App-based learning as an alternative for instructors in teaching basic life support to school children: a randomized control trial

ABSTRACT

Background: The importance of early cardiopulmonary resuscitation (CPR) during an out-of-hospital cardiac arrest (OHCA) cannot be emphasized enough and has a major impact on survival. Unfortunately, CPR education in schools is often inadequate or non-existing due to lack of educators and financial resources. The introduction of application-based teaching could facilitate education as no instructor is needed. The aim of present study is to compare app-based self-teaching (intervention group) with a traditional instructor-led course (control group). This trial is in line with the endorsement of training school children by the World Health Organization (WHO).

Methods: This randomized controlled trial contains 165 participants between 16 and 18 years. The control group followed an instructor-led course, while the intervention group used a tablet application to complete a self-education course.Both groups were taught in separated classes during 40 min and used manikins and automated external defibrillator (AED) trainer kits. Before and after training, both groups were evaluated in a practical test to examine their skills (an overall score and sub-scores on different sections were obtained, following ERC 2015 guidelines).

Results: No significant difference (p = 0.304) in overall teaching effectiveness was found between both groups. Although, in a sub-analysis, we found significantly better results for the instructor group for checking airway (p = 0.018), asking for an AED (p < 0.01) and shocking the patient (p = 0.002).

Conclusions: App-based teaching can be a valuable alternative for classic instructor-based education. Yet new apps have to be evaluated before being implemented in CPR education.

KEYWORDS:

• Emergency medicine
• education
• basic life support
• CPR
• children

Acknowledgments

We would like to thank all the instructors of the Catholic University of Leuven who volunteered to teach BLS to the participants. We also wish to thank the participating school Sint-Jozefscollege in Aarschot and their students for their active participation. We would like to thank Lize Vaes for her contribution to the survey section. The authors gratefully acknowledge Nathalie Charlier, Peter Iserbyt and Marc Sabbe for developing the application ‘StartNHart’ used in this trial and Jan De Flander for the technical support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical considerations

The design of the intervention received approval from the ethical review board of the University Hospitals of Leuven (registration number mp07498). The participants received and accepted a digital informed consent prior to the start of the intervention.