Knowledge and Attitude on Cardiopulmonary Resuscitation Education of Primary and Secondary Schoolteachers in China
Cardiopulmonary resuscitation (CPR) is a critical skill that can significantly improve the survival and long-term quality of life of patients experiencing out-of-hospital cardiac arrest. Early bystander CPR is particularly crucial in these situations. Recognizing the importance of CPR, many countries and health organizations, including the World Health Organization, highly recommend training schoolchildren in CPR. Schoolteachers, especially those with prior CPR training, are often suggested as ideal candidates to instruct students in CPR. The knowledge and previous training of these teachers are vital for their willingness to teach CPR and the quality of their instruction. A six-year longitudinal study has shown that teachers who attended a 60-minute theoretical and practical CPR course could provide adequate resuscitation training in schools. In Belgium, Flemish primary schoolteachers demonstrated a high interest in CPR training and were willing to teach CPR. However, in China, there is limited information on teachers’ CPR knowledge and their attitudes toward CPR education. This study aimed to evaluate the current CPR knowledge, previous training, and attitudes toward CPR education among primary and secondary schoolteachers in China.
The study conducted a prospective anonymous online survey using the Tencent questionnaire website, which was disseminated through WeChat, a widely used social media platform in China. The questionnaire was designed based on the European Resuscitation Council Guidelines for Resuscitation 2015 and previously documented scenario-based surveys. It consisted of 24 items divided into four sections: demographic information, current awareness of CPR and previous CPR training, willingness and attitude toward participating in CPR training and teaching, and automated external defibrillator (AED)-related information and CPR knowledge. The survey collected responses from primary and secondary schoolteachers who were willing to participate by clicking on the online link via WeChat. The data were collected between January 24 and February 8, 2018, and analyzed using SPSS software. A total of 5556 questionnaires were submitted, with 5324 being valid for analysis.
The study participants included 2329 primary schoolteachers and 2995 secondary schoolteachers. Among them, 96.8% had previously heard about CPR, with the majority learning about it from television (70.0%) and the least from newspapers (39.1%). Previous CPR training was common, with 54.0% of participants having received such training. Significant differences in previous CPR training were observed among teachers of different ages, with the highest proportion of training in teachers aged 30 to 39 years (60.7%) and the lowest in those aged 50 years or older (36.6%). This suggests that teachers aged 30 to 39 years could be potential CPR instructors.
Most teachers knew how to assess consciousness (71.9%) and respiration (51.1%). The majority also knew the correct hand placement (77.4%) and hand posture (80.9%) for chest compressions. However, only a small percentage knew the correct depth of chest compressions (18.0%), the frequency of chest compressions (29.1%), and the correct ratio of chest compressions to artificial respiration (28.4%). Additionally, only 16.2% knew how to use AEDs, and 12.7% were aware of the placement of AEDs in their neighborhood. These findings indicate a need for further learning and systematic reviews of teachers’ theoretical CPR knowledge.
Importantly, 96.4% of participants expressed a willingness to attend CPR training, 93.1% supported the development of a CPR training curriculum in schools, and 91.8% stated their willingness to teach CPR. In comparison, a study in Barcelona found that 83% of secondary schoolteachers identified schools as the best setting for CPR training, and 69% were willing to teach CPR. Danish secondary schoolteachers, however, were unwilling to perform CPR training unless they had acquired sufficient CPR skills through previous training. The study suggests that CPR training in schools is more likely to be realized in China if relevant supporting policies, clear curriculum guidelines, and training-related equipment are available.
In summary, the study revealed that Chinese primary and secondary schoolteachers have a preliminary understanding of CPR but lack exact theoretical knowledge. More than half of the teachers had previous CPR training and expressed a high interest in participating in and conducting CPR training. The findings highlight the potential for schoolteachers to play a significant role in CPR education, provided they receive adequate training and support.
doi.org/10.1097/CM9.0000000000000236
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