I. Introduction
1. Necessity
2. Terminology
1) Behaviorism theory
2) ADDIE model for instructional design
3) FD-CPR program
II. Methods
Table 1
1. Step of analysis
2. Step of design
3. Step of development
III. Results
1. Step of analysis
1) Training requirement survey
2) Domestic and foreign research reviews
Table 2
No | Author | Target | Research design & Intervention method |
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1 | Kang (2004) | For high-risk cardiac arrest family | ・Exp. group (BLS for improving self-efficacy, 240 min) |
・Con. group (no treatment, 0 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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2 | Jung (2009)* | For first-class EMT in the fire department | ・Exp. group (CPR field work protocol, 35 min) |
・Con. group (applying the existing method of CPR, 15 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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3 | KDCA (2014) | For youth | ・Exp. group (health teacher education program, 120 min) |
・Con. group (existing education program, 120 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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No | Author | Target | Research design & Intervention method |
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4 | Park and Kim (2016) | For nursery teacher | ・Exp. group (infant health management education program, 540 min) |
・Con. group (no treatment, 0 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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5 | Lee and Choi (2016) | For care worker | ・Exp. group (BLS tailored to the characteristics of nursing care workers, 240 min) |
・Research design (one group study) | |||
・Tool (video, mannequin, PWW) | |||
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6 | Kim (2016) | For nurse | ・Exp. group (disease experience narrative class, 150 min) |
・Con. group (general lecture style class, 120 min) | |||
・Research design (randomized controlled study) | |||
・Tool (video, mannequin) | |||
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7 | Kwon (2017) | For the elderly | ・Exp. group (educational program for chest compression resuscitation tailored to the elderly, 80 min) |
・Con. group (chest compression resuscitation program, 80 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin, PWW) | |||
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8 | Leeand and Chae (2017)* | For first-class EMT | ・Exp. group (BLS with improved personal and social factors, 60 min) |
・Con. group (existing BLS training, 60 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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9 | Park (2018) | For parent | ・Exp. group (child CPR education program, 120 min) |
・Research design (one group study) | |||
・Tool (video, mannequin) | |||
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10 | Song (2018) | For nurse | ・Exp. group (professional CPR education program using a patient simulator, 480 min) |
・Con. group (abbreviated professional CPR education program, 240 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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11 | Kim (2018) | For teacher | ・Exp. group (developed educational program, 240 min) |
・Con. group (no treatment, 0 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) | |||
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12 | Kim (2018) | For nurse | ・Exp. group (interaction-based clinical nursing skill content, 1 week) |
・Con. group (clinical nursing skill content, 1 week) | |||
・Research design (Randomized controlled study) | |||
・Tool (smartphone, mannequin) | |||
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13 | Jung (2019) | For the general people | ・Exp. group (360 degree virtual reality video, 100 min) |
・Con. group (general standard video, 100 min) | |||
・Research design (randomized controlled study) | |||
・Tool (video, PWW) | |||
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14 | Park et al. (2019)* | For EMT | ・Exp. group (simulation-based professional CPR training, 180 min) |
・Con. group (traditional professional CPR training, 180 min) | |||
・Research design (nonequivalent control study) | |||
・Tool (video, mannequin) |
Table 3
No | Author | Subject | Content |
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1 | NIOSH (2002) | 2001 Firefighter fatality investigation from Phoenix’s Southwest Supermarket fire, RIT problems & improvements | ・RIT problems (organization, mission, equipment, training, etc.) and improvement methods for each timeline |
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2 | Steve (2003) | 2001 Firefighter fatality investigation from Phoenix’s Southwest Supermarket fire, Simulation evaluation to find RIT problems | ・Demonstration of cardiac arrest firefighters in three empty buildings similar to the situation in Phoenix’s Southwest supermarket store (bowling alley, restaurant, bar) |
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3 | USFA (2003) | RIT development and improvement measures | ・Reconsideration of RIT and policy recommendations through a special report from the U.S. Fire Department |
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4 | Robert (2005) | RIT equipment and components | ・Introduction of RIT bag composition and equipment |
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5 | Fred (2009) | Training to improve the survival rate of firefighters who fell at the fireground | ・Scenario training to improve the survival rate of firefighters who fell down at the fireground |
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6 | Nicholas (2012) | SCBA problems and improvements for isolated firefighters at the fireground | ・March 14, 2001 Phoenix Southwest Supermarket Fire Analysis (Use of RIT’s SCBA due to the isolated firefighter’s SCBA problem) |
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7 | HFD (2014) | Southwest Inn Hotel fire, RIT problems & improvements | ・May 31, 2013 Texas Southwest Inn Hotel fire kills 4 firefighters, RIT problems (organization, mission, equipment, training, etc.) and improvement methods for each timeline. |
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8 | Herbert and Woatford (2014)* | Cardiac arrest Firefighters CPR at the fireground | ・An introduction to the FD-CPR 10 step procedure created by a firefighter (Michael Herbert, Christopher watford) hased in Leland, North Carolina, USA |
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9 | Joe (2015) | How to operate RIT for suburban areas | ・RIT problems and improvement measures in suburban areas |
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10 | Mark et al. (2016) | How to rescue a firefighter who fell down at the fireground | ・Improved survival technique in case of a firefighter who fell down at a fireground |
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11 | Jarrod (2016) | How to survive when isolated at the fireground | ・4 ways to survive when I’m isolated at a fire site |
