Effectiveness of web-based education in addition to basic life support learning activities: A cluster randomised controlled trial

Abstract

Background: Effective education in basic life support (BLS) may improve the early initiation of high-quality cardiopulmonary resuscitation and automated external defibrillation (CPR-AED).

Aim: To compare the learning outcome in terms of practical skills and knowledge of BLS after participating in learning activities related to BLS, with and without web-based education in cardiovascular diseases (CVD).

Methods: Laymen (n = 2,623) were cluster randomised to either BLS education or to web-based education in CVD before BLS training. The participants were assessed by a questionnaire for theoretical knowledge and then by a simulated scenario for practical skills. The total score for practical skills in BLS six months after training was the primary outcome. The total score for practical skills directly after training, separate variables and self-assessed knowledge, confidence and willingness, directly and six months after training, were the secondary outcomes.

Results: BLS with web-based education was more effective than BLS without web-based education and obtained a statistically significant higher total score for practical skills at six months (mean 58.8, SD 5.0 vs mean 58.0, SD 5.0; p = 0.03) and directly after training (mean 59.6, SD 4.8 vs mean 58.7, SD 4.9; p = 0.004).

Conclusion: A web-based education in CVD in addition to BLS training enhanced the learning outcome with a statistically significant higher total score for performed practical skills in BLS as compared to BLS training alone. However, in terms of the outcomes, the differences were minor, and the clinical relevance of our findings has a limited practical impact.

Fig 1. Description of the BLS intervention.

Description of the educational intervention in the cluster randomised controlled trial, comparing learning outcome after training in basic life support (BLS) with training in basic life support including a preparatory web-based education on cardiovascular disease (BLS+WEB). Abbreviations: BLS, basic life support; BLS+WEB, basic life support plus a web-based education; SCA, sudden cardiac arrest; CPR, cardiopulmonary resuscitation; AED, automated external defibrillation; CVD, cardiovascular disease; AMI, acute myocardial infarction.

Fig 2. Flow-chart.

Flow chart according to CONSORT (www.consort-statement.org), to compare the effectiveness of basic life support (BLS) education with preparatory web-based education in cardiovascular disease (CVD) in addition to BLS training (BLS+WEB). The participants were randomised, educated in BLS and assessed for their total score in practical skills of BLS. The post-test was performed directly after training and the retention test was performed six months after training. The main intervention was BLS education compared with BLS+WEB education. Additional training comprised self-learning training (SLT), instructor-led training (ILT), instructions from a mobile application (A), instructions from a video film (F), three reflective questions (R) and a device for feedback on compression depth (CF).