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Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
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Skill retention after school-based CPR training - a systematic review and meta-analysis.

Umut Onbasilar1, Thilo von Groote2, Rebecca Brülle2

  • 1Department of Anaesthesiology, Intensive Care and Pain Medicine, Florence Nightingale Hospital, Kreuzbergstraße 79, Düsseldorf, 40489, Germany.

BMC Public Health
|November 5, 2025
PubMed
Summary

School-based cardiopulmonary resuscitation (CPR) training effectively teaches children CPR skills. However, these skills decline over time, indicating a need for refresher courses to maintain proficiency in CPR.

Keywords:
CPR trainingMeta-analysisSchool-basedSkill retentionSystematic review

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Area of Science:

  • Emergency Medicine
  • Pediatric Education
  • Public Health Interventions

Background:

  • Early cardiopulmonary resuscitation (CPR) is critical for out-of-hospital cardiac arrest survival.
  • School-based CPR programs aim to increase bystander CPR rates.
  • Long-term skill retention and the necessity of refresher training remain areas of uncertainty.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of school-based CPR training.
  • To assess CPR skill acquisition and long-term retention in student populations.
  • To evaluate the impact of training on CPR technique and proficiency over time.

Main Methods:

  • Systematic search of eight databases for randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs).
  • Inclusion of studies with participants aged 6-18 years and follow-up assessments ≥3 months.
  • Meta-analysis of weighted means and paired comparisons, with study quality assessed using ROBINS-I and RoB 2 tools.

Main Results:

  • Eighteen studies (12 RCTs, 6 NRSIs) met inclusion criteria.
  • CPR training significantly improved initial skill acquisition (74%-90% correct performance).
  • A notable decline in skill retention was observed, particularly in chest compression quality within 6-8 months.

Conclusions:

  • School-based CPR training is effective for initial skill acquisition in children.
  • A significant decay in CPR skill retention occurs over time.
  • Periodic refresher courses are recommended to sustain CPR proficiency and maximize educational impact.