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Improving competence and confidence | Laerdal Medical
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Improve confidence and competence

Low-dose high-frequency training

Lack of practice leads to skill deterioration

Research shows that healthcare providers’ skill retention declines as soon as three months after training. Most healthcare workers do not get the experience they need to maintain skills outside of infrequent training intervals.

In terms of CPR compliance regulations, healthcare institutions must ensure competence and adherence to protocol which is a time-consuming process of collating and confirming training documentation for reporting. In addition, loss of time on the job for training results in reduced patient care.

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A little goes a long way

Low-dose high-frequency training is a competence-building approach that promotes maximum retention of clinical knowledge, skills, and attitudes. Low-dose high-frequency training is short, targeted in-service simulation-based learning activities which are spaced over time and reinforced with structured, ongoing practice sessions at the workplace.

Low-dose high-frequency training is not only effective for skill building, but also for continuous improvement and helps to maintain competence over time.

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Big results

Low-dose high-frequency training is the foundation of the Resuscitation Quality Improvement (RQI) program.

Two years after the implementation of the RQI program at the Texas Health Resources hospital in Dallas, Texas, the hospital achieved almost full course completion for participants. They also were able to document a large cost savings resulting from less time used for off-site training. Most importantly, Texas Health showed a 21% increase in survival rates from cardiac arrest.

98% Course completion
$250k Reduction in CPR training costs
21% Increase in survival rates

Cabrini Health of Australia rolled out the RQI program across their entire healthcare provider workforce. All staff completed training and the data showed the benefit of having the RQI system on the ward where training could occur 24/7 with training peaks around shift changes. With the implementation of RQI, Cabrini received a “Met with Merit” indication in their hospital accreditation.

Helping Babies Breathe (HBB) is a program designed to reduce neonatal mortality in low and middle income countries. It is an evidence-based hands-on program to teach the initial steps of resuscitation within the first minutes of life.


When first introduced at a rural Tanzanian hospital as a one day training course, the number of healthcare providers passing the simulated “routine care” and “neonatal resuscitation” scenarios increased after HBB training; from 41 to 74% and from 18 to 74% respectively. However, this increase in knowledge did not transfer into clinical practice. The number of babies suctioned and/or ventilated at birth did not change, and the use of stimulation in the delivery room decreased after HBB training. These results compelled the question: How can improved knowledge be transferred to clinical practice – where it really counts?

To answer this question, HBB simulation training was implemented as weekly 3-minute practice sessions and 40 minute monthly re-training sessions. This new method of low-dose high-frequency training showed both a positive effect on transfer of new knowledge and skills into clinical practice, but most importantly, resulted in a 40% reduction in neonatal mortality.

How Laerdal can help

Laerdal solutions are designed to help you integrate low-dose high-frequency training into your routines. Whether training CPR for 10 minutes every quarter to keep skills sharp or practicing newborn resuscitation techniques, low-dose high-frequency training enables you to maintain competence — and confidence.

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