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12 | Laszlo, Gyorgy (2017) | How to rescue an unconscious and fell down firefighter at the fireground | ・4 steps to efficient rescue in firegournd |
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13 | Tom (2017) | How to efficiently rescue Firefighter who has fallen at the fireground | ・Rescue method using equipment of a firefighter who fell down at the firegournd (Designing how to use pulley equipment) |
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14 | Kos (2017)* | Firefighters CPR at the fireground | ・Introduction to FD-CPR 5-Step procedures taught at Coral Springs Fire Academy in Florida, USA |
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15 | SNFES (2017)* | Firefighters CPR at the fireground | ・Introducing the FD-CPR 4 Step Procedures taught at the Ontario Fire Training Center in Canada |
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16 | Guido (2021) | How to operate RIT of firefighters with cardiac arrest at high-rise building fireground | ・In the case of high-rise buildings, it takes a long time to come down to the entrance, so immediate CPR treatment is required |
2. Step of design
1) Setting the learning objective
2) Arrangement of the contents of the training
3) Building the instructional strategy
4) Selection of media
5) Development of skill performance evaluation items
Table 4
Table 5
Table 6
Before modification* | After modification |
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15. Hands-off time (within 10 seconds)) | 15. time to cease chest compression (within 10 seconds |
3. Step of development
1) Scenario development
2) Training program development
Table 7
No | Curriculum | Method | Time(min) |
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1 | -Curriculum and Instructor Introduction | Orientation | 5 |
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2 | -Statistics on occurrence of cardiac arrest firefighters at the fireground -The importance of CPR for witnesses -Exemption from bona fide emergency medical care | Video watching | 10 |
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3 | -Status check and radio notification of fell down firefighters -move to the safe zone -Secure a stable posture and remove equipment | PWW* | 5 |
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4 | -Consciousness check and radio help request -Breathing check | 5 | |
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5 | -Chest compression resuscitation | 20 | |
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6 | -Remove the protective clothing of fallen firefighter -Chest compressions after shift | 5 | |
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7 | -Use of AED | Video watching | 5 |
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8 | -AED practice | PWW* | 10 |
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9 | -Full-course practice | PWW* | 10 |
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10 | -Course evaluation and Q&A | Feedback | 5 |
3) Validation of applicability via pilot -test
Table 8
No | Scenario | Video | |
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Step 1 | Before* |
※ Firefighter fell down on suddenly fireground FF 1) -check the mental status -spread the situation (“Order 1, here OO fire 2, colleague fell down, will carry to the safety zone out of the exit on OO floor”) |
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After |
※ Firefighter fell down suddenly on fireground FF 1) -check the mental status while tapping the shoulder (“OO chief, are you okay?”) -spread the situation (“Order 1, here OO fire 2, colleague fell down, will carry to the safety zone out of the exit on OO floor”) |
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Step 2 | Before† |
FF 1, 2) -carry to the safety zone |
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After |
FF 2) -remove the obstacle in the way and open the exit FF 1) -use the method of dragging the shoulder string to carry to safety zone(5 meters outside the exit) |
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Step 3 | Before‡ |
FF 1) -hold the string of shoulder and sit on the air cylinder between the legs → remove the helmet of the fallen colleague → remove the mask → remove the hood FF 2) -remove the belts of chest and waist of fallen colleague → unzip → the turnout coat zipper → oppen the turnout coat |
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After |
FF 1) -hold the string of shoulder and sit on the air cylinder between the legs → remove the own SCBA and gloves → remove the helmet of the fallen colleague → remove the mask → remove the hood FF 2) -remove the own SCBA and gloves → remove the belts of chest and waist of fallen colleague → unzip → the turnout coat zipper → oppen the turnout coat |
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Step 5 | Before§ |
FF 2) -perform chest compression for about 2 minutes(30 times compression, 7 times repetition) FF 1) -feedback to firefighter 2(position, posture, depth, rate) loosen the shoulder string of colleague suffering from cardiac arrest |
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After |
FF 2) -perform chest compression for about 2 minutes(30 times compression, 7 times repetition) Alternative) -① kneeling down beside the fallen colleague -② straighten knees the fallen colleague FF 1) -feedback to firefighter 2(position, posture, depth, rate) loosen the shoulder string of colleague suffering from cardiac arrest |
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Step 6 | Before‖ |
FF 2) -(after the seventh cycle finished) come closer to the legs of fallen colleague and hold both of the knees FF 1) -raise both arms of the fallen colleague and take both thumbs out of sleeve then Alternative) -① ready to pull both strings of inner shoulder and turnout coat -② ready to pull around the sleeves FF 2) -follow the shout of firefighter 1 and pull down toward the legs(remove the turnout coat and SCBA) |
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After |
FF 2) -(after the seventh cycle finished) come closer to the legs of fallen colleague and hold both of the knees FF 1) -raise both arms of the fallen colleague and take both thumbs out of sleeve then(ready to pull around the sleeves) FF 2) -follow the shout of firefighter 1 and pull down toward the legs(remove the turnout coat and SCBA) |
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* difficulty: required to change because of the impossibility of checking the precise status of fallen colleague on dangerous fireground
† difficulty: required to share the task and change the way to deliver for preventing the musculoskeletal injury
‡ difficulty: required for revision due to the personal protective apparatus, it was impossible to check the precise the status of cardiac arrest and remove the outfit