resuscitation highlight that the science of education in Cardiopulmonary Resuscitation (CPR) is a key variable for improving survival outcomes after a Cardiopulmonary Arrest (CPA). Thus, the teaching of Basic Life Support (BLS) through the promotion of CPR teaching must persist in a disseminated way to increase the prevalence of CPR and improve the results of Out-of-Hospital Cardiac Arrest (EHCPA), whose survival rates are at the same level since 2012(1,2).

Among the audiences that require training, we have the adolescents. Despite being able to recognize and treat a patient with EHCPA, there are structural, political and educational limitations that make it difficult to teach CPR to this population. As an impact of this assertion, a study pointed out that adolescents had little knowledge about what they should do to help someone in CPA(3).

So, the need to know strategies based on evidence that are capable of improving the knowledge of adolescents about CPR is pointed out. The AHA and the World Health Organization (WHO) postulate that training should occur in schools for children and adolescents through use of educational technologies based on instructional design(1,4).

In this perspective, mapping the scenario that involves the use of educational technologies for teaching Hands-Only CPR to adolescents is an essential step to guide actions to improve the health education process. An integrative review research identified the teaching and learning strategies of cardiopulmonary resuscitation aimed at lay people. However, there was no mapping of educational technologies undertaken in the educational process(5). Among the gaps that need to be explored, there is the lack of knowledge of the list of the most adopted technologies and their effectiveness, theoretical references are followed, and mainly if they went through a validation process.

Preliminary searches performed through May 27, 2022 in Medical Literature and Retrieval System Online (MEDLINE) via National Center for Biotechnology Information (NCBI/PubMed); Web of Science, SCOPUS, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL) via Thomson Reuters collection, Virtual Health Library, COCHRANE and Google Scholar did not find ongoing or completed scoping reviews that presented aspects related to the aim of this study. Thus, the scoping review study is relevant, which aims to map educational technologies designed to teach basic life support to adolescents.

METHOD

This study is a scoping review protocol that will be conducted following the method proposed by the Joanna Briggs Institute (JBI)(6) and its findings will use the checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR)(7). The strategy of this protocol is on an open science platform that can be verified at: https://osf.io/bsczm/?view_only=4f04b314048e43d494761bed3412328e.

Review question

The question was formulated based on the PCC (Population, Concept and Context) strategy. Thus, the question is: “What are the educational technologies elaborated/used on basic life support for adolescents?”.

Inclusion criteria

Participants

This scope review will consider adolescents aged between 10 and 19 years old, following the definition proposed by the WHO for adolescents(8). This definition was chosen because it is a delimitation of international scope.

Concept

This review will include studies that mention the use of educational technologies designed to teach BLS to adolescents. Educational technologies provide the improvement of knowledge, scientific increment and the acquisition of new skills(9). Studies that did not use material technologies will be excluded. However, it is known that technologies are the result of material products, or not, with the aim of generating interventions in practical situations(10). However, not delimiting the concept of technology would make the scope of the review unfeasible, due to the possibility of covering management and assistance technologies that include, for example, relationships such as bonding, empowerment and reception. Thus, studies that expose educational strategies but do not mention educational technologies will also be excluded, since these strategies have already been well delimited by the current literature(5).

Context

Studies should contextualize BLS teaching for adolescents in the pre-hospital setting, but will not be limited to considering cultural factors, such as geographic location and/or specific social, cultural or gender interests. In the scenario, BLS is considered one of the factors that influence survival, especially in cases of EHCPA, where a bystander can provide immediate CPR(11).

Types of evidence sources

This study will be based on any existing literature, of any methodological design. Searches will be performed on the following (MEDLINE) via (NCBI/PubMed); (CINAHL) via Thomson Reuters collection, Web of Science (WOS)- main collection via Clarivate Analytics and Embase via Elsevier, accessed through the Journal Portal of the Coordination for the Improvement of Higher Education Personnel (CAPES); Latin American and Caribbean Literature on Health Sciences (LILACS), Spanish Bibliographic Index on Health Sciences (IBECS) and Nursing Database (BDENF) via the Virtual Health Library (VHL). Google Scholar search will be considered as additional strategies.

Search strategy

To develop the search strategy, the study question, eligibility criteria, particularities of each database and which descriptors and/or keywords could retrieve the studies were observed. Figure 1 shows the bases and the respective strategies used.

Source: Elaborated by the authors, 2022.

Figure 1 - Search Strategy. Teresina, PI, Brazil, 2022

The search strategy followed three steps as recommended in the literature(6). In the first one, a search was carried out in the MEDLINE databases (NCBI/PubMed) and then, studies were searched in CINAHL. This initial search consisted of analyzing the terms contained in the title and abstract and the indexing terms used to search for the articles. In the second step, a second search was performed using all identified keywords and index terms across all included databases. In the third stage, the researchers will search the reference lists for possible studies that mention educational technologies whose focus is similar to the object of this study. It should be noted that studies published in any language and without time limits will be considered.

