THE EFFECTIVENESS OF SIMULATION AND AUDIOVISUAL METHODS

IN BHD TRAINING FOR STUDENTSSMA AGAINST STUDENTS

ABILITY IN DOING RJP IN STATEHIGH SCHOOL 1
TABUNGANEN YEAR 2019.

MANUSKRIP

Oleh :

HENNY KUSUMA WARDANI

NIM. 1814201210032

MUHAMMADIYAH UNIVERSITY OF BANJARMASIN

FACULTY OF NURSING AND HEALTH SCIENCE
STUDY PROGRAM S.1 NURSING
BANJARMASIN, 2020

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 THE EFFECTIVENESS OF SIMULATION AND AUDIOVISUAL METHODS
IN BHD TRAINING FOR STUDENTSSMA AGAINST STUDENTS
ABILITY IN DOING RJP IN STATEHIGH SCHOOL 1
TABUNGANEN YEAR 2019.

Henny Kusuma Wardani*, Hj. Noor Khalilati**, Dr.Syamsul Firdaus***

Universitas Muhammadiyah Banjarmasin

Fakultas Keperawatan dan Ilmu Kesehatan
The Faculty of Nursing and Health Sciences
Study Program S.1 Nursing

Email : henykusuma95@gmail.com

Abstract
The incidence of cardiac arrest or cardiac arrest ranges from 10 out of 100,000 normal people aged under 35
years and annually reaches around 300,000-350,000 events. This causes a lack of oxygen that can be
distributed throughout the body, especially the brain and heart itself. Education that can be done to increase
the number of OHCA helpers is through simulations and videos (in this case self-directed video). The
purpose of this study is to determine the effectiveness of the method simulation and audiovisual in the BHD
training of high school students of the ability of students to perform RJP in SMA Negeri 1 Tabunganen. This
research is a quasi-experimental study with a nonequivalent comparison-group design using the Independent
T-test statistical test. Samples were determined by purposive sampling of 30 people. The results of this study
found that there was effectiveness of simulation and audiovisual methods in BHD training of high school
students on the ability of students to perform RJP.

Keywords: Simulation Methods, Audiovisual, BHD Training

Reference list: 43 (2010-2019)

Abstrak
Angka kejadian henti jantung atau cardiac arrest ini berkisar 10 dari 100.000 orang normal yang berusia
dibawah 35 tahun dan per tahunnya mencapai sekitar 300.000-350.000 kejadian.  Hal ini menyebabkan
kurangnya oksigen yang dapat disalurkan ke seluruh tubuh terumata otak dan jantung itu sendiri. Edukasi
yang dapat dilakukan untuk meningkatkan jumlah penolong OHCA adalah melalui simulasi maupun video
(dalam hal ini adalah self-directed video).Tujuan penelitian ini untuk mengetahui efektifitas metode simulasi
dan audiovisual pada pelatihan BHD siswa siswi SMA terhadap kemampuan siswa dalam melakukan RJP Di
SMA Negeri 1 Tabunganen. Penelitian ini merupakan penelitian eksperimen semu (quasi experiment)
dengan desain nonequivalent comparison-group designdengan menggunakan uji statistik Independen T-test.
Sampel di tentukan dengan purposive sampling sebanyak 30 orang. Hasil penelitian ini di dapatkan bahwa
ada efektivitas metode simulasi dan audiovisual pada pelatihan BHD siswa siswi SMA terhadap kemampuan
siswa dalam melakukan RJP.

