{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:50:08Z","timestamp":1793505008803,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,23]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\u2018Quality Cardiopulmonary Resuscitation (QCPR) Classroom\u2019 was recently introduced to provide higher-quality Cardiopulmonary Resuscitation (CPR) training. This study aimed to examine whether novel QCPR Classroom training can lead to higher chest-compression quality than standard CPR training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cluster randomised controlled trial was conducted to compare standard CPR training (control) and QCPR Classroom (intervention).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Layperson CPR training in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Six hundred forty-two people aged over 15 years were recruited from among CPR trainees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>CPR performance data were registered without feedback on instrumented Little Anne prototypes for 1\u2009min pretraining and post-training. A large classroom was used in which QCPR Classroom participants could see their CPR performance on a big screen at the front; the control group only received instructor\u2019s subjective feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcomes were compression depth (mm), rate (compressions per minute (cpm)), percentage of adequate depth (%) and recoil (%). Survey scores were a secondary outcome. The survey included participants\u2019 confidence regarding CPR parameters and ease of understanding instructor feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 259 and 238 people in the control and QCPR Classroom groups, respectively, were eligible for analysis. After training, the mean compression depth and rate were 56.1\u00b19.8\u2009mm and 119.2\u00b17.3\u2009cpm in the control group and 59.5\u00b17.9\u2009mm and 116.8\u00b15.5\u2009cpm in the QCPR Classroom group. The QCPR Classroom group showed significantly more adequate depth than the control group (p=0.001). There were 39.0% (95% CI 33.8 to 44.2; p&lt;0.0001) and 20.0% improvements (95%\u2009CI 15.4 to 24.7; P&lt;0.0001) in the QCPR Classroom and control groups, respectively. The difference in adequate recoil between pretraining and post-training was 2.7% (95% CI \u22121.7 to 7.1; pre 64.2\u00b136.5%\u2009vs post 66.9%\u00b134.6%; p=0.23) and 22.6% in the control and QCPR Classroom groups (95%\u2009CI 17.8 to 27.3; pre 64.8\u00b137.5%\u2009vs post 87.4%\u00b122.9%; p&lt;0.0001), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>QCPR Classroom helped students achieve high-quality CPR training, especially for proper compression depth and full recoil. For good educational achievement, a novel QCPR Classroom with a metronome sound is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026140","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T04:45:15Z","timestamp":1560314715000},"page":"e026140","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Effect of real-time visual feedback device \u2018Quality Cardiopulmonary Resuscitation (QCPR) Classroom\u2019 with a metronome sound on layperson CPR training in Japan: a cluster randomized control trial"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3191-9808","authenticated-orcid":false,"given":"Shota","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Tsukigase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Hara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Sagisaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Myklebust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonje Soraas","family":"Birkenes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayana","family":"Iwata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Kidokoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoyo","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ueta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideharu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"2024052011045709000_9.6.e026140.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000350"},{"key":"2024052011045709000_9.6.e026140.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405796"},{"key":"2024052011045709000_9.6.e026140.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278483"},{"key":"2024052011045709000_9.6.e026140.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.7938"},{"key":"2024052011045709000_9.6.e026140.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.723411"},{"key":"2024052011045709000_9.6.e026140.6","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.ajem.2017.08.034","article-title":"Does dispatcher-assisted CPR generate the same outcomes as spontaneously delivered bystander CPR in Japan?","volume":"36","author":"Takahashi","year":"2018","journal-title":"Am J Emerg Med"},{"key":"2024052011045709000_9.6.e026140.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.8068"},{"key":"2024052011045709000_9.6.e026140.8","unstructured":"American Heart Association. Highlights of the 2015 American Heart Association guidelines update for CPR and ECC. 2015 https:\/\/eccguidelines.heart.org\/wp-content\/uploads\/2015\/10\/2015-AHA-Guidelines-Highlights-English.pdf (Accessed 1 Sep 2017)."},{"key":"2024052011045709000_9.6.e026140.9","unstructured":"Japan Resuscitation Council. Chapter 1 BLS: Basic Life Support. https:\/\/www.japanresuscitationcouncil.org\/wp-content\/uploads\/2016\/04\/1327fc7d4e9a5dcd73732eb04c159a7b.pdf (Accessed 3 Feb 2019)."},{"key":"2024052011045709000_9.6.e026140.10","unstructured":"Global Resuscitation Alliance. Improving Survival from Out-of-Hospital Cardiac Arrest: A Call to Establish a Global Resuscitation Alliance. http:\/\/www.laerdalevents.com\/gra\/wp-content\/pdf\/call_to_establish.pdf (Accessed 2 Dec 2017)."},{"key":"2024052011045709000_9.6.e026140.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2004.10.007"},{"key":"2024052011045709000_9.6.e026140.12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1930"},{"key":"2024052011045709000_9.6.e026140.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2004.10.009"},{"key":"2024052011045709000_9.6.e026140.14","first-page":"S315","article-title":"American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Part 1: Executive Summary","volume":"2015","author":"Neumar","year":"2015","journal-title":"Circulation"},{"key":"2024052011045709000_9.6.e026140.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.015"},{"key":"2024052011045709000_9.6.e026140.