Development and Effect of Basic Cardiopulmonary Resuscitation Training Program for Firefighters

Abstract

This study was aimed at developing and examining the effects of a training program for basic cardiopulmonary resuscitation for firefighters to improve their survival rate after cardiac arrest on the fireground. The 5 steps of the ADDIE (Analysis, Design, Development, Implementation, Evaluation) instructional design based on the behaviorism theory and the contents validity index (CVI) were used by the group, consisting of 7 experts (1 emergency medicine professor, 1 emergency medical technology professor, 2 fire service academy professors, 1 education professor, 2 firefighters with more than 15 years of experience on the field), to develop and validate the program. The randomized control group pretest-posttest design was used to verify the effects. The participants of this study were 63 new firefighters undergoing training at K Fire Service Academy located in Gyeonggi Province pending appointment. Block randomization, with Microsoft Excel, was used to group the participants. The experimental and control groups comprised 31 and 32 members, respectively. The research lasted from November 13 to December 18, 2020, and the collected data were analyzed with IBM SPSS Statistics V25.0. The newly developed basic cardiopulmonary resuscitation training program (FDCPR-BLS program) was applied to the experimental group, and the preexisting basic cardiopulmonary resuscitation program (KACPR-BLS program) was applied to the control group. After each practice for 80 minutes at a time in both groups, the effects on the knowledge, self-efficacy, skill performance, and learning satisfaction were tested, and the results were as follows. The knowledge of the experimental group increased by 4.12 points from 6.94 to 11.06 and that of the control group increased by 4.15 points from 6.91 to 11.06. Therefore, the magnitudes of change in the knowledge score in the experimental group significantly decreased than that in the control group (t=16.869, p<.001). The self-efficacy of the experimental group increased by 2.46 points from 44.35 to 46.81 and that of the control group decreased by 5.47 points from 42.66 to 37.19 after the program. Therefore, the magnitudes of change in the self-efficacy score in the experimental group significantly increased than that in the control group (t=3.331, p<.002). The skill performance of the experimental group increased by 6.81 points from 6.74 to 13.55 and that of the control group increased by 4.47 points from 6.56 to 11.03. Therefore, the magnitudes of change in the skill performance score in the experimental group significantly increased than that in the control group (t=13.782, p<.001). The time to reach the initial chest compression in the experimental group decreased by 76.0 seconds from 124.13 to 48.13 seconds and that of the control group decreased by 15.9 seconds from 123.06 to 107.10. Therefore, the magnitudes of change in the time to reach initial chest compression in the experimental group significantly decreased than that in the control group (t=-38.284, p<.001). The learning satisfaction was 21.77 points higher in the experimental group than in the control group, and the difference was statistically significant (t=-28.220, p<.001). Self-efficacy (β=-0.572, p<.001) and skill performance (β=-0.397, p<.001), but not knowledge (β=0.050, p>.05), were negatively correlated with the time to reach initial chest compression. A higher self-efficacy or skill performance was associated with a shorter time to reach initial chest compression. The FDCPR-BLS Program developed in this study was effective in enhancing the knowledge, self-efficacy, skill performance, and learning satisfaction of the firefighters on CPR. If this program is added to the ‘Fire Reacting Capability Test (Fire-fighter Ⅰ, Ⅱ)’, the iterative training to CPR can be conducted, and the skill performance of CPR could be maintained. Furthermore, the program can facilitate a better survival rate of colleagues suffering from cardiac arrest.