Mollo A, Beck S, Degel A, Greif R, Breckwoldt J
Institute of Anesthesiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Internal Medicine, Spital Limmattal, Zurich, Switzerland.
Resusc Plus. 2024 Aug 29;20:100755. doi: 10.1016/j.resplu.2024.100755. eCollection 2024 Dec.
CPR training for schoolchildren to increase bystander CPR-rates is widely applied. HCPs are regarded as the instructor gold standard, but using non-HCP instructors (e.g., peer-tutors, schoolteachers, medical students) challenges that. This systematic review assesses whether cardiopulmonary resuscitation (CPR) training for children led by peer-tutors, schoolteachers, or medical students results in different learning outcomes to training by health-care professionals (HCPs).
We searched studies that compared CPR training for schoolchildren delivered by peer-tutors, schoolteachers, or medical students with training led by HCPs assessing student knowledge, skills, willingness and/or confidence to perform CPR . We included randomized and non-randomized controlled trials Medline, Embase, Psychinfo, Cinahl, Cochrane, Scopus, Web of Science, and Eric were searched from inception until December 23rd, 2023 . Two independent reviewers performed title, abstract, full text screening, bias assessment, and grading of certainty of evidence. We followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines, and registered the review with PROSPERO.
Of 9'092 studies identified, 14 were included. Comparison of intervention groups to HCP-led training showed similar overall results (knowledge, skills, self-confidence). Superior results for HCP training were only reported for 'ventilation volume', while schoolteachers and medical students achieved superior knowledge transfer. A meta-analysis was possible for 'compression depth' between peer-tutors and HCPs showing no significant differences. Certainty of evidence was 'low' to 'very low'.
This systematic review of CPR training for school children revealed that peer-tutors, schoolteachers and medical students achieve similar educational outcomes compared to those of HCPs. Non-HCPs training schoolchildren is an appropriate cost-efficient alternative and easy to implement in school curricula.
对学童进行心肺复苏术（CPR）培训以提高旁观者实施心肺复苏术的比例已得到广泛应用。医疗保健专业人员（HCP）被视为指导者的黄金标准，但使用非医疗保健专业人员指导者（如同伴辅导者、学校教师、医学生）对这一标准提出了挑战。本系统评价评估由同伴辅导者、学校教师或医学生对儿童进行的心肺复苏术培训与由医疗保健专业人员进行的培训相比，是否会产生不同的学习成果。
我们检索了将同伴辅导者、学校教师或医学生对学童进行的心肺复苏术培训与医疗保健专业人员指导的培训进行比较的研究，评估学生实施心肺复苏术的知识、技能、意愿和/或信心。我们纳入了随机和非随机对照试验，从数据库建库至2023年12月23日检索了Medline、Embase、Psychinfo、Cinahl、Cochrane、Scopus、Web of Science和Eric。两名独立评审员进行标题、摘要、全文筛选、偏倚评估和证据确定性分级。我们遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，并在PROSPERO上注册了该评价。
在识别出的9092项研究中，纳入了14项。干预组与医疗保健专业人员指导的培训相比，总体结果相似（知识、技能、自信心）。仅在“通气量”方面报告了医疗保健专业人员培训的更好结果，而学校教师和医学生在知识传授方面取得了更好的效果。对同伴辅导者和医疗保健专业人员之间的“按压深度”进行Meta分析显示无显著差异。证据确定性为“低”至“极低”。
这项对学童心肺复苏术培训的系统评价表明，同伴辅导者、学校教师和医学生与医疗保健专业人员相比，取得了相似的教育成果。非医疗保健专业人员对学童进行培训是一种合适的、具有成本效益的替代方案，并且易于在学校课程中实施。
