Review Article

Bystander CPR training: is non-classroom based CPR training as effective as a classroom based approach? A systematic review of randomised controlled trials


Michael Cross1 MA(Hons), Medical Student

Eleanor Harlow2 BA(Hons), Medical Student

Sean R Morrison3 BA(Hons), Medical Student *

Marc Place4 BSc(Hons), Medical Student

Malcolm Sutherland5 MA(Hons), Medical Student

Julia Thomas6 BSc(Hons), Medical Student

name here
Stephen James Leslie7
PhD, Consultant Cardiologist and Honorary Professor


1, 2, 3, 4, 5, 6 School of Medicine and Dentistry, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK

7 Cardiac Unit, Raigmore Hospital, Inverness, IV2 3UJ, UK; and Department of Diabetes & Cardiovascular Science, University of the Highlands and Islands, The Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK

ACCEPTED: 6