Skill retention after school-based CPR training - a systematic review and meta-analysis.

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.