Document Type : Original Article

Authors

1 Department of Psychiatric and Mental Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Kerman Province, Iran

2 Department of Community Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Science, Rafsanjan, Kerman Province, Iran

Abstract

BACKGROUND: Although basic life support (BLS) has been taught in school by a variety
of professionals, it is still unclear that, whether the instructor’s previous cardiopulmonary
resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of
BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary
high school students.
MATERIALS AND METHODS: In this randomized controlled trial, 150 high school students were
selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74
in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart
Association guidelines on mannequins in three 60 min in‑person training sessions. The knowledge
and skill scores were measured for both groups before, immediately, and 1 month after intervention
by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi‑square,
Mann–Whitney U, repeated‑measure ANOVA tests, and statistically modeling at a significance
level of 0.05.
RESULTS: There were no significant differences between groups regarding demographic
characteristics. The knowledge and skill scores in both groups increased significantly compared
to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no
significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy
and 1 month after the intervention, the skill score in “Group A” was significantly higher than the
“Group B” (P = 0.001).
CONCLUSIONS: The trainer’s experience of CPR in the actual setting in the transfer of BLS
knowledge is not important, but it improved Student’s BSL skill acquisition score.

Keywords

  1. Myat A, Song KJ, Rea T. Out‑of‑hospital cardiac arrest: Current
    concepts. Lancet 2018;391:970‑9.
    2. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS,
    Callaway CW, et al. Heart disease and stroke statistics – 2021
    update: A report from the American Heart Association.
    Circulation 2021;143:e254‑743.
    3. Wissenberg M, Lippert FK, Folke F, Weeke P, Hansen CM,
    Christensen EF, et al. Association of national initiatives to improve
    cardiac arrest management with rates of bystander intervention
    and patient survival after out‑of‑hospital cardiac arrest. JAMA
    2013;310:1377‑84.
    4. Böttiger BW, Van Aken H. Training children in cardiopulmonary
    resuscitation worldwide. Lancet 2015;385:2353.
    5. Shimamoto T, Kiyohara K, Matsuyama T, Kitamura T, Kiguchi T,
    Nishiyama C, et al. Impact of bystander cardiopulmonary
    resuscitation and dispatcher assistance on survival after
    out‑of‑hospital cardiac arrest among adult patients by location
    of arrest. Int Heart J 2020;61:46‑53.
    6. Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A,
    Hazinski MF, et al. Importance and implementation of training
    in cardiopulmonary resuscitation and automated external
    defibrillation in schools: A science advisory from the American
    Heart Association. Circulation 2011;123:691‑706.
    7. Neumar RW, Eigel B, Callaway CW, Estes NA 3rd, Jollis JG,
    Kleinman ME, et al. American Heart Association response to the
    2015 institute of medicine report on strategies to improve cardiac
    arrest survival. Circulation 2015;132:1049‑70.
    8. Abelairas‑Gómez C, Schroeder DC, Carballo‑Fazanes A,
    Böttiger BW, López‑García S, Martínez‑Isasi S, et al. KIDS SAVE
    LIVES in schools: Cross‑sectional survey of schoolteachers. Eur
    J Pediatr 2021;180:2213‑21.
    9. Haskins B, Nehme Z, Ball J, Mahony E, Parker Stebbing L,
    Cameron P, et al. Comparison of out of hospital cardiac arrests
    occurring in schools and other public locations: A 12 year
    retrospective study. Prehosp Emerg Care 2022;26:179-88.
    10. Böttiger BW, Van Aken H. Kids save lives – Training school
    children in cardiopulmonary resuscitation worldwide is
    now endorsed by the World Health Organization (WHO).
    Resuscitation 2015;94:A5‑7.
    11. Brown LE, Lynes C, Carroll T, Halperin H. CPR instruction in U.S.
    high schools: What is the state in the nation? J Am Coll Cardiol
    2017;70:2688‑95.
    12. Aaberg AM, Larsen CE, Rasmussen BS, Hansen CM, Larsen JM.
    Basic life support knowledge, self‑reported skills and fears in
    Danish high school students and effect of a single 45‑min training
    session run by junior doctors; a prospective cohort study. Scand
    J Trauma Resusc Emerg Med 2014;22:24.
    13. Rajagopalan B, Shen WK, Patton K, Kutyifa V, Di Biase L, Al
    Ahmad A, et al. Surviving sudden cardiac arrest – Successes,
    challenges, and opportunities. J Interv Card Electrophysiol 2021;
    28 April:1-5.
    14. Plant N, Taylor K. How best to teach CPR to schoolchildren:
    A systematic review. Resuscitation 2013;84:415‑21.
    15. Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K,
    Berg KM, et al. Part 1: Executive summary: 2020 American Heart
    Association guidelines for cardiopulmonary resuscitation and
