Open Online Course on Basic Cardiopulmonary Resuscitation: Investigation of an Audience and the Effects of Distant Training

Aim. To study the demand for the massive open online course on basic cardiopulmonary resuscitation (CPR), and to evaluate effects of the training based on the socio-demographic profile of the audience.

Material and methods. The data obtained from a survey conducted on participants of the online course «First Aid in Cardiac Arrest (Basic Resuscitation)» during a one-year period (07.2018–07.2019) were analyzed, including demographic data, initial and final levels of knowledge on CPR, and willingness to resuscitate a stranger. The 5-point Lickert scale was used for self-assessment of knowledge and willingness to attempt CPR.

Results. The analysis includes data collected from 11,924 people, out of which 3,445 (29%) have completed the training. Eighty percent of participants live in the Russian Federation. The mean age of trainees, who completed the course, was 25.7 years, 45% of them were males, 42% had learnt CPR previously, 12% had medical education. As a result of the training, a significant increase (P<0.001) in the willingness to attempt CPR (from 3.26 to 4.16 points) and an increase in self-perceived CPR knowledge (from 2.24 to 3.98 points) were registered. The percentage of trainees who expressed a high level of willingness to perform CPR (4–5 points) increased from 44% to 81% (P<0.001). The course was more likely to be completed by those trainees who had previous training in CPR (p<0.001), who initially demonstrated higher willingness to provide CPR (P=0.003) or a higher level of knowledge in CPR (P<0.001). Trainees who had previous CPR training showed a much higher level of knowledge, higher self-confidence and a higher level of readiness to provide CPR (P<0.001). Approximately 14% of trainees with medical education reported having no previous training in CPR.

Conclusions. The massive open online course promotes knowledge of CPR and serves as an important tool for increasing the willingness of lay people to provide first aid in case of cardiac arrest. Previous CPR training is a motivating factor to continue education in resuscitation.

1. Perkins G.D., Handley A.J., Koster R.W., Castrén M., Smyth M.A., Olasveengen T., Monsieurs K.G., Raffay V., Gräsner J.T., Wenzel V., Ristagno G., Soar J.; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015; 95: 81–99. DOI: 10.1016/j.resuscitation.2015.07.015.

2. Resuscitation guidelines of the European Resuscitation Council (2015 revision). Ed. Corr. RAS Moroz V.V. 3rd edition, revised and supplemented. 2016. — 192 p.[In Russ.]

3. Vostrikov V.A., Kuzovlev A.N. Public-Access Defibrillation in Sudden Cardiac Arrest (Short Review). Obshchaya reanimatologiya = General Reanimatology. 2018; 14 (1): 58–67. [In Russ.] DOI: 10.15360/1813-9779-2018-1-58-67

4. Coons S.J., Guy M.C. Performing bystander CPR for sudden cardiac arrest: behavioral intentions among the general adult population in Arizona. Resuscitation. 2009; 80 (3): 334–340. DOI: 10.1016/j.resuscitation.2008.11.024.

5. Rajapakse R., Noc M., Kersnik J. Public knowledge of cardiopulmonary resuscitation in Republic of Slovenia. Wiener Klinische Wochenschrif. 2010; 122: 667–672. PMID: 21132393 DOI: 10.1007/s00508-010-1489-8

6. Birkun A., Kosova Y. Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea. World J Emerg Med. 2018; 9 (4): 237–248. DOI: 10.5847/wjem.j.1920–8642.2018.04.001.

7. Tanigawa K., Iwami T., Nishiyama C., Nonogi H., Kawamura T. Are trained individuals more likely to perform bystander CPR? An observational study. Resuscitation. 2011; 82 (5): 523–528. DOI: 10.1016/j.resuscitation.2011.01.027.

8. Eisenberg M., Lippert F.K., Castren M., Moore F., Ong M., Rea T., Steen P.A., Walker T., Shin S.D. Acting on the call. Global Resuscitation Alliance, 2018 [Electronic resource]. — Access mode: https: //www.globalresus-citationalliance.org/wp-content/pdf/acting_on_the_call.pdf. — Blank from the screen. — Checked on 30.12.2019.

9. Lysenko K.I., Dezhurnyj L.I., Baturin D.I., Tishkov E.A. Problems of training lay people first aid and cardiopulmonary resuscitation. Anestesiol i reanimatol. 2011; 5: 76–78 [In Russ.].

10. Dezhurnyj L.I., Boyarintsev V.V., Neudakhin G.V. First aid system in Russia and its interaction with the emergency medical service. Skoraya meditsinskaya pomoshch. 2013; 2 (14): 44–50 [In Russ.].

11. Dezhurnyj L.I., Gumenyuk S.A., Zakirov R.R., Maksimov D.A., Trofimenko A.V. First aid in the Russian Federation. Recent changes and immediate prospects. Kremlevskaya meditsina. Klinicheskij vestnik. 2019; 3: 15–22. DOI: 10.26269/4q8v-ym04 [In Russ.].

12. Birkun A.A. Accessibility of cardiopulmonary resuscitation training for the population of the Russian Federation: analysis of information resources of the Russian-language segment of the Internet. Sotsialniye aspekty zdorovya naseleniya. 2018; 63 (5): 8. DOI: 10.21045/2071-5021-2018-63-5-8. [In Russ.].

13. Greif R., Lockey A.S., Conaghan P., Lippert A., De Vries W., Monsieurs K.G.; Education and implementation of resuscitation section Collaborators; Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 10. Education and implementation of resuscitation. Resuscitation. 2015; 95: 288–301. DOI: 10.1016/j.resuscitation.2015.07.032.

