• Sabine Wingen, Daniel C Schroeder, Hannes Ecker, Susanne Steinhauser, Sibel Altin, Stephanie Stock, Alex Lechleuthner, Andreas Hohn, and Bernd W Böttiger.
• From the Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne (SW, DCS, HE, AH, BWB), Institute of Medical Statistics and Computational Biology, Informatics and Epidemiology, University Hospital of Cologne (SSte), Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne (SA, SSto) and Institute of Emergency Medicine, Technology Arts Sciences, Cologne, Germany (AL).
• Eur J Anaesthesiol. 2018 Jul 1; 35 (7): 519-526.

BackgroundEducation of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society.Objective(S)The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improved CPR knowledge and self-confidence were investigated.DesignRandomised-interventional controlled study.SettingFour secondary schools in Germany.ParticipantsFour hundred and twenty-four schoolchildren aged from 14 to 18 years were included into the study. Fifty-one percent were female, and 33% had an immigrant background.InterventionThe intervention group received a 90-min CPR training session, whereas controls had no intervention. Levels of knowledge and self-confidence in initiating CPR were analysed by a study questionnaire before (t0), 90 min after (t1) and 6 months after training (t2).Main Outcome MeasuresBased on the evaluation of study questionnaires, the primary endpoint was to determine the development of resuscitation knowledge and self-confidence in initiating cardiopulmonary resuscitation at survey time-points t0, t1 and t2.ResultsSchoolchildren in the intervention group (n=207) showed a significantly higher level of knowledge (P < 0.001) and self-confidence (P < 0.001) at t1 and t2 compared with controls (n=217). Age was a predictor for long-term self-confidence [odds ratio (OR), 1.20; 95% confidence interval (95% CI), 1.02 to 1.41; P = 0.032]. The long-term benefit in the level of knowledge and self-confidence were significantly higher in native compared with immigrant schoolchildren: (OR, 1.79; 95% CI, 1.14 to 2.82; P = 0.011) and (OR, 1.67; 95% CI, 1.07 to 2.60; P = 0.024), respectively.ConclusionGuideline compliant (90 min) theoretical and practical CPR training improves the level of knowledge and self-confidence in 14 to 18-year-old schoolchildren. Older schoolchildren are more likely to have increased self-confidence with respect to initiating CPR. Schoolchildren with an immigrant background showed a significantly lower increase in their level of knowledge and self-confidence compared with native children. Adaptation and simplification of teaching materials and further research on educational methods for CPR are urgently needed to enable a sustainable approach to teaching CPR, which also produces a long-lasting effect in the entire population.

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