Team-based versus individual learning for out-of-hospital cardiac arrest rhythm recognition in newly hired emergency medical service providers: cluster-randomized equivalence trial.

Authors

Young Shin Cho, Choung Ah Lee

Published in

Scientific reports. Jul 12, 2026. Epub Jul 12, 2026.

Abstract

Early recognition of shockable and non-shockable rhythms is critical for survival in out-of-hospital cardiac arrest (OHCA). Team-based learning (TBL) occurs in emergency care, yet its impact on rhythm recognition remains unclear. We tested whether team-based and individual formats yielded equivalent short-term improvements in OHCA rhythm recognition. A single-center, session-level cluster-randomized parallel-group equivalence trial was conducted within an induction course for newly hired EMS personnel in South Korea. Eight training sessions (four per arm) were the unit of randomization, allocated in permuted blocks of size two in TBL→Individual (AB) or Individual→TBL (BA) sequences. The 90-min curriculum included lectures, interactive defibrillator rhythm cases, and feedback. Outcome was OHCA rhythm recognition (0-9). Secondary outcomes included confidence (1-5 Likert scale) and 1-month online follow-ups. Paired t-tests, analysis of covariance, and equivalence testing within a 1.0-point margin were used. Participants (n = 387) completed both assessments (individual 188, team 199). Knowledge improved by + 1.32 points (95% confidence interval [CI], 1.12-1.52). Between-format difference in gain (team-individual = - 0.13; 90% CI - 0.47 to 0.21) met the equivalence margin. At one month, knowledge gains were maintained among completers, but follow-up completion was differential between arms. Paramedic job category was independently associated with higher post-training scores, whereas career duration was not. When content and feedback were held constant, team-based and individual formats yielded equivalent short-term gains in arrest-rhythm recognition. The 1-month retention findings should be interpreted cautiously because of differential follow-up completion. Future work should test behavioral and patient-level outcomes.Clinical trial registration This trial was retrospectively registered at the Clinical Research Information Service (CRIS, KCT0011562) on February 2, 2026.

PMID:
42437779
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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