Massive open online learning in basic life support and automated external defibrillation: an efficient way to improve confidence and readiness of lay people to provide help

Abstract

BACKGROUND: Education of lay people in cardiopulmonary resuscitation (CPR) is recognised as an important contributor to increased survival from out-of-hospital cardiac arrest. Nowadays, due to the increased risk of COVID-19, it is recommended to withhold traditional face-to-face training in CPR [1]. Whereas Internet-based distance learning is suggested as a suitable alternative to instructor-led training, little is currently known about the effectiveness of the online learning in resuscitation. PURPOSE: The objective of this study was to investigate the effects of self-learning in basic life support (BLS) and automated external defibrillation (AED) utilising a massive open online course (MOOC) on lay people's self-confidence and willingness to provide help. METHODS: Lay trainees of the brief (approximately one hour long) theoretical self-paced Russian-language MOOC in BLS/AED were inquired to rate their knowledge of resuscitation and readiness to attempt CPR on a stranger both in the beginning and after completion of the course based on a five-point rating scale. A retrospective analysis of data obtained for one year (July 2018 – July 2019) was conducted. RESULTS: During the studied period, 11,924 persons joined the MOOC, and 3,445 (29%) trainees have finished the course. Of those who completed the course, 42% had some form of previous training in resuscitation, 45% were males; median age – 23 years. When compared to the pre-training levels, after mastering the course material the average levels of self-perceived knowledge and readiness to attempt CPR on a stranger improved significantly (p<0.001): from 2.2 points to 4.0 points, and from 3.3 points to 4.2 points, respectively. After the training, the proportion of people who expressed a high level of willingness to give CPR (4–5 points) was almost two times higher than at baseline (81% vs. 44%; p<0.001). Completion of the course curriculum and higher levels of self-confidence and readiness to provide CPR were strongly associated with previous resuscitation training (p<0.001). CONCLUSIONS: To the best of the authors' knowledge, no previous study has investigated and demonstrated the motivating effect of online learning in CPR. This study suggests that the free-of-charge massive online course in BLS/AED represent an effective tool for increasing coverage of the population with resuscitation training, improving self-confidence of potential rescuers and their willingness to provide the life-saving help. The distant theoretical training provides an important way to enhance and support laypeople's motivation to attempt CPR during the COVID-19 pandemic. Further research could be conducted to determine the effectiveness of the Internet-based massive self-directed learning supplemented with synchronous or asynchronous hands-on practice. FUNDUNDING ACKNOWLEDGEMENT: Type of funding sources: None.