2013

persons over the impact of rescuers’ hands placement on the

quality of chest compressions was organized.

Participants were asked to perform four cycles of cardio-

pulmonary resuscitation (CPR) on a manikin in two different

scenarios. First, participants were asked to perform CPR in

a typical manner. Second, CPR was performed with a mark

indicating rescuers’ proper hands position.

Timing for two scenarios were 60� 7 s (43–83 s) and

60� 5.75 seconds (47–81 s). In both scenarios 61% exceeded

1 min. Concerning quality of the compressions, at first scenario

88% achieved adequate compression depth while at the second

100%. Existence of the indication mark is correlated with better

performance (r¼ 0.591, p5 0.01). Existence of the indicator

did not change mean time but reduced standard deviation and

increased participants’ achievement of adequate depth.

Further data analysis revealed negative correlation of

female sex with adequate depth (r¼�0.306, p5 0.01).

Older age is correlated with longer timing (r¼ 0.196,

p5 0.05) and adequate depth achievements (r¼ 0.216,

p5 0.05). Previous attendance is correlated with worse

timing performance (p¼ 0.04) but also adequate depth

achievement (r¼ 0.287, p5 0.01).

Hand position during CRP is an issue concerning a variety

of studies. ERC guidelines recommend as appropriate the

lower half on the sternum (Koster et al. 2010) alongside

with teaching in a simplified manner. This is reasonable since

more complex guidelines, such as the ones of 2000 could

potentially lead to bad positioning as shown by Owen et al.

(2011) in a study comparing 2000 and 2005 guidelines.

Giagou Dimitra, Michalinos Adamantios, Stamati Anastasia,

Koufoudakis Dionysios, Tribonia Aikaterini, Papadimitriou Lila

& Troupis Theodore. Faculty of Medicine, National and

Kapodistrian University of Athens, Greece. E-mail:

dimitragiagou@yahoo.gr

References

Koster RW, Baubin MA, Bossaert LL, Caballero A, Cassan P, Castren M,

Granja C, Handley AJ, Monsieurs KG, Perkins GD, et al. 2010. European

Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult

basic life support and use of automated external defibrillators.

Resuscitation 81(10):1277–1292.

Owen A, Harvey P, Kocierz L, Lewis A, Walters J, Hulme J. 2011.

A randomised control trial comparing two techniques for locating

chest compression hand position in adult Basic Life Support.

Resuscitation 82(7):944–946.

Student expectations of

problem-based

learning (PBL)

Dear Sir

The transition from a predominantly lecture-based education

to one that utilizes self-directed learning and group work is

stressful for students. PBL, with its emphasis on self-directed

learning in small groups, places the onus for learning squarely

on the student’s shoulders. Students accustomed to teacher-

directed learning may initially experience confusion and

frustration with the lack of direction, information, and

affirmation from an authority figure. The purpose of this

letter is to discuss impact of a PBL experience on applicants’

expectations of themselves and others on criteria related to

successful participation in a self-directed/PBL curriculum.

Scales currently used for assessment of readiness for self-

directed learning focus more on characteristics of the

individual than expectations of performance within the

group (Fisher & King 2010). Given the group processes

inherent to PBL, we developed a 10-item questionnaire

based on characteristics associated with positive performance

in a PBL setting, such as respect, reflection, cooperative

learning, communication skills, self-directed learning, and self-

evaluation (Chamberlain & Searle 2005). We administered

this questionnaire to 121 applicants to our physician assistant

program before and after a one-hour PBL group experience.

The pretest–posttest effect overall across groups for five of

the ten items indicated that applicants significantly changed

their expectations toward self-directed learning and group

learning in the positive direction of student qualities valued in

a PBL setting. Items which did not significantly change had

very high pretest scores, thus leaving little room for change.

A one-hour PBL experience significantly changed applicant

expectations regarding group learning in the direction

associated with expected success in a PBL environment.

Evaluation of student expectations of PBL in a small group

setting can inform faculty regarding student readiness to take

part in small group learning experiences. Future research

needs to examine the impact of PBL experiences on enhancing

student readiness for both individual and group aspects of self-

directed work. A good assessment tool could be useful both in

student selection initially and subsequently in prediction of

student outcomes.

Susan Hawkins, Mark Hertweck, Anthony Goreczny &

John Laird, Chatham University, Woodland Rd., Pittsburgh,

PA 15232, USA. E-mail: hawkins@chatham.edu

References

Chamberlain SE, Searle J. 2005. Assessing suitability for a problem-based

learning curriculum: Evaluating a new student selection instrument.

Med Ed 39:250–257.

Fisher MJ, King J. 2010. The self-directed learning readiness scale for

nursing education revisited: A confirmatory factor analysis. Nurse Educ

Today 30:44–48.

LETTER TO THE EDITOR

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