    emergency cardiovascular care. Circulation 2020;142:S337‑57.
    16. Waltz CF, Bausell RB. Nursing Research: Design, Statistics, and
    Computer Analysis. Philadelphia: FA Davis Company; 1981.
    17. Chamdawala H, Meltzer JA, Shankar V, Elachi D, Jarzynka SM,
    Nixon AF. Cardiopulmonary resuscitation skill training and
    retention in teens (CPR START): A randomized control trial in
    high school students. Resusc Plus 2021;5:100079.
    18. Böttiger BW, Lockey A, Georgiou M, Greif R, Monsieurs KG,
    Mpotos N, et al. KIDS SAVE LIVES: ERC Position statement
    on schoolteachers’ education and qualification in resuscitation.
    Resuscitation 2020;151:87‑90.
    19. Wang MF, Wu YK, Chien CY, Tsai LH, Chen CB, Seak CJ, et al.
    Learning effectiveness assessment between primary school
    students and adults in basic life support education. Emerg Med
    Int 2021;2021:5579402.
    20. Martínez Isasi S, García Suárez M, Rodríguez MA, Gómez
    Salgado J, Fernández N, Méndez Martínez C, et al. Basic life
    support training programme in schools by school nurses: How
    long and how often to train? Medicine 2021;100:e24819.
    21. Schmid KM, García RQ, Fernandez MM, Mould‑Millman NK,
    Lowenstein SR. Teaching hands‑only CPR in schools: A program
    evaluation in San José, Costa Rica. Ann Glob Health 2018;84:612‑7.
    22. Suwanpairoj C, Wongsombut T, Maisawat K, Torod N,
    Jaengkrajan A, Sritharo N, et al. Outcome of basic life support
    training among primary school students in Southeast Asia. Clin
    Exp Emerg Med 2020;7:245‑9.
    23. Stærk M, Vammen L, Andersen CF, Krogh K, Løfgren B. Basic life
    support skills can be improved among certified basic life support
    instructors. Resusc Plus 2021;6:100120.
    24. Yeung J, Kovic I, Vidacic M, Skilton E, Higgins D, Melody T,
    et al. The school lifesavers study – A randomised controlled trial
    comparing the impact of lifesaver only, face‑to‑face training only,
    and lifesaver with face‑to‑face training on CPR knowledge, skills
    and attitudes in UK school children. Resuscitation 2017;120:138‑45.
    25. Süss‑Havemann C, Kosan J, SeiboldT, Dibbern NM, DaubmannA,
    Kubitz JC, et al. Implementation of basic life support training in
    schools: A randomised controlled trial evaluating self‑regulated
    learning as alternative training concept. BMC Public Health
    2020;20:50.
    26. Bylow H, Karlsson T, Claesson A, Lepp M, Lindqvist J, Herlitz J.
    Self‑learning training versus instructor‑led training for basic life
    support: A cluster randomised trial. Resuscitation 2019;139:122‑32.
    27. Tanaka S, Hara T, Tsukigase K, Sagisaka R, Myklebust H,
    Birkenes T, et al. School CPR training by non‑CPR teaching
    experienced teacher: A pilot study of targeting 1000 chest
    compressions hands‑on practice during 50 min of PWW‑based
    QCPR Classroom training. Resuscitation 2018;130:e82‑3.
    28. Zinckernagel L, Malta Hansen C, Rod MH, Folke F,
    Torp‑Pedersen C, Tjørnhøj‑Thomsen T. What are the barriers
    to implementation of cardiopulmonary resuscitation training in
    secondary schools? A qualitative study. BMJ Open 2016;6:e010481.
    29. Bohn A, Lukas RP, Breckwoldt J, Böttiger BW, Van Aken H. ‘Kids
    save lives’: Why schoolchildren should train in cardiopulmonary
    resuscitation. Curr Opin Crit Care 2015;21:220‑5.
    30. Cuijpers PJ, Bookelman G, Kicken W, de Vries W, Gorgels AP.
    Medical students and physical education students as CPR
    instructors: An appropriate solution to the CPR‑instructor
    shortage in secondary schools? Neth Heart J 2016;24:456‑61.
    31. Magid KH, Heard D, Sasson C. Addressing gaps in
    cardiopulmonary resuscitation education: Training middle
    school students in hands‐only cardiopulmonary resuscitation.
    J Sch Health 2018;88:524‑30.
    32. Kesici S, Bayrakci Z, Birbilen AZ, Hanalioglu D, Öztürk Z,
    Teksam Ö, et al. Peer education model for basic life support
    training among high school children: A randomized trial. Prehosp
    Disaster Med 2021;36,5:1-8.
  2. 33. Nasr‑Esfahani M, Yazdannik A, Mohamadiriz S. Development
    of nursing students’ performance in advanced cardiopulmonary
    resuscitation through role‑playing learning model. J Educ Health
    Promot 2019;8:151.
    34. Aminizadeh M, Rasouli Ghahfarokhi SM, Pourvakhshoori N,
    Beyramijam M, Majidi N, Shahabi Rabori MA. Comparing the
    effects of two different educational methods on clinical skills
    of emergency intermediate technician: A quasi‑experimental
    research. J Educ Health Promot 2019;8:54.
    35. Jafarizadeh H, Moradi Y, Rasouli J, Zeinalzadeh S. The effect of
    scenario‑based and participatory method of cardiopulmonary
    resuscitation (CPR) training on the knowledge of basic and
    advanced life support (BLS and ACLS) in emergency medical
    technicians. Med Legal Update 2020;20:245‑9.
    36. Karimi N, Saadat‑Gharin S, Tol A, Sadeghi R, Yaseri M,
    Mohebbi B. A problem‑based learning health literacy intervention
    program on improving health‑promoting behaviors among girl
    students. J Educ Health Promot 2019;8:251.