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.10.027"},{"issue":"d512","key":"2024052011045709000_9.6.e026140.17","first-page":"1","article-title":"Effect of real-time feedback during cardiopulmonary resuscitation outside hospital: prospective, cluster-randomised trial","volume":"342","author":"Hostler","year":"2011","journal-title":"BMJ"},{"key":"2024052011045709000_9.6.e026140.18","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1016\/j.ajem.2016.05.077","article-title":"Impact of a feedback device on chest compression quality during extended manikin CPR: a randomized crossover study","volume":"34","author":"Bul\u00e9on","year":"2016","journal-title":"Am J Emerg Med"},{"key":"2024052011045709000_9.6.e026140.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.12.020"},{"key":"2024052011045709000_9.6.e026140.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.10.005"},{"key":"2024052011045709000_9.6.e026140.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.07.029"},{"key":"2024052011045709000_9.6.e026140.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.05.011"},{"key":"2024052011045709000_9.6.e026140.23","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1001\/jamapediatrics.2014.2616","article-title":"International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) CPR Investigators. Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial","volume":"169","author":"Cheng","year":"2015","journal-title":"JAMA Pediatr"},{"key":"2024052011045709000_9.6.e026140.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2014.11.015"},{"key":"2024052011045709000_9.6.e026140.25","doi-asserted-by":"crossref","first-page":"438","DOI":"10.11622\/smedj.2017072","article-title":"Measuring the effectiveness of a novel CPRcard feedback device during simulated chest compressions by non-healthcare workers","volume":"58","author":"White","year":"2017","journal-title":"Singapore Med J"},{"key":"2024052011045709000_9.6.e026140.26","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12245-017-0147-6","article-title":"Comparison of quality of chest compressions during training of laypersons using Push Heart and Little Anne manikins using blinded CPRcards","volume":"10","author":"Tanaka","year":"2017","journal-title":"Int Emerg Med"},{"key":"2024052011045709000_9.6.e026140.27","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1017\/cem.2016.410","article-title":"Real-time visual feedback during training improves laypersons' CPR quality: a randomized controlled manikin study","volume":"19","author":"Baldi","year":"2017","journal-title":"CJEM"},{"key":"2024052011045709000_9.6.e026140.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.04.012"},{"key":"2024052011045709000_9.6.e026140.29","doi-asserted-by":"crossref","unstructured":"Kong SY , Shin SD , Song KJ , et al . Effect of instructor\u2019s real-time feedback using QCPR-classroom device during layperson cardiopulmonary resuscitation (CPR) training on quality of CPR Performances: A prospective cluster-randomised trial. BMJ Open 2018;8.","DOI":"10.1136\/bmjopen-2018-EMS.25"},{"key":"2024052011045709000_9.6.e026140.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.05.008"},{"key":"2024052011045709000_9.6.e026140.31","unstructured":"American Heart Association. AHA requirement on Use of feedback devices in adult CPR training courses. http:\/\/ahainstructornetwork.americanheart.org\/idc\/groups\/ahaecc-public\/@wcm\/@ecc\/documents\/downloadable\/ucm_495639.pdf (Accessed 1 Sep 2017)."},{"key":"2024052011045709000_9.6.e026140.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0169591","article-title":"Use of a Real-Time Training Software (Laerdal QCPR\u00ae) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial","volume":"12","author":"Cortegiani","year":"2017","journal-title":"PLoS One"},{"key":"2024052011045709000_9.6.e026140.33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39167.459028.DE"},{"key":"2024052011045709000_9.6.e026140.34","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.ajem.2017.03.060","article-title":"Complete chest recoil during laypersons' CPR: Is it a matter of weight?","volume":"35","author":"Contri","year":"2017","journal-title":"Am J Emerg Med"},{"key":"2024052011045709000_9.6.e026140.35","doi-asserted-by":"publisher","DOI":"10.1016\/0300-9572(91)90080-I"},{"key":"2024052011045709000_9.6.e026140.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.09.008"},{"key":"2024052011045709000_9.6.e026140.37","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2014-203736"},{"key":"2024052011045709000_9.6.e026140.38","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1016\/j.resuscitation.2014.08.006","article-title":"Debriefing bystanders of out-of-hospital cardiac arrest is valuable","volume":"85","author":"M\u00f8ller","year":"2014","journal-title":"Resuscitation"},{"key":"2024052011045709000_9.6.e026140.39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1757-7241-22-31","article-title":"Effectiveness of a simplified cardiopulmonary resuscitation training program for the non-medical staff of a university hospital","volume":"22","author":"Hirose","year":"2014","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2024052011045709000_9.6.e026140.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2007.07.018"},{"key":"2024052011045709000_9.6.e026140.41","doi-asserted-by":"publisher","DOI":"10.1016\/0300-9572(94)90064-7"},{"key":"2024052011045709000_9.6.e026140.42","unstructured":"Van Hoeyweghen RJ , Bossaert LL , Mullie A , et al . Quality and efficiency of bystander CPR. Resuscitation. Emerg Med J 2014:1\u20136."},{"key":"2024052011045709000_9.6.e026140.43","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1001\/jama.1995.03530240032036","article-title":"Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest","volume":"274","author":"Gallagher","year":"1995","journal-title":"JAMA"},{"key":"2024052011045709000_9.6.e026140.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2013.12.019"},{"key":"2024052011045709000_9.6.e026140.45","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2016-000208"},{"key":"2024052011045709000_9.6.e026140.46","unstructured":"Japan Resuscitation Council. Chapter 8 ETI: Education, Implementation, and Teams. http:\/\/www.japanresuscitationcouncil.org\/wp-content\/uploads\/2016\/04\/b7b5b647189bc07f38f6fecf014cf5d9.pdf (Accessed 2 Dec 2017)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-026140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T14:13:08Z","timestamp":1716214388000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-026140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":46,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,11]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bmjopen-2018-026140"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-026140","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}