ORIGINAL RESEARCH Open Access

Impact of additional module training on the levelof basic life support knowledge of first yearstudents at the University of MariborDamjan Lenik1, Bojan Lenik1, Jerneja Golub2, Miljenko Krimari2,3, tefan Mally2,4 and tefek Grmec1,2,3,5*

Abstract

Aim: The aim of this study was to investigate the impact of additional (two versus one session) basic life support(BLS) training of university students on knowledge and attitude concerning the performance of cardiopulmonaryresuscitation.

Methods: A total of 439 students in three separate groups were tested: those with no prior BLS training; BLStraining in high school (part of the drivers education course); and BLS training in high school (in the driverseducation course) and additional BLS training at the university.

Results: Our study showed the best results of BLS education in a group of university students who took anadditional BLS module approximately half a year after the drivers education BLS course. In our study we observedequal levels of knowledge between the group with BLS training in high school and the group without any formalBLS education. The questionnaire revealed a disappointing level of knowledge about BLS in both groups.

Conclusion: Additional basic life support training (two BLS training sessions: high school and university) improvesretention of knowledge and attitudes concerning performing CPR in first year university students.

IntroductionRecent studies have emphasized that bystander cardio-pulmonary resuscitation (CPR) is a very important con-tributing factor in the survival of out-of-hospital cardiacarrest (OHCA) patients [1-10]. The practice of basic lifesupport (BLS) by lay people is therefore essential forsufficient functioning of the chain of survival and is defi-nitely an important part of effective emergency servicesfor a patient needing resuscitation [11]. However, laypeople can only play their role within the chain of survi-val if they are adequately trained and if continuous repe-titions of relevant training information are offered andused [12]. Introducing CPR training in high school anduniversity settings has been widely recommended as along-term strategy to educate the wider community. Ingeneral, students have poor theoretical knowledge,although most of them are willing and motivated tolearn CPR [12-17]. A pyramidal teaching approach

involving students who had BLS training shows potentialfor spreading BLS knowledge to lay people [18]. In aprevious study we confirmed that the potential bystan-der in our community is generally poorly educatedabout performing CPR, but willing to gain knowledgeand skills in BLS and to follow dispatchers instructions[19].The aim of this study was to investigate the impact of

additional basic life support (BLS) training of universitystudents on knowledge and attitude for performing car-diopulmonary resuscitation (one training session vs. twotraining sessions).

MethodsThe study was conducted in the context of the cam-paign program Education of lay people in BLS in theMaribor area and arranged by the authors. The cam-paign program was designed to facilitate the wider disse-mination of BLS skills and knowledge in the localpopulation.Data for the study were collected in the spring of

2009. We compared the knowledge of BLS in three

* Correspondence: grmec-mis@siol.net1Center for Emergency Medicine, Ulica talcev 9, 2000 Maribor, SloveniaFull list of author information is available at the end of the article

Lenik et al. International Journal of Emergency Medicine 2011, 4:16http://www.intjem.com/content/4/1/16

2011 Lenik et al; licensee Springer. This is an Open Access article distributed under the terms of the Creative Commons AttributionLicense (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium,provided the original work is properly cited.

university student groups at the end of the first year ofcollege: those with no prior BLS training, those who hadBLS training in high school (in the drivers educationcourse) approximately 13 months before testing, andthose who had BLS training in high school and addi-tional BLS training at the university (within 6 monthsafter the drivers education BLS course and approxi-mately 8 months before testing). Approximately 90% ofhigh school students successfully accomplished the dri-vers education course. The 10% of high school studentswho failed the drivers education course (and thus didnot have any other opportunity for BLS training in highschool) would therefore be expected to perform poorlyin the BLS program at the university level. Participantsin the first two groups were students of the Faculty ofElectrical Engineering/Computer Science and of theFaculty of Education. In the third group were studentsof the Faculty of Medicine and Faculty of HealthSciences.The drivers education BLS courses were guided by

