Digital Stop The Bleed® training compared with in-person Stop The Bleed® training: Human instructors needed to demonstrate psychomotor skills.

BACKGROUND: Stop the Bleed® (STB) training can effectively prepare first responders to intervene and prevent the injured from dying from uncontrolled bleeding, but traditional in-person instruction limits the number of people who can access training. The aim of this study was to evaluate the effectiveness of a digital STB training package consisting of an animated video and a short interactive quiz, compared with conventional instructor-led training. STUDY DESIGN: Pseudo-randomised non-inferiority simulation study with N = 93 layperson participants recruited at a single health service precinct. Groups were randomised to either in-person training with an instructor or digital training on a laptop. Participants' knowledge and ability to perform STB bleeding control techniques was assessed with a manikin arm. Participant self-rating and self-efficacy were compared with performance. RESULTS: Participants' mean (standard deviation) knowledge scores were significantly non-inferior in the digital group (9.74 (0.26)) compared with in-person (9.62 (0.35), p = 0.003) at a non-inferiority margin of 0.2 SDs. However, digital training participants succeeded less frequently at wound packing (80%) and tourniquet application (52%) compared to in-person training participants (100% packing and 86% tourniquet). Participants' self-efficacy ratings of performance correlated poorly with actual performance. CONCLUSIONS: Digital Stop the Bleed® training was as effective as instructor-led training for teaching laypersons the recognition and theory of immediate management of life-threatening bleeding. Psychomotor skills (packing, tourniquet) were inferior, highlighting the utility of observing physical demonstration for skill acquisition. These findings inform future improvements to digital STB training and suggest that the place of digital training in the widespread rollout of STB is to supplement rather than replace instructor-led training.