Intervention
breathing movements
This study was conducted at the Faculty of Health Studies at the Technical University of Liberec, which has an accredited 3-year bachelor’s degree program for nurses. The performance of CPR was evaluated during January and February 2019, comparing 2 groups of students of CC education who had completed either 1 (group CC1) or 3 (group CC3) semesters of undergraduate nursing CC education. CC education is a mandatory part of the nursing degree and is taught over 3 semesters: throughout the entire second year, and during the first semester of the third (final) study year (CC1 takes place in the winter semester, CC2 in the summer semester, and CC3 in the winter semester). Since 2017, CC has been taught entirely in the form of simulation teaching on a patient manikin, with lectures and practice using solely this approach. In each semester, the CC lessons took place in blocks lasting 6 weeks, comprising six 90-minute-long lectures presented by an experienced CC physician who demonstrated various functionalities, feasible manipulations, and basic CC medical interventions on an adult manikin model (SimMan 3G, Laerdal Medical). In these lectures, students were close enough to the simulator to observe, touch, and explore various functions and simulated components (e.g., breathing movements and sounds, presence of the pulse on defined body parts, signal characteristics on bedside monitors, etc.), and to follow the progression of scenarios progressing over time according to the simulated or played script. After each lecture, students were split into 2 groups, each having a 45-minute session of practical training led by 2 non-physician teachers (master of science in CC plus bachelor of science in rescue service, both supported by 3 technicians setting up various real-time components of the patient simulator), who instructed students to work together as an efficient CC team, encountering a manikin patient model by solving various CC scenarios and exploring its behavior and functionality. This is, in essence, the description of the educational intervention analyzed in this study—namely, 2 additional semesters of CC teaching with lectures and practical sessions taught entirely on simulators (covering topics seen in the first column of 