Effects of deliberate practice at different training frequencies on long-term retention of high-quality chest compression proficiency among novice nurses: a quasi-experimental study

Background Nurses are pivotal first responders in in-hospital cardiac arrest (IHCA), and timely, guideline-concordant BLS substantially improves survival. While deliberate practice (DP) enhances skill acquisition, the optimal retraining interval for maintaining long-term proficiency among novice nurses remains unclear. This study aimed to compare the effects of single versus repeated DP sessions on the 6-month retention of Cardiopulmonary Resuscitation (CPR) quality and knowledge. Methods A quasi-experimental study enrolled 148 novice nurses allocated to Single-DP group (baseline training only) a Repeated-DP group (baseline plus a 3-month booster session). CPR quality (compression depth, rate, chest recoil, compression fraction), theoretical knowledge, and overall skill scores were assessed at baseline, immediately after training, and 6-month follow-up. Generalized estimating equations (GEE) assessed group, time, and their interaction. Results A total of 148 novice nurses completed the study, with no significant differences in baseline characteristics. Immediately after training, the Single-DP group achieved higher scores in theoretical knowledge ( P = 0.001) and overall skill ( P = 0.011). At the 6-month follow-up, the Repeated-DP group demonstrated superior retention in raw performance metrics, maintaining significantly greater median compression depth (52.00 vs. 47.50 mm; P = 0.014) and higher overall skill scores (57.72 vs. 54.55; P < 0.001). However, GEE analysis revealed no significant group-by-time interaction at 6 months for knowledge ( P = 0.344) or overall skill ( P = 0.400), suggesting that the repeated intervention did not yield a statistically significant benefit in adjusted retention rates. Notably, prior real-world CPR experience was identified as a significant predictor of skill retention ( P = 0.004). Conclusion DP significantly improves CPR skill proficiency in novice nurses. However, a 3-month refresher did not enhance 6-month retention compared to single training. The finding that prior real-world experience significantly predicts retention underscores the gap between simulation and clinical practice. Therefore, to ensure high-quality patient care, CPR training programs should replace single-session instruction with high-frequency, high-fidelity simulation-based education for novice nurses.