The Effectiveness of Online-Only Blended Cardiopulmonary Resuscitation Training: Static-Group Comparison Study

Abstract

Background Basic life support (BLS) education is essential for improving bystander cardiopulmonary resuscitation (CPR) rates, but the imparting of such education faces obstacles during the outbreak of emerging infectious diseases, such as COVID-19. When face-to-face teaching is limited, distance learning—blended learning (BL) or an online-only model—is encouraged. However, evidence regarding the effect of online-only CPR training is scarce, and comparative studies on classroom-based BL (CBL) are lacking. While other strategies have recommended self-directed learning and deliberate practice to enhance CPR education, no previous studies have incorporated all of these instructional methods into a BLS course. Objective This study aimed to demonstrate a novel BLS training model—remote practice BL (RBL)—and compare its educational outcomes with those of the conventional CBL model. Methods A static-group comparison study was conducted. It included RBL and CBL courses that shared the same paradigm, comprising online lectures, a deliberate practice session with Little Anne quality CPR (QCPR) manikin feedback, and a final assessment session. In the main intervention, the RBL group was required to perform distant self-directed deliberate practice and complete the final assessment via an online video conference. Manikin-rated CPR scores were measured as the primary outcome; the number of retakes of the final examination was the secondary outcome. Results A total of 52 and 104 participants from the RBL and CBL groups, respectively, were eligible for data analysis. A comparison of the 2 groups revealed that there were more women in the RBL group than the CBL group (36/52, 69.2% vs 51/104, 49%, respectively; P=.02). After adjustment, there were no significant differences in scores for QCPR release (96.9 vs 96.4, respectively; P=.61), QCPR depth (99.2 vs 99.5, respectively; P=.27), or QCPR rate (94.9 vs 95.5, respectively; P=.83). The RBL group spent more days practicing before the final assessment (12.4 vs 8.9 days, respectively; P<.001) and also had a higher number of retakes (1.4 vs 1.1 times, respectively; P<.001). Conclusions We developed a remote practice BL–based method for online-only distant BLS CPR training. In terms of CPR performance, using remote self-directed deliberate practice was not inferior to the conventional classroom-based instructor-led method, although it tended to take more time to achieve the same effect. Trial Registration Not applicable.

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“…The literature also contains some recent studies that have integrated online and virtual CPR training for remote communities. Although the CPR quality results did not differ between online and face-to-face training, and although online training required more days to improve competency, they nevertheless recommended online training as their first choice ( Chong et al, 2023 ; Lin et al, 2021 ). However, online CPR training might be limited by the internet connection and technology support in rural communities; moreover, most participants prefer traditional face-to-face training ( Jaskiewicz & Timler, 2023 ).…”

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“…These decreases reduced the expenditure, human resources, and time requirements for learners and instructors in CPR training courses [ 21 ]. One study investigated the cost-effectiveness of blended learning for CPR training; the results revealed that blended learning decreased training costs while achieving similar maintenance of CPR skills relative to the traditional method [ 23 ]. However, some researchers have indicated that despite the costs and time reductions offered by blended learning, such learning does not ensure that participants will acquire further professional knowledge and proficiency in a demanding training environment [ 22 ].…”

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“…BLS training by self-directed remote online-only learning and deliberate practice was reported to be comparable to the conventional classroom-based instructor-led method. 16 …”