International Journal of Emergency Medicine
From diverse baselines to score convergence in cardiopulmonary resuscitation knowledge: a pre-post study on instructor-led training to healthcare professionals, medical students and laypeople
By Abel Nicolau, Inês Jorge, Inês Mariana Lourenço and 2 others.
Abstract
Abstract Background Effective cardiopulmonary resuscitation (CPR) training is crucial, yet performance often remains suboptimal among both professionals and laypeople. While structured training improves skills and attitudes, traditional instructor-led sessions may be limited by subjective assessment of CPR quality. Aim To assess the acquisition of CPR knowledge after instructor-led certified training in healthcare professionals (HCP), medical students (MS) and laypeople (LP). Methods A single-arm pre-post quasi-experimental study was implemented involving three independent groups registered for certified Basic Life Support (BLS) training courses: HCP, MS and LP. All participants were asked to complete a 12-question anonymous questionnaire based on the American Heart Association guidelines for resuscitation, before and immediately after training. Knowledge gain was assessed by comparing pre- and post-training scores. Results The study included 285 participants. Theoretical knowledge improved significantly across all groups ( p < 0.001), with mean scores increasing from 80.35%±13.95% to 90.88% ±8.46%. While pre-test scores reflected baseline experience (HCP: 89.18%; MS: 80.34%; LP: 70.74%), post-test scores showed no statistically significant difference between groups ( p = 0.378), reflecting score convergence. Significant improvement was observed in the overall cohort, MS, and LP ( p < 0.001), whereas the improvement among HCP did not reach statistical significance ( p = 0.055). Analysis of specific items may suggest a “theoretical-practical dissonance” in LP, who struggled with the conceptual recall of hand positioning and depth despite practical training. Conversely, HCPs showed only marginal improvement in the BLS algorithm, likely due to cognitive interference from more complex clinical workflows. Conclusion Instructor-led BLS training effectively equalizes theoretical knowledge across diverse backgrounds. However, the nature of knowledge acquisition may vary: novices benefit most from standardized algorithms, while experts may experience interference from advanced frameworks. Furthermore, in LP, practical proficiency may develop through muscle memory even when theoretical recall remains biased, suggesting that educational assessments should increasingly integrate both cognitive and procedural metrics.



