Abstract
BackgroundThe Kids save lives statement recommends annual Basic Life Support (BLS) training for school children but the implementation is challenging. Trainings should be easy to realise and every BLS training should be as effective as possible to prepare learners for lifesaving actions. Preparedness implies skills and positive beliefs in the own capability (high self-efficacy).MethodsThis randomized controlled cluster study investigates, if self-regulated learning promotes self-efficacy and long-term retention of practical BLS skills. Students in the age of 12 years participated in a practical training in BLS and a scenario testing of skills. In the control group the practical training was instructor-led. In the intervention group the students self-regulated their learning processes and feedback was provided by the peer-group. The primary outcome self-efficacy for helping in cardiac arrest after the training and 9 months later was analysed using a multilevel mixed model. Means and pass-rates for BLS skills were secondary outcomes.ResultsContrary to the assumptions, this study could not measure a higher self-efficacy for helping in cardiac arrest of the students participating in the intervention (n = 307 students) compared to the control group (n = 293 students) after training and at the follow-up (mean difference: 0.11 points, 95% CI: − 0.26 to 0.04, P = 0.135). The odds to pass all items of the BLS exam was not significantly different between the groups (OR 1.11, 95% CI: 0.81 to 1.52, p = 0.533). Self-regulated learning was associated with a higher performance of male students in the BLS exam (mean score: 7.35) compared to females of the intervention (female: 7.05) and compared to males of the control (7.06).ConclusionThis study could not resolve the question, if self-regulated learning in peer-groups improves self-efficacy for helping in cardiac arrest. Self-regulated learning is an effective alternative to instructor-led training in BLS skills training and may be feasible to realise for lay-persons. For male students self-regulated learning seems to be beneficial to support long-term retention of skills.Trial registrationISRCTN17334920, retrospectively registered 07.03.2019.
Highlights
The Kids save lives statement recommends annual Basic Life Support (BLS) training for school children but the implementation is challenging
Data of 307 students of the intervention group (20 Clusters) and 293 students of the control group (21 Clusters) could be analysed immediately after the training. 257 of the intervention group students and 237 of the control group students participated at the follow up nine months later (Fig. 1)
For the main outcome of self-efficacy for helping in cardiac arrests no significant difference between the groups was found
Summary
The Kids save lives statement recommends annual Basic Life Support (BLS) training for school children but the implementation is challenging. The Introduction of CPR training for school children is an effective intervention to improve bystander-CPR-rates and increased survival of out-of-hospital cardiac arrest two- to four-fold [3]. Physicians, nurses, students and emergency medical staff engage in the training of school children, but the implementation is difficult. Important barriers of implementation in schools are lack of instructors and equipment and assumed high costs [7]. In turn there are some factors associated with good implementation rates. These factors are awareness of mandating legislation and successful implementation at other schools. As well as a person in charge for the implementation and teachers, who feel competent to conduct trainings [5]
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