Does blended learning enhance CPR knowledge and attitudes?

Dr Kunal Patel 29 Nov 2019

Cardiopulmonary resuscitation or CPR is essential in both the hospital and community. Some elements crossover in terms of approach depending on the setting and some are different depending on what tools are available. However, CPR is taught across all specialities in healthcare but also to the public and is vital for saving lives.

Commonly, within a hospital or clinical setting, nurses are first to the scene and must, therefore, be fully trained in CPR. The way we have delivered such training is usually via courses that focus on basic or advanced life support (BLS vs ACLS). This is often repeated, and promoting self-efficacy as part of this repetition and training is incredibly important in scenarios that require CPR.

To enhance this repeated training and ensure it is up to date, blended learning is a method that has been suggested. Hyunjung Moon from South Korea has recently published a randomly controlled trial looking at the effect of blended learning versus traditional training on CPR knowledge. 120 nursing students were randomized and provided training which was either blended or using paper-based training only. Their attitudes and knowledge were assessed at baseline and afterwards. The figure below shows how this was done


CPR study

Flow diagram of study distribution (Moon, H. & Hyun, H.S. BMC Med Educ, 2019) 

The blended learning component was based around four sessions, using video and paper printouts. The intervention group, i.e. those exposed to blended learning were found to have higher knowledge scores as well as an improved emotional attitude, with significant changes within the intervention group. Emotional attitude refers to a student’s feelings about “performing basic CPR to a cardiac arrest patient”. There were some significant differences, showing higher scores between the intervention group and controls for knowledge and emotional attitude. However, though other variables such as self-efficacy and cognition were higher in the test group, the difference was not significant.

Even though video is not always perfect, the researchers have shown a benefit of blended learning for CPR, however, self-efficacy did not significantly improve. This could be purely down to the video content and course design, and further work should be done. However, due to the high demand needed to train more students in CPR, this method and program should not be ignored. Instead, it can be utilized and be further improved upon, as should be the case with all educational interventions.