Kata Kunci: Metode Simulasi, Audiovisual, Pelatihan BHD

Daftar rujukan: 43 (2010-2019)

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PRELIMINARY
Data from the World Health Organization (WHO)
in 2018 showed 17.5 million people worldwide
died from cardiovascular disease or 31% of 56.5
million deaths worldwide. More than ¾ deaths
from cardiovascular disease occur in developing
countries with low to moderate income
In various parts of the world, the prevalence of
cardiac arrest cases is quite high. For example, in
the United States the incidence of cardia carrest
reaches 200,000 cases per year (Roger et al.
2017). In addition, according to Herlitz et al.
(1999) the prevalence of cardiac arrest in Europe
reaches 350,000 cases per year (cited in Quintard
et al. 2011).
The incidence of cardiac arrest or cardiac arrest
ranges from 10 out of 100,000 normal people
aged under 35 years and annually reaches around
300,000-350,000 events
Cardiac arrest can occur in a variety of locations,
both those that cannot be anticipated (outside the
hospital) to those that can be anticipated (for
example; intensive care rooms). When there is a
cardiac arrest victim, the person who is near the
victim has a very large role in performing an RJP
quickly. CPR performed especially in the first few
minutes of cardiac arrest contributes to 2 to 3
times the chance of survival (AHA, 2017).
Education that can be done to increase the number
of helpers is through simulations and videos (in
this case self-directed video). The educational
program through simulation and audiovisual has
its own advantages and disadvantages. Simulation
is one of the methods that are often used to train
RJP in lay people and professional staff.
The RJP training method with simulations guided
directly by certified trainers is the only training
method that is recognized in Indonesia at present.
Furthermore, trainees get formal certificates as
trainees. The advantage of the simulation method
is that it is more interactive because the audience
can ask the facilitator directly, but it requires a lot
of time and a large place to do this method.
While audiovisual is a learning method that can
empower people to be able to learn independently
through video shows and the directions delivered
in the educational video.
Rahmi's research results (2017) found that
research conducted at SMAN 1 Yogyakarta found
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that there were differences in Chest Compression
Value in High School Student RJP Training with
Simulation and Audiovisual Methods. The
simulation method is very good because it is able
to practice directly compared to the audiovisual
method.
The age of high school students (SMA) is
generally between 16-18 years. In a study entitled
"How effectively young people can do pulmonary
resuscitation (CPR) without training" conducted
by Beard et al. (2015) showed that an 11-year-old
child could direct the dispatcher (EMS operator)
to perform an RJP with the appropriate chest
velocity and depth.
This shows that high school students aged 16-18
have met the criteria for conducting CPR
effectively. Coupled with the humanitarian spirit
that is already owned by these students can be the
main capital in carrying out RJP assistance when
there are victims in need.
Based on data from SMAN 1 Tabunganen
students of class X and XI at SMAN 1
Tabunganen amounted to 271 people. The results
of a preliminary study of 10 students found that 7
people had not been able to do chest compression
and 3 people had heard about chest compression
in CPR training.
Based on the above background, the study is
interested in conducting research related to
"Effectiveness in RJP Training of High School
Students with Simulation and Audiovisual
Methods Against the Capabilities of Students in
Tabunganen 1 High School"
METHOD
This research was conducted at SMAN 1
Tabunganen. This type of research used in this
research This research is a quasi-experimental
study with a nonequivalent comparison-group
design. The analysis technique used is the
Independent t-test.
Population and Sample
The population in this study were all students of
class X and XI in SMAN 1 Tabunganen. The
sample in this study was class X students from 2
classes totaling 69 students and XI from 2 classes
totaling 65 students in SMAN 1 Tabunganen,
which is divided into two groups. The first group b. Post-test results before being given training
of 15 students will take part in training with with simulation and audiovisual methods at
learning using audiovisual methods and the SMAN 1 Tabunganen
second group of 15 students will take part in
training with learning using simulation methods. Table 3: Frequency distribution based on post-test
results before being given training with simulation
and audiovisual methods at SMAN 1 Tabunganen
RESEARCH RESULT
BHD Simulasi Audiovisual
a. Characteristics of Respondents by Age N % N %
Table 1: Distribution of frequency of respondents No Training
by age in BHD training in SMA N 1 Tambungen 1. corresponding 15 100 15 100
2019 2. it is not in 0 0 0 0
accordance
No Age Frequency (%) with
amount 15 100 15 100
1 ≤ 17 years 25 66,7 Source: Primary Data for 2019
2 > 17 years 8 33,3
In Total 30 100 Based on the table above shows that all
Source: Primary Data for 2019 respondents according to the BHD training using
simulation methods as many as 15 people (100%)