Selection of studies

The results will be imported into EndNote Web where the investigation of duplicity of bibliographic references, obtained from different data sources,(12) will happen. For analysis, selection and exclusion of articles, the software Rayyan (Qatar Computing Research Institute, Doha, Qatar)(13) will be used. Articles will be included or excluded first by reading the title and abstract. They will then be read in full and evaluated according to the inclusion/exclusion criteria. In cases of disagreement between reviewers, the opinion of a third reviewer will be requested. The studies coming from the gray literature will have the same standardized dynamics for the analysis of the published literature (peer review).  

Data extraction

For the extraction of information from the articles, an instrument will be developed based on the template available in the JBI manual(6). The instrument for descriptive mapping of the study variables will be built in Microsoft Office Excel 365/2022, in the form of a synoptic table, whose variables will be, at first: year, country, study design, objectives, educational technology, level of evidence of the study, theoretical framework for building the technology, authors' professional category, validation process, results and conclusion.

It should be noted that, as reviewers map each source, it may become apparent that additional unanticipated data is usefully mapped. In order to familiarize the review team with the extraction of results, a pilot stage will be carried out. In turn, the process of screening the studies will be described according to the guidelines of the PRISMA-ScR(7).

Source: Elaborated by the authors, 2022.

Figure 2 – Data extraction instrument. Teresina, PI, Brazil, 2022

Evidence analysis

JBI's meta-aggregative approach or meta-ethnographic approaches will not be carried out since they are beyond the purpose of a scoping review(6). However, when seeking to highlight the quality of the information source, the inserted articles will have their quality evidenced through JBI's Critical Appraisal Tools (https://jbi.global/critical-appraisal-tools);

Results presentation

The results will be presented in tables and diagrams that will accompany a descriptive summary (of the research variables) of the conceptual categories.

CONFLICT OF INTERESTS

The authors have declared that there is no conflict of interests.

REFERENCES

1. American Heart Association (AHA). Diretrizes de RCP e ACE de 2020 da American Heart Association [Internet]. Dallas (TX): American Heart Association; 2020 [cited 2022 May 05]. Available from: https://cpr.heart.org/-/media/CPR-Files/CPR-Guidelines-Files/Highlights/Hghlghts_2020ECCGuidelines_Portuguese.pdf

2. Perkins GD, Gräsner J-T, Semeraro F, Olasveengen T, Soar J, Lott C, et al. European Resuscitation Council Guidelines 2021: Executive summary. Resuscitation. 2021;161:1–60. https://doi.org/10.1016/j.resuscitation.2021.02.003

3. Kua PHJ, White AE, Ng WY, Fook-Chong S, Ng EKX, Ng YY, et al. Knowledge and attitudes of singapore schoolchildren learning cardiopulmonary resuscitation and automated external defibrillator skills. Singapore Med J. 2018;59(9):487–99. https://doi.org/10.11622%2Fsmedj.2018021

4. Böttiger BW, Van Aken H. Kids save lives - Training school children in cardiopulmonary resuscitation worldwide is now endorsed by the World Health Organization (WHO). Resuscitation. 2015;94:A5–7. http://dx.doi.org/10.1016/j.resuscitation.2015.07.005

5. Siqueira TV, Nascimento J da SG, Regino D da SG, Oliveira JLG de, Pereira LA, Dalri MCB. Estratégias educativas de ressuscitação cardiopulmonar para leigos: revisão integrativa da literatura. Reme - Rev Min Enferm [Internet]. 2021 [2022 May 03]; 25:e-1411. Available from: https://cdn.publisher.gn1.link/reme.org.br/pdf/e1411.pdf  

6. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; 2020 [cited 2022 May 09]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL/4687342/Chapter+11%3A+Scoping+reviews. https://doi.org/10.46658/JBIMES-20-12  

7. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73. https://doi.org/10.7326/m18-0850

8. World Health Organization (WHO). Young people’s health - a challenge for society [Internet]. Geneva: World Health Organization; 1986 [cited 2022 May 07];731:1–117. Available from: https://apps.who.int/iris/handle/10665/41720

9. Caetano DM, Silva FH, Melo EVD. Tecnologias educacionais e a formação docente no contexto da educação profissional e tecnológica. RBEPT. 2019;1(16):e8022. https://doi.org/10.15628/rbept.2019.8022

10. Nietsche EA, Backes VMS, Colomé CLM, Ceratti RN, Ferraz F. Education, Care and Management Technologies : a reflection based on nursing teatchers’ conception. Rev Lat-Am Enferm. 2005;13(3):344–53. https://doi.org/10.1590/S0104-11692005000300009

11. Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142:16(suppl 2):S366–468. https://doi.org/10.1161/CIR.0000000000000916

12. Mendes KDS, Silveira RCCP, Galvão MC. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto Contexto Enferm. 2019;28: e20170204. https://doi.org/10.1590/1980-265X-TCE-2017-0204

13. Ouzzani M. Rayyan — a web and mobile app for systematic reviews. Syst Rev. 2017;(2016):1–10. http://dx.doi.org/10.1186/s13643-016-0384-4

Submission: 06/03/2022

Approved: 01/17/2023