Training and educational paperComparison of three instructional methods for teaching cardiopulmonary resuscitation and use of an automatic external defibrillator to high school students☆
Introduction
Training middle and high school students in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) represents an opportunity to increase the number of laypersons who can apply CPR1 and use an AED. Efforts to engage older adults in CPR training have been discouraging,2, 3 whereas high school students are an accessible population that may be interested in learning CPR.4, 5 Many high schools, however, do not provide CPR training due to barriers such as lack of classroom time, and lack of time for teacher training in CPR and AED instruction, or for implementing the training in the classroom.6
In order to address these barriers, less instructor-dependent modalities, such as interactive computer, video, film, and self-training methods have been explored. Several studies indicate that adults trained with video self-instruction7, 8, 9 or an automated manikin10 may be able to achieve similar or better CPR performance than those trained with the traditional American Heart Association's classroom training method. In randomized, controlled studies of computer software for CPR training, results have been mixed. One study showed improvement in behavior and assessment skills, but not in the motor skills needed to adequately provide CPR,11 while another showed improved performance of some skills, such as bag mask ventilation.12 However, neither study included training in the use of an AED, and no study has evaluated CPR and AED training of high school students without the use of instructors. There are two relevant AED studies, but neither focused on high school students. One indicated that students in the sixth grade were capable of learning how to use an AED,13 and the other that AED use can be taught to senior citizens without an instructor.14
Section snippets
Study design
We conducted a cluster-controlled trial of three instructional interventions among high school students with random allocation based on classrooms. Within each participating high school we assigned at random participating classrooms to one of the three instructional methods or to the control group, and assessed student knowledge and skills 2 days and 2 months later.
Setting
The study took place in urban and suburban public high schools in the Seattle, Washington region, during the 2003–2004 school year.
Interventions
Characteristics of study subjects
The initial post-training knowledge test was completed by 784 students, but 5 could not be included in any analysis because of missing data of important information (e.g., prior AED use, grade in school). The number of students who took the skills tests ranged from 623 to 752. Participation in each of the interventions and the control group ranged from 75 to 80%.
Previous CPR training ranged from 66 to 73% by the trial arm (Table 2). Of the students reporting previous CPR training, 22% received
Discussion and conclusions
Computer-based CPR and AED training for high school students is appealing because it requires little classroom time (about 45 min), and does not require the classroom teacher to take time to be trained in CPR and AED instruction or to prepare to teach students CPR and AED knowledge and skills.
Other studies have found video self-instruction to be more effective in teaching CPR performance than the traditional American Heart Association's classroom training method, but none of these studies
Acknowledgements
The authors thank all the school nurses, health educators, computer lab coordinators, principals, classroom teachers and high school students, without whose participation the study would not have been possible. We also thank the University of Washington first year medical students who provided the hands-on CPR and AED training to the high school students. Finally, we give special thanks to the evaluators and evaluation coordinator who showed ongoing flexibility and resourcefulness in
References (29)
- et al.
Life supporting first aid training of the public—review and recommendations
Resuscitation
(1999) - et al.
CPR instruction by videotape: results of a community project
Ann Emerg Med
(1995) - et al.
Factors associated with CPR certification within elderly community
Resuscitation
(2001) - et al.
The effectiveness of repeated cardiopulmonary resuscitation training in a school population
Resuscitation
(1989) - et al.
Teaching school-children cardiopulmonary resuscitation
Resuscitation
(1996) - et al.
Cardiopulmonary resuscitation training in Washington state public high schools
Resuscitation
(2003) - et al.
Simple CPR, a randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in African American church congregation
Ann Emerg Med
(1999) - et al.
Cardiopulmonary resuscitation performance of subjects over forty is better following half-hour video self-instruction compared to traditional four-hour classroom training
Resuscitation
(2000) - et al.
An automated voice advisory manikin system for training in basic life support without an instructor. A novel approach to CPR training
Resuscitation
(2001) - et al.
Learning effect of a novel interactive basic life support CD: the JUST system
Resuscitation
(2004)
Training seniors in the operation of an automated external defibrillator: a randomized trial comparing two training methods
Ann Emerg Med
A reliable and valid method for evaluating cardiopulmonary resuscitation training outcomes
Resuscitation
Statistical considerations in the design and analysis of community intervention trials
J Clin Epidemiol
CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation
Resuscitation
Cited by (118)
Teaching Cardiopulmonary Resuscitation to Later Elementary School Students
2024, Annals of Emergency MedicineBlended learning for accredited life support courses – A systematic review
2022, Resuscitation PlusCitation Excerpt :The studies were conducted between 2006 and 2021. Most studies used face-to-face only as the control group, with only two adult BLS studies having online learning only as a control group.1,36 Fourteen studies focused on BLS courses (thirteen randomised1,25–34,36,45 and one observational35), and these are summarised in Table 1.
- ☆
A Spanish translated version of the summary of this article appears as Appendix in the online version at 10.1016/j.resuscitation.2005.08.020.