Discussion
This study investigated whether a short reflective practice exercise increases the effectiveness of an established BLS training. Results confirmed that combining a structured reflective practice exercise with a standard BLS training improves students’ timely and effective provision of BLS over the period of one week. No significant differences were observed between the two study groups regarding their self-rated confidence in their BLS skills.These findings highlight the great potential of reflective practice to improve traditional BLS education by increasing students’ ability to internalize and retain learning outcomes. The functionality of reflective processing is increasingly discussed in medical education research and has long been highlighted in the domain of cognitive psychology by the levels of processing theory of memory [Another clear strength of reflective practice is that costs and infrastructural requirements are minimal. The reflective practice exercise as applied in this study solely required a short written instruction. The great advantage of this method is that it can be easily implemented in any setting. The reflective practice exercise was based on standardized questions and did not require any guidance by an expert instructor. This is particularly useful to increase training effectiveness in BLS training settings in which professional instructors are lacking (e.g., in schools or companies).Additionally, this method can make acquired knowledge more easily accessible and refreshable to learners outside the training environment. Previous studies showed that without any training refreshment, BLS knowledge and practical skills significantly deteriorate within three to twelve months [Furthermore, our findings show that reflective practice did not influence students’ self-rated confidence to perform CPR over the period of one week. This observation does not confirm previous preliminary findings suggesting that reflective practice can increase uncertainty or self-doubt in individuals [Finally, while this study focuses on the use of reflective practice in the context of BLS, it is likely reflective practice may also improve basic medical education in other areas in which basic practical skills have to be acquired, internalized and effectively applied (e.g., wound suturing, knots). Combining reflective practice with traditional teaching therefore provides a promising didactic approach that has the potential to improve basic practical skills training in healthcare in a cost-effective way.