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Impact of instructor professional background and interim retesting on knowledge and self-confidence of schoolchildren after basic life support training: a cluster randomised longitudinal study
  1. Rainer Haseneder1,
  2. Matthias Skrzypczak1,
  3. Bernhard Haller2,
  4. Stefan K Beckers3,
  5. Julia Holch4,
  6. Christina Wank4,
  7. Eberhard Kochs1,
  8. Christian M Schulz1
  1. 1 Department of Anaesthesiology and Intensive Care, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
  2. 2 Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
  3. 3 Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
  4. 4 Girls' Boarding School Max-Josef-Stift, Munich, Germany
  1. Correspondence to Prof Dr Rainer Haseneder, Department of Anaesthesiology and Intensive Care, Klinikum rechts der Isar der Technischen Universität München, Munich 81675, Germany; rainer.haseneder{at}


Introduction To increase the rate of bystander resuscitation, basic life support (BLS) training for schoolchildren is now recommended on a broad level. However, debate continues about the optimal teaching methods. In this study, we investigated the effects of a 90 min BLS training on female pupils’ BLS knowledge and self-confidence and whether learning outcomes were influenced by the instructors’ professional backgrounds or test-enhanced learning.

Methods We conducted a cluster randomised, longitudinal trial in a girls’ grammar school in Germany from 2013 to 2014. Pupils aged 10–17 years were randomised to receive BLS training conducted by either emergency physicians or medical students. Using a multiple-choice questionnaire and a Likert-type scale, BLS knowledge and self-confidence were investigated before training (t0), 1 week (t1) and 9 months after training (t2). To investigate whether test-enhanced learning influenced learning outcomes, the questionnaire was administered 6 months after the training in half of the classrooms. The data were analysed using linear mixed-effects models.

Results The study included 460 schoolchildren. BLS knowledge (mean number of correct answers) increased from 5.86 at t0 to 9.24 at t1 (p<0.001) and self-confidence (mean score on the Likert-type scale) increased from 8.70 at t0 to 11.29 at t1 (p<0.001). After 9 months, knowledge retention was good (8.94 at t2; p=0.080 vs t1), but self-confidence significantly declined from t1 to 9.73 at t2 (p<0.001). Pupils trained by medical students showed a slight but statistically significant greater increase in the knowledge at both t1 and t2, whereas instructors’ background did not influence gain or retention of self-confidence. Retesting resulted in a marginally, non-significantly better retention of knowledge.

Conclusions BLS training led to short-term gains in knowledge and self-confidence. Although knowledge was retained at 9 months after the training session, self-confidence significantly decreased. Interim testing did not appear to impact retention of knowledge or self-confidence. Medical students should be considered as instructors for these courses given their favourable learning outcomes and greater availability.

  • education
  • pre-hospital
  • resuscitation
  • resuscitation, training
  • teaching

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  • Contributors RH, EK and CMS designed the study. Data collection was performed by RH, MS, JH and CW. The data were analysed by RH, MS and BH and interpreted by RH, MS, BH, SKB and CMS. RH drafted the manuscript, which was then revised critically for important intellectual content by MS, BH, SKB, EK and CMS. All authors were involved with manuscript editing and approved the final version of the manuscript.

  • Funding Support was provided solely from departmental sources.

  • Competing interests None declared.

  • Ethics approval The study has been reviewed and approved from an ethical and legal perspective by the ethics committee of the medical faculty of the Technische Universität München (registration number: 5917/13). Written informed consent was obtained from the parents or legal guardians of the participating pupils.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.