Comparing Instructor-led Versus Blended Cardiopulmonary Resuscitation Training Among Nursing Students

NCT07851311 | Completed

• 1 other identifier: DRGS-2025-2
• Study Type: interventional
• Target: 208
• Locations: 1 country
• Sites: 1

Brief Summary

Objectives of the Study The current study aimed to investigate how individual and team personality traits, academic motivation, and academic procrastination predict CPR training outcomes at individual and team levels, and to what extent these associations vary across different CPR training modalities (instructor-led versus blended). Material and methods Design This study employed an experimental, posttest-only control group design. Subjects The target population comprised undergraduate nursing students enrolled in the BSN program. The inclusion criteria were determined as follows: (1) third- and fourth-year students, (2) they had already completed foundational coursework. On the other hand, the exclusion criteria were: (1) students enrolled in the program through bridging tracks, and (2) students who had completed the comprehensive clinical course. Potential participants were randomly selected from eligible nursing students listed in academic records, screened for inclusion criteria, and invited via email. A total of 133 nursing students were enrolled and randomly assigned to one of two study groups. They were then divided into groups of 6 using block randomization to balance group sizes. Because the interventions differed in content and delivery, blinding of students and instructors was not possible. The required sample size was calculated through an independent samples t-test aimed at detecting a moderate effect size (Cohen's d = 0.5) between the two training groups, with a statistical power of 0.80 and a significance level of 0.05. Based on that, a minimum of 63 students per group was required to ensure adequate power to detect statistically significant differences in the measured outcomes. Randomization Participants were selected using a random sampling technique following the acquisition of a complete list of eligible nursing students from official academic records. Based on the predefined inclusion and exclusion criteria, a filtered list of potential participants was generated. From this list, students were randomly selected and invited to participate through a recruitment link sent to their email addresses. Those who filled out the link were screened again for eligibility, and then the researchers contacted those who met the criteria to notify them of their enrollment. Recruited participants were then assigned to one of the two study groups, ensuring an unbiased and systematic approach to participant recruitment (Figure 1). Randomization utilized stratified randomization (to ensure that the distribution of both nursing schools is similar across treatment groups) and block randomization (to ensure that the number of participants assigned to each treatment group remains roughly equal throughout the trial). Due to the varying educational materials and delivery methods, it was not possible to blind or conceal the allocation to either students or instructors. Interventions All CPR training sessions were conducted over nine weeks (May - July 2025) at the Life Support Center at the private university, which is accredited by the American Heart Association (AHA) and equipped with high-fidelity manikins and advanced audiovisual technology. Following participant selection, students were randomly assigned to one of two intervention groups, each receiving a different CPR training modality. Both training methods were based on the most recent guidelines from the AHA and delivered by certified instructors to ensure consistency and quality of instruction (American Heart Association \[AHA\], 2020). Each participant received an official invitation via email, which included a cover letter, details of the training schedule, course materials, and an informed consent form. To reduce potential external influences, both groups received their respective training at the same time. Upon completion of the training, participants were immediately asked to complete the postest self-reported questionnaires through Google Forms, with all items set as mandatory. Students were instructed to complete the surveys independently and were assured of the confidentiality and anonymity of their responses. Intervention and Data Collection All CPR training sessions were conducted over nine weeks (May - July 2025) at the Life Support Center at the private university, which is accredited by the American Heart Association (AHA) and equipped with high-fidelity manikins and advanced audiovisual technology, providing a realistic and interactive environment to support hands-on, experiential learning under standardized conditions. Following participant selection, students were randomly assigned to one of two intervention groups, each receiving a different CPR training modality. Both training methods were based on the most recent AHA guidelines and delivered by certified instructors to ensure consistency and quality of instruction. participants were assessed at day of the course and after 3 months.

Conditions

Knowledge; Skill Retention; Satisfaction; Cardiopulmonary Resuscitation (CPR); Competence

Outcome Measures

Primary Outcomes (4)

• CPR knowledge using the AHA written exam

  Measured using the AHA -BLS written exam. The written exam was composed of 25 multiple-choice questions (with four alternatives) about BLS science, with a total score of 100%, and the passing score was set at 84%. Students have one attempt at remediation if their scores range between 76% and 84%, by correcting their own mistakes on the same form.

  Initial measure at the day of the course

• CPR Competency using the AHA competency checklist

  The BLS adult and infant checklists (AHA 2025) were used to check the participants' competence level. Participants had to complete each step in the checklist to pass the exam. According to the AHA guidelines, if a participant failed to meet all the criteria, the instructor had to indicate the step to the students and had to allow time for practice before a remedial test was conducted. Each participant is allowed one remedial attempt only.