Based on table 4.2 it can be seen that the majority Bivariate Analysis
of respondents aged <17 years as many as 25
people (66.7%). Table 4. Effectiveness of BHD training before and
after training given using simulation methods at
Tabunganen SMAN 1 in 2019
Univariate Analysis
Variable Mean SD SE P N
a. Pre-test results before being given training
value
with simulation and audiovisual methods at
SMAN 1 Tabunganen Simulation Method
Before 1,53 0,516 0,133 0,000 15

Table 2: Frequency distribution based on pre-test After 1,00 0,000 0,000

results before being given training with simulation
and audiovisual methods at SMAN 1 Tabunganen Source: Primary Data for 2019

Based on the results of the T-Test independent

statistical test, it can be seen that training with
No BHD Simulation Audiovisual simulation methods can increase BHD training at
Training Tabunganen SMAN 1 in 2019. Based on the
N % N %
analysis results it can be seen that BHD training is
1. corresponding 7 46,7 7 46,7
given before and after effective training provided
2. it is not in 8 53,3 8 53,3 by using simulation methods at SMAN 1
accordance Tabunganen year 2019 with a significant level (p
with = 0,000)
amount 15 100 15 100
Source: Primary Data for 2019 Table 5. Effectiveness of BHD training before and
after being given training using audiovisual
Based on the table above shows that the majority methods at SMAN 1 Tabunganen in 2019
of respondents Not Suitable in using simulation
and audiovisual methods, as many as 8 people
(53.3%). Variable Mean SD SE P N
value

