Emergency Medicine, Government Medical College, Kannur, Pariyaram, Kerala, India


BACKGROUND: Demonstration‑Observation‑Assistance‑Performance (DOAP) and Video‑Assisted
Learning (VAL) are small‑group teaching/learning methods (TLM) in medical education. Comparison
studies between the two are scanty. There is a gap in knowledge, skills, and attitude among medical
interns toward Advanced Cardiac Life Support (ACLS). The author studied the effectiveness of DOAP
and VAL in training ACLS using mannequins and automated external defibrillator (AED)-simulators
among interns in 2021.
MATERIALS AND METHODS: This descriptive study was done in the Emergency Department of
a tertiary teaching hospital in South India. Out of 80 medical interns, 39 and 41 were allocated to
ACLS training by DOAP (Group 1) and VAL (Group 2), respectively, by convenient sampling with
random allocation, with the use of mannequins and AED‑Simulators (10 interventions in each small
group; three‑five participants in each session). Pre‑validated pre‑test and posttest multiple‑choice
questionnaires (MCQs) and attitude questionnaires, OSCE by two blinded assessors, and perception
by Likert‑based questionnaire were analyzed with appropriate statistical analysis.
RESULTS: The mean pretest and posttest MCQs and Attitude and OSCE scores of DOAP and VAL
showed no statistically significant difference between them (MCQ pre‑test 44.51 (11.43); 42.54 (6.56);
p = 0.350 and MCQ posttest, 78.97 (8.59); 77.22 (11.29); p = 0.438; OSCE 40.51 (2.43) and
40.63 (1.92); p = 0.804; Attitude: 11 (3), 11 (2); p = 0.567; 14 (2), 14 (3); p = 0.095). MCQ post‑tests
showed improved scores (p < 0.001) in both the methods and the standardized mean difference
based on the MCQ scores for the DOAP group was 3.02, and for the VAL group 3, showed the
effectiveness of both methods. Perception scores showed learners’ interest and positive feedback
to both methods and ACLS.
CONCLUSION: Both DOAP and VAL were equally effective TLMs in imparting knowledge, skills, and
attitude to medical interns with positive feedback. In DOAP, the learner performs under supervision
and clarifies doubts. As repeatable and cost‑effective, VAL is useful in resource‑limited settings.
Both can be used as complementary methods in training ACLS. The attitude of learners towards
ACLS improved with training.


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