health workers who are first aid instructors certified bythe Slovenian Red Cross organization and supervised bythe Slovenian Resuscitation Council (pyramid teachingmethods). The drivers education BLS training is part ofthe first aid course for all drivers license candidates.The BLS training includes a lecture (1 h) and practicaltraining in small groups (4 h) in accordance with Eur-opean Resuscitation Council (ERC) recommendations.The additional BLS module was given by ERC instruc-tors. The drivers education BLS training and the BLSmodule have identical structures, presentations, con-tents, tools and equipment. Both groups were trained byERC instructors. The Red Cross group had ERC licensesfor the BLS course, and the ERC group had licenses forthe BLS and Advanced Life Support course.Knowledge of BLS was tested with a questionnaire in

accordance with the 2005 ERC guidelines for BLS andapproved by the deans of all four faculties, who wereinformed about the results at the end of the study andwere advised of a concrete plan of action to improve theBLS knowledge of their students. According to theDeclaration of Helsinki, data were made anonymous [20].A standardized questionnaire with 28 items (see Tables1, 2 and 3) included checkboxes or open answer areas,and contained information about the intention of thesurvey. It was presented to students and collected per-sonally by the authors at the end of testing in hard form.Comparisons were made among the groups and within

the third group with the BLS module course, where thecollected data were compared between the two faculties(Faculty of Medicine and Faculty of Health Sciences).Statistical analyses were performed using SPSS for Win-dows, release 12.0; SPSS, Chicago IL. Wilcoxon signedrank test, t-test and Fishers exact test were used where

appropriate. Descriptive values of variables wereexpressed as average, standard deviation and percen-tages. Power analysis was made by using G-Power3.0.10 for Microsoft Windows XP (Microsoft Inc.,Redmond, WA). Wilcoxon signed rank test, t-test andFishers exact test were used where appropriate. Fordata not normally distributed, the Wilcoxon signed ranktest was used. All p values of less than 0.05 were consid-ered to indicate statistical significance.

ResultsA total of 439 students (118 men and 321 women; aver-age age 19.5 +/- 0.8 years) participated in the study.There were 197 participants with additional BLS training(Faculty of Medicine and Faculty of Health Sciences), 179participants who had taken the drivers education BLScourse and 63 participants who had had no BLS training.All results are shown in Tables 1, 2 and 3.Compared to the group who received an additional

BLS training module, we found that the group with BLStraining from the drivers education course was morewilling to follow dispatchers instructions by telephoneto perform CPR (67% vs. 54%; p < 0.05) and less willingto take BLS training, especially in course form (p /AntiAliasGrayImages false /CropGrayImages true /GrayImageMinResolution 300 /GrayImageMinResolutionPolicy /Warning /DownsampleGrayImages true /GrayImageDownsampleType /Bicubic /GrayImageResolution 500 /GrayImageDepth -1 /GrayImageMinDownsampleDepth 2 /GrayImageDownsampleThreshold 1.50000 /EncodeGrayImages true /GrayImageFilter /DCTEncode /AutoFilterGrayImages true /GrayImageAutoFilterStrategy /JPEG /GrayACSImageDict > /GrayImageDict > /JPEG2000GrayACSImageDict > /JPEG2000GrayImageDict > /AntiAliasMonoImages false /CropMonoImages true /MonoImageMinResolution 1200 /MonoImageMinResolutionPolicy /Warning /DownsampleMonoImages true /MonoImageDownsampleType /Bicubic /MonoImageResolution 1200 /MonoImageDepth -1 /MonoImageDownsampleThreshold 1.50000 /EncodeMonoImages true /MonoImageFilter /CCITTFaxEncode /MonoImageDict > /AllowPSXObjects false /CheckCompliance [ /None ] /PDFX1aCheck false /PDFX3Check false /PDFXCompliantPDFOnly false /PDFXNoTrimBoxError true /PDFXTrimBoxToMediaBoxOffset [ 0.00000 0.00000 0.00000 0.00000 ] /PDFXSetBleedBoxToMediaBox true /PDFXBleedBoxToTrimBoxOffset [ 0.00000 0.00000 0.00000 0.00000 ] /PDFXOutputIntentProfile (None) /PDFXOutputConditionIdentifier () /PDFXOutputCondition () /PDFXRegistryName () /PDFXTrapped /False

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