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 Audiovisual Method
Before 1,53 0,516 0,133 0,000
After 1,00 0,000 0,000
Source: Primary Data for 2019
Based on the results of the T-Test independent
statistical test, it can be seen that training with
audiovisual methods can improve BHD training at
Tabunganen SMAN 1 in 2019. Based on the
analysis results it can be seen that BHD training
before and after being given training using
audiovisual methods at SMAN 1 Tabunganen in
2019 significant level (p = 0,000)
Table 6. Effectiveness of the effectiveness of
BHD training with simulation and audiovisual
methods at SMAN 1 Tabunganen in 2019
Variable Mea F SE P N
n valu
e George & Doto. (2016), said that there are 5
Simulation 0,533 3146,00 0,13 0,00
Method 0 3 0 5
Audiovisua 0,743 3146,00 0,13
l Method 0 3
Source: Primary Data for 2019
Based on the results of the study in the table
above shows that there are differences in the mean
value between the simulation and audiovisual
methods, where the method that has increased
after being given training is an audiovisual
method with a mean value of 0, 743. Then the
mean results mean that the audiovisual and
simulation methods are equally effective in
improve BHD skills although there are differences
in the mean but not too semifigkan.
DISCUSSION
1. Pre-test results before being given training
with simulation and audiovisual methods at
SMAN 1 Tabunganen
Responding well to doing simulations perform all
the steps in performing compression on RJP
patients, namely adjusting the patient's position on
a flat or hard mat, patient's upper shirt opening
(trauma), Checking patient care by way of
15 (Calling name.
Asking the situation, shaking the shoulder /
pinching the patient), Open the airway with head
tilt chin lift (press the forehead lift the chin) and
clean the airway from the blockage, Assess the
breathing by way of (Seeing the movement of the
chest / stomach, hearing the sound of air in and
out of the nose, Feel the air from the mouth / nose
cheek), If the patient does not breathe, give
artificial breath twice 2x, Check the heart rate by
touching the carotid pulse, if the carotid pulse is
palpable enough to give artificial breath every 5
seconds once for 1 minute, if the pulse carotid not
palpated immediately do a combination of
artificial breathing and cardiac compression with a
ratio of 30: 2 (30 cardiac massages, 2 artificial
breaths / ventilation) with a speed of 100-120x /
minute for 5-7 cycles, check the carotid pulse
every 2 minutes and check breathing each 5
cycles, If the breath is still not there continue with
compression, do an evaluation.
factors that influence the results of psychomotor
training, namely: (1) the ability of students, (2)
1 inadequate demonstration, (3) inappropriate
feedback (4) affective factors, (5) participant
perception. The ability of students in this study is
very diverse because respondents come from 7
different educational institutions. This is related to
the cognitive abilities of each respondent that will
underlie their thinking patterns in analyzing and
internalizing the feedback given.
Education that can be done to increase the number
of OHCA helpers is through simulations.
Educational programs through simulations and
self directed videos have their own advantages
and disadvantages. Simulation is one of the
methods that are often used to train RJP in lay
people and professional staff.
Audiovisual is a learning method that can
empower people to be able to learn independently
through video shows and directions delivered on
the educational video. The advantage of
Audiovisual is that it can be used by people with
free time (not bound) and is consistent in terms of
the content delivered.
Audiovisual which is proven to be able to improve
the ability to manage cardiac arrest can be a
solution and innovation in RJP training.
Audiovisual can be one of the effective and cost-
effective methods for educating lay people about
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CPR.
Under simulated conditions, lay people who are
shown a CPR Compression-only video are
significantly more likely to resuscitate than those
who have never seen the training video (Bobrow,
et al., 2011). Audiovisuals are proven to be able to
improve stop handling skills the heart can be a
solution and innovation in CPR training.
2. Post-test results before being given training
with simulation and audiovisual methods at
Tabunganen SMAN 1
Post-test results for all respondents In accordance
with using the simulation method as many as 15
people (100%), the BHD training method with
simulations guided directly by certified trainers is
the only training method that is recognized in
Indonesia at this time. Furthermore, trainees
receive formal certificates as training participants.
The advantages of simulation methods are that
they are more interactive because the audience
can ask the facilitator directly, but it requires a lot
of time and a large place to do this method.
In BHD training, as the opinion of George &
Doto. (2016) the role of instructors is still very
dominant because the existence of Manikin is
only a means for skill demonstration. It can be
said that the good and bad abilities of participants
will be greatly influenced by the ability of
instructors. Instructors must master both the
sequence / sequence and quality of RJP
techniques. Therefore, instructor standardization
is an absolute prerequisite for avoiding
misperceptions of trainees, as well as the quality
of training outputs. the quality of this instructor,
so what happens is a decrease in the quality of the
training itself.
The results of the study by Dine, et.al. (2008)
which states that audio visual feedback alone is
