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Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
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Related Experiment Video

Updated: May 26, 2026

Setup and Execution Of the Blindfolded Code Training Exercise
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Crossing life-saving thresholds: learning-forgetting trajectories in secondary-school basic life-support training:

Raquel Cantón-Cortés1,2, Pedro Fernández-Florido2,3, Azahara Fernández-Carbonell2,4

  • 1Specialist in Family and Community Medicine, Emergency Department, Poniente University Hospital, El Ejido, Spain.

Frontiers in Public Health
|May 25, 2026
PubMed
Summary

Basic life support (BLS) knowledge in students significantly improves after training but declines over six months. Specific concepts like agonal breathing are forgotten faster, suggesting targeted refreshers are needed for lasting BLS competence.

Keywords:
basic life supportcardiopulmonary resuscitationforgetting curvelearning curvesecondary educationstem educationthreshold concepts

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Area of Science:

  • Public Health
  • Medical Education
  • Pediatric Emergency Medicine

Background:

  • Basic life support (BLS) training in schools is crucial for public health.
  • Long-term retention of BLS knowledge among secondary school students is not well understood.
  • Identifying learning and forgetting curves for critical BLS concepts is essential.

Purpose of the Study:

  • To quantify the learning and forgetting curves of six key threshold concepts in BLS among secondary school students.
  • To examine demographic factors (gender, grade, school location) that may moderate knowledge retention.
  • To assess the long-term durability of BLS knowledge acquired in a school setting.

Main Methods:

  • A quasi-experimental design involving 459 secondary school students (ages 12-15) across six schools.
  • Students completed a 20-item multiple-choice test on BLS at baseline, immediately post-instruction, and 6 months later.
  • Statistical analyses included Friedman tests and mixed linear models to evaluate changes over time and demographic interactions.

Main Results:

  • Mean BLS knowledge scores increased significantly from baseline (40.5%) to post-instruction (67.3%) and decreased at 6 months (55.1%).
  • Females and 4th-year students demonstrated significantly better knowledge retention compared to their peers.
  • Forgetting rates varied by concept, with agonal breathing recognition showing the steepest decline (-27%) while time-critical aspects remained more stable (-9%).

Conclusions:

  • BLS competence is built on key concepts that decay at different rates over time.
  • Regular, targeted micro-refreshers, particularly on agonal respiration and AED use, are recommended to enhance long-term learning and retention.
  • Educational strategies should address the differential forgetting rates of BLS concepts to ensure sustained proficiency.