Background: The introduction of Compression-Only CPR (CCPR) to the public comes in many different forms from public service announcements on media to airport kiosks. The public health message of CCPR is to take action in an emergency and provide the most good. Ideally this would lead to further education and participation through more robust courses with more holistic education around heart disease, cardiac arrest, and development of evidence based skills. School and young adult populations represent a large and accessible group that would benefit from the exposure to CCPR in a formative format. Our goal was to identify the method of instruction and practice that yield the best outcomes while considering the cost of resources (manikins and instructors) on teaching CCPR. We investigated the differences between combinations instruction modalities with CPR practice devices in the learning of CCPR in both intentions to act and CCPR objective metrics.
Methods: Participants included young adult learners that included high school juniors to college freshman (n = 60) recruited from public institutions. This investigation employed a 3x4 two-factor factorial design analyzed using analysis of variance techniques. The two factors included three instruction modalities and four practice methods with learners randomly assigned to 1 of 12 instruction by practice combinations. The four practice treatments included a manikin, compression block, compression block with an adult sillouete cutout, and a control that did not engage in CCPR practice prior to assessment. The three instruction modalities included instructor led, standardized video and application based step-wise training, or self-teaching using skills sheets. Prior to learning CCPR, learners completed the preliminary portion of the Intention to Aid (I2A) survey instrument to assess confidence, willingness, attitudes towards helping behaviors, and intentions to act in a first aid emergency. After five minutes of instruction and five minutes of practice, learners performed 1 minute of CCPR using a feedback manikin (Brayden Pro, Aero Healthcare US) that included 5 metrics of CCPR quality (rate, depth, hand placement, recoil, and compression fraction). Following practice, learners completed the post portion of the I2A .