What question did this study set out to answer?

This study aimed to determine the necessity of post-qualification CPR training and compare the effectiveness of face-to-face versus online training on knowledge retention for nursing students.

May 24, 2026Open Access

Evaluating Nursing Students’ Performance and Retention of BLS/AED Knowledge and Skills One Year After Training: A Randomized Controlled Trial

Key Points

This study aimed to determine the necessity of post-qualification CPR training and compare the effectiveness of face-to-face versus online training on knowledge retention for nursing students.
Three-group, parallel randomized-controlled, single-blind design with 133 nursing students
Participants completed a BLS/AED course and were re-assessed after six months
Data analyzed using Kruskal-Wallis's test, Pearson's Chi-Squared test, and multiple linear regression
Both intervention groups showed significantly higher knowledge scores at follow-up (P < 0.001) compared with the control group
Significant decrease in skill scores in the control group after one year (P < 0.001)
Intervention groups exhibited significant improvement in nine out of eleven assessed skills (all P < 0.05)

Abstract

INTRODUCTION: Nurses often serve as the initial responders in cases of cardiac arrest, making cardiopulmonary resuscitation (CPR) competence essential to effective resuscitation. It is therefore important for nursing students to possess sufficient CPR knowledge and skills for future clinical practice. OBJECTIVE: The aim of this study was to examine whether CPR post-qualification training is needed in maintaining knowledge and skills and if face-to-face or online training is more effective as an educational method in preserving CPR knowledge and skills in nursing students. METHODS: A three-group, parallel randomized-controlled, single-blind design was used. The participants were 133 nursing students, randomly assigned to the face-to-face group (n = 43), the e-learning group (n = 43), and the control group (n = 47). Before randomization, all participants (n = 133) successfully completed the European Resuscitation Council (ERC) standard five-hour Basic Life Support/Automated External Defibrillation (BLS/AED) course (t0) and a questionnaire based on the 2021 ERC Guidelines to assess their knowledge. Six months later, Group A received face-to-face training, Group B received e-learning training, and Group C had no intervention. Six months after interventions, all participants (n = 133) were re-assessed on the same questionnaire, and they were given the same scenario of cardiopulmonary arrest that was used during the initial BLS course to assess the skills that they retained (t1) with the use of the ERC CPR/AED 11-item checklist. The collected data were analyzed with inferential "among group" analysis involving Kruskal-Wallis's and Pearson's Chi-Squared test and inferential "within group" analysis including Wilcoxon's Signed-Rank and McNemar's test. Multiple linear regression was used for adjusting demographic characteristics. RESULTS: Based on pairwise differences between independent groups, both intervention groups presented higher scores in knowledge at t1 (P < 0.001) and in skills at t1 (P < 0.001) compared to the control group. Moreover, both training methods demonstrated comparable effectiveness. Based on comparisons between paired groups, there was also a statistically significant decrease in the Skill Score in the control group after one year (P < 0.001). Most skills were notably higher, primarily in the e-learning group, and to a lesser extent in the face-to-face group. In specific, intervention groups demonstrated statistically significant improvement in nine of the eleven assessed skills (all P < 0.05). CONCLUSION: The current study showed that post-qualification training is needed to retain CPR knowledge and skills of nursing students, and that face-to-face and e-learning training had similar outcomes.

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