Effects of peer-education training on cardiopulmonary resuscitation knowledge and skill retention of secondary school students: A feasibility study

Abstract

Objectives The need for cardiopulmonary resuscitation (CPR) training dissemination in the community could be resolved by mass school training programmes. However, the availability of instructors remains an unsolved problem. Our purpose was to investigate the effects of three different instructor types: healthcare professionals, schoolteachers and peer students, on CPR skills retention of secondary school students 6 months after training. Design The study was designed as a prospective randomised single-blinded controlled trial. The study ended before reaching the target sample size for the schoolteacher arm. Setting and participants Students from three different secondary schools in Heraklion, Greece, were recruited to attend CPR training. Interventions All participants received a manual and a digital video disc demonstrating the CPR/automated external defibrillator (AED) algorithm, followed by hands-on training. They were randomly assigned to receive training by either healthcare professionals, schoolteachers or peer students, who had previously been trained appropriately. Outcome measures CPR knowledge and skill retention were evaluated immediately (secondary outcome) and 6 months after training (primary outcome), using a knowledge questionnaire, skill checklists and feedback device. Results 408 students (199 girls-two non-binary) were enrolled in the study with a median age of 13 (IQR 12-14) years. A total of 255 students (125 girls) were reassessed at 6 months. Preliminary analysis of the data revealed no statistically significant differences between the three groups regarding factual knowledge immediately after training (p=0.226) and at 6 months (p=0.867). Immediately after training, more students trained by healthcare professionals or teachers performed safe defibrillation (p<0.000); however, this finding was dissipated at 6-month reassessment (p=0.202). Compliance with the CPR algorithm and the quality of hands-only CPR were not different (p>0.05) among the groups. Conclusions The type of instructor did not affect the CPR knowledge and skill retention of students 6 months after training. Schoolchildren acting as peer instructors could be an effective alternative to healthcare professionals and schoolteachers, although further studies are needed.