14. Riggs M., Franklin R., Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation. 2019; 138: 259–272. DOI: 10.1016/j.resuscitation.2019.03.019. PMID: 30928504

15. Finn J.C., Bhanji F., Lockey A., Monsieurs K., Frengley R., Iwami T., Lang E., Ma M.H., Mancini M.E., McNeil M.A., Greif R., Billi J.E., Nadkarni V.M., Bigham B.; Education, Implementation, Teams Chapter Collaborators. Part 8: Education, implementation, and teams: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2015; 95: e203–224. DOI: 10.1016/j.resuscitation.2015.07.046.

16. International Federation of the Red Cross and Red Crescent Societies. International First Aid and Resuscitation Guidelines 2016. Geneva: IFRC, 2016 [Electronic resource]. — Access mode: http: //www.ifrc.org/Global/Publications/Health/First-Aid-2016-Guide-lines_EN.pdf. — Blank from the screen. — Checked on 30.12.2019.

17. Birkun A.A. Birkun A.A. [Electronic resource]. — Mode of access: https: //stepik.org/course/13222/syllabus. — Blank from the screen. — Checked on 30.12.2019.

18. Derrick B., White P. Comparing Two Samples from an Individual Likert Question. International Journal of Mathematics and Statistics. 2017; 18 (3): 1–13.

19. Lau Y., Nyoe R.S.S., Wong S.N., Ab Hamid Z.B., Leong B.S.-H., Lau S.T. Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials. Resuscitation. 2018; 131: 14–23.

20. Teague G., Riley R.H. Online resuscitation training. Does it improve high school students’ ability to perform cardiopulmonary resuscitation in a simulated environment? Resuscitation. 2006; 71 (3): 352–357. PMID: 17069951 DOI: 10.1016/j.resuscitation.2006.05.007

21. Tobase L., Peres H.H.C., Gianotto-Oliveira R., Smith N., Polastri T.F., Timerman S. The effects of an online basic life support course on undergraduate nursing students’ learning. Int J Med Educ. 2017; 8: 309–313. DOI: 10.5116/ijme.5985.cbce. PMID: 28850944 PMCID: PMC5699862

22. Birkun A.A., Altukhova I.V., Perova E.A., Frolova L.P., Abibullayev L.R. Blended Distance-classroom Training as an Alternative to the Traditional Classroom Training in Basic Cardiopulmonary Resuscitation and Automated External Defibrillation. Russian Sklifosovsky Journal «Emergency Medical Care». 2019; 8 (2): 145–151. [In Russ.]. DOI: 10.23934/2223-9022-2019-8-2-145-151.

23. Cho G.C., Sohn Y.D., Kang K.H., Lee W.W., Lim K.S., Kim W., Oh B.J., Choi D.H., Yeom S.R., Lim H. The effect of basic life support education on laypersons’ willingness in performing bystander hands only cardiopulmonary resuscitation. Resuscitation. 2010; 81 (6): 691–694. DOI: 10.1016/j.resuscitation.2010.02.021.

24. Urban J, Thode H, Stapleton E, Singer A.J. Current knowledge of and willingness to perform Hands-Only CPR in laypersons. Resuscitation. 2013; 84 (11): 1574–1578. DOI: 10.1016/j.resuscitation.2013.04.014.

25. Lee M.J., Hwang S.O., Cha K.C., Cho G.C., Yang H.J., Rho T.H. Influence of nationwide policy on citizens’ awareness and willingness to perform bystander cardiopulmonary resuscitation. Resuscitation. 2013; 84 (7): 889–894. DOI: 10.1016/j.resuscitation.2013.01.009.

26. Lu C., Jin Y., Shi X., Ma W., Wang Y., Wang W., Zhang Y. Factors influencing Chinese university students’ willingness to performing bystander cardiopulmonary resuscitation. International Emergency Nursing. 2017; 32: 3–8. DOI: 10.1016/j.ienj.2016.04.001.

27. Son J.W., Ryoo H.W., Moon S., Kim J.Y., Ahn J.Y., Park J.B., Seo K.S., Kim J.K., Kim Y.J. Association between public cardiopulmonary resuscitation education and the willingness to perform bystander cardiopulmonary resuscitation: a metropolitan citywide survey. Clin Exp Emerg Med. 2017; 4 (2): 80–87. DOI: 10.15441/ceem.16.160.

28. Filatova, A.A., Chernyh M.A., Churkina A.S., Yakimets A.A., Bersenyova O.V., Novikova V.P., Samylov V.V. The theoretical level of knowledge of medical students in matters of cardiopulmonary resuscitation, students according to different educational standard. Vestnik Soveta molodyh uchyonykh i spetsialistov Chelyabinskoj oblasti.2013; 1: 50–58 [In Russ.]

29. Potapov A.F., Ivanova A.A., Aprosimov L.A., Gogolev N.M. Assessment of the adequacy of basic cardiopulmonary resuscitation during circulatory arrest (results of primary accreditation of specialists). Modern science: actual problems of theory and practice. Sovremennaya nauka: aktualnye problemy teorii i praktiki. Seriya: Estestvennye i tekhnicheskie nauki.2017; 2: 83–87 [In Russ.]

30. Tanishina E.N., Artemeva G.B. A differentiated assessment of the initial level of theoretical knowledge of the standards of cardiopulmonary resuscitation in cadets of the Center for Simulation Training of Ryazan State Medical University and the impact on the quality of medical care. Nauka molodyh — Eruditio Juvenium. 2019; 1 (7): 66–71. [In Russ.]. DOI: 10.23888/HMJ20197166-71