  Initial measure at the day of the course

• Skills relention using the AHA competency checklist

  The BLS adult and infant checklists (AHA 2025) were used to check the participants' competence level. Participants had to complete each step in the checklist to pass the exam.

  After 3 months of attending the training

• Knowledge retention using the AHA written exam

  Measured using the AHA -BLS written exam. The written exam was composed of 25 multiple-choice questions (with four alternatives) about BLS science, with a total score of 100%, and the passing score was set at 84%. Students have one attempt at remediation if their scores range between 76% and 84%, by correcting their own mistakes on the same form.

  After 3 months of attending the training

Secondary Outcomes (3)

• Satisfaction and Self-Confidence: using the Student Satisfaction and Self-Confidence in Learning questionnaire was developed by the National League for Nursing

  Initial measure at the day of the course

• Team performance using observation and feedback device during a 10-minute CPR scenario

  Initial at the day of the training

• Retention of team performance using observation and feedback device during a 10-minute CPR scenario

  After 3 months of attending the training

Study Arms (2)

Instructor-Led

ACTIVE COMPARATOR

Other: Instructor-led training

Heartcode

EXPERIMENTAL

Other: Blended learning

Interventions

Blended learning OTHER

Students in the intervention group (blended learning, HeartCode course) attended an online session lasting about 2 hours, with integrated test questions to assess their knowledge and progress. Then, they attended hands-on training (2-3 hours) in the simulation lab

Heartcode

Instructor-led training OTHER

Students in this group received a traditional, face-to-face BLS course in a classroom and simulation lab setting. The training consisted of a 4-5-hour interactive session featuring theoretical videos, demonstrations, guided discussions, and hands-on practice with high-fidelity manikins. Emphasis was placed on immediate feedback, real-time technique correction, and active engagement through instructor supervision.

Instructor-Led

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Third- and fourth-year students
• Had already completed foundational coursework.

You may not qualify if:

• students enrolled in the program through bridging tracks
• students who had completed the comprehensive clinical course

Sponsors & Collaborators

• Applied Science Private University: lead

Study Sites (1)

Applied Science Private University

Amman, Jordan

Location

Related Publications (1)

• • Abdulwahhab, M. (2017). Effectiveness of simulation techniques on the nursing students knowledge toward cardiopulmonary resuscitation for adults at college of nursing/university of baghdad. Kufa Journal for Nursing Sciences, 7(1), 24-27. https://doi.org/10.36321/kjns.vi20171.2288 • Andérson, G., Gaetz, M., & Statz, C. (2012). Cpr skill retention of first aid attendants within the workplace. Prehospital and Disaster Medicine, 27(4), 312-318. https://doi.org/10.1017/s1049023x1200088x • Blewer, A., Leary, M., Esposito, E., González, M., Riegel, B., Bobrow, B., … & Abella, B. (2012). Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training. Critical Care Medicine, 40(3), 787-792. https://doi.org/10.1097/ccm.0b013e318236f2ca • Fukushima, H., Asai, H., Seki, T., Takano, K., & Bolstad, F. (2020). The effect of 10-min dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study. International Journal of Emergency Medicine, 13(1). https://doi.org/10.1186/s12245-020-00287-9 • Gebremedhn, E., Gebregergs, G., & Anderson, B. (2014). The knowledge level of final year undergraduate health science students and medical interns about cardiopulmonary resuscitation at a university teaching hospital of northwest ethiopia. World Journal of Emergency Medicine, 5(1), 29. https://doi.org/10.5847/wjem.j.issn.1920-8642.2014.01.005 • Hassan, E. and Elsaman, S. (2022). The effect of simulation-based flipped classroom on acquisition of cardiopulmonary resuscitation skills: a simulation-based randomized trial. Nursing in Critical Care, 28(3), 344-352. https://doi.org/10.1111/nicc.12816 • Jeong, H., Ju, D., Lee, A., Lee, J., Kang, N., Choi, E., … & Moon, S. (2022). Effect of a hybrid team-based advanced cardiopulmonary life support simulation program for clinical nurses. Plos One, 17(12), e0278512. https://doi.org/10.1371/journal.pone.0278512 • Kim, E. and Cho, K. (2023). Comparing the e

  BACKGROUND

MeSH Terms

Conditions

Personal Satisfaction

Condition Hierarchy (Ancestors)

Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: September 20, 2026
• First Posted: October 1, 2026
• Study Start: May 13, 2025
• Primary Completion: July 31, 2025
• Study Completion: July 31, 2025
• Last Updated: October 1, 2026

Record last verified: 2026-09

Locations

JO (1)