Recruiting and Training Junior Medical Students as Basic Life Support Instructors for Primary School Students: Prospective Pilot Implementation Study

Vollständiger Abstract

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Abstract Background Basic life support (BLS) significantly improves survival and neurological outcomes after out-of-hospital cardiac arrest (OHCA). However, bystander cardiopulmonary resuscitation (CPR) rates vary widely worldwide, reaching only 40% in Geneva, Switzerland. The European Resuscitation Council’s “Kids Save Lives” statement advocates for integrating BLS education into mandatory school curricula to improve bystander CPR rates, and thus OHCA outcomes. Training medical students as BLS instructors could help address the shortage of qualified instructors needed to implement school-based BLS programs in primary schools. Objective The primary aim of this pilot study was to assess the feasibility of involving medical students as BLS instructors for primary school classes and to evaluate the impact of their teaching on primary school students’ immediate knowledge acquisition and self-confidence. Methods This pilot implementation study was conducted in Geneva, Switzerland. Second- and third-year medical students were presented the project during their emergency skills training and invited to complete an online questionnaire. Sixteen students were selected and underwent instructor training, enabling them to deliver a BLS course in a primary school class. Participating seventh-grade primary school students completed a questionnaire designed to assess immediate knowledge acquisition and confidence. The primary outcome was the feasibility of involving medical students as BLS instructors, including the proportion of medical students willing to become BLS instructors, the number trained and certified, and the number of BLS courses delivered. Secondary outcomes included children’s mean knowledge score and confidence in calling the emergency phone number. Predictors of willingness, and of knowledge and confidence, were also examined. Results Among 325 eligible students, 107 (32.9%) completed the questionnaire, and 87 (26.8% of all eligible students; 81.3% of respondents) expressed willingness to fully participate in this program. The 16 selected students successfully completed the instructor training and delivered courses in 16 primary school classes. No significant predictors of willingness were identified. A total of 295 (81.7%) of 361 children completed the postcourse questionnaires. Knowledge acquisition was high, with a mean score of 5.4 (SD 1.1) out of 7. High proportions of correct responses were observed for most BLS concepts, except for breathing assessment and recovery position indications. Overall, 78% (230/295) of children reported confidence in calling emergency services. No significant predictors of knowledge or confidence were found. Conclusions Medical students can effectively deliver BLS training to primary school students and may represent a useful workforce for school-based BLS programs. However, the low response rate introduces a selection bias, as many students did not respond and the observed willingness may not reflect that of the overall student population. Sustainable scale-up will require involving other instructors. Further studies should assess the feasibility of large-scale implementation.