able to improve BHD skills and reduce variations
in cardiac compression counts, but the
combination of audio visual feedback and
debriefing from instructors has the greatest
advancement effect on BHD skills.
But this research. Training is focused on
controlling the speed of compression, with the aim
of delaying fatigue, ensuring adequate
compression depth and improving the quality of
chest compression. AHA (2010) also recommends
that to guarantee the quality of depth and
compression speed.
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3. The effectiveness of BHD training before and
after the training is given using simulation
methods
BHD training before and after effective training is
given using simulation methods at SMAN 1
Tabunganen in 2019 with a significant level (p =
0,000)
The use of simulation methods is very dependent
on the instructor's ability to train technical skills.
This requires the dominant role of the instructor to
improve the ability of students. Because of the
limited support devices on the Manikin, so the
techniques taught by the instructor are more
towards the experience that has been done so far
which focuses on qualitative, estimating and
feeling.
George & Doto. (2001), said that there are 5
factors that influence the results of psychomotor
training, namely: (a) the ability of students, (b)
inadequate demonstration, (3) inappropriate
feedback (4) affective factors, (5) participant
perception. The ability of students in this study is
very diverse because respondents have the
cognitive abilities of each respondent that will
underlie their thinking patterns in analyzing and
internalizing the feedback given.
4. The effectiveness of BHD training before and
after the training is given using audiovisual
methods
BHD training before and after being given
training using audiovisual methods at SMAN 1
Tabunganen in 2019 significant level (p = 0,000)
The results of the study are slightly different
conducted by Dine, et.al. (2008) which states that
audio visual feedback alone is able to improve
CPR skills and reduce variations in cardiac
compression counts, but the combination of audio
visual feedback and debriefing from instructors
has the greatest improvement on RJP skills
5. Effectiveness of BHD training with
simulation and audiovisual methods
There is the effectiveness of bhd training with
simulation and audiovisual methods on the skills
of students doing rjp in sman 1 savings
Pulmonary Resuscitation (RJP) is a skill that must
be mastered by students. A quality CPR can
optimize return of spontaneous circulation, but
many medical students are not confident in
carrying out this procedure. Oermann et al (2011),
in their research on the quality of RJP actions on
nurses, found that the quality of RJP performed by
nurses was still poor even though they had
attended training.
This is due to the knowledge and skills in
conducting RJP, without doing practice and recall,
it will tend to disappear over time. This is
supported by the results of his research Husebo et
al, (2012) who obtained data that nurses'
performance in performing CPR was still poor.
Perkins et al (2008), said that knowledge and
skills are very necessary in carrying out RJP
actions, but in the context of students who are less
exposed to events that require such actions, often
do not have competence in BLS. Therefore, it is
important to provide learning and find teaching
methods that support their knowledge and skills
about RJP.
Efforts that can be made to increase the retention
of community understanding when learning CPR,
props are needed that are easily accessible and
economical. I-CARRER Cardiac Resuscitation
Menekin is a teaching aid used to practice CPR.
This tool is designed simply in the form of a half
adult body with a thickness of 8 cm.
In addition, the I-CARRER Cardiac Resuscitation
Menekin device has an indicator light that shows
the accuracy of depth when doing a heart
massage. The advantages obtained from the RJP
props "I-CARRER Cardiac Resuscitation
Menekin" is a simple tool, raw material that is
economical but does not reduce the essence of
RJP learning.
Beard et al. (2015) showed that an 11-year-old
child could direct the dispatcher (EMS operator)
to perform an RJP with the appropriate chest
velocity and depth. This shows that high school
students aged 15-17 have fulfilled the criteria for
conducting RJP effectively.
CONCLUSION
a The results of the pre-test of the majority of
respondents were inappropriate in using the
method
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a simulation and audiovisual as many as 8 people
(53.3%).
b. The results of the post-test of all respondents
according to conducting RJP using the simulation
method were 15 people (100%).
c BHD training before and after being effectively
given training using simulation methods at SMAN
1 Tabunganen in 2019 with a significant level (p =
0,000).
d BHD training before and after being given
training using audiovisual methods at SMAN 1
Tabunganen in 2019 significant level (p = 0,000).
e There Is Effectiveness of Simulation and
Audiovisual Methods in BHD Training of High
School Students Against the Students' Ability to
Perform RJP in SMA Negeri 1 Tabunganen.
SUGGESTION
Recommended RPJ using ICARRER Cardiac
Resuscitation Menekin through Self Directed
Video can be a method that can be applied in high
school environment to increase the number of
bystander.
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* Henny Kusuma Wardani. Nursing S1 Student at Muhammadiyah University, Banjarmasin
** Hj. Noor Khalilati, Ns., M.Kep Lecturer at Muhammadiyah University Banjarmasin
*** Dr. Syamsul Firdaus, S.Kp, M.Kes Poltekes of the Ministry of Health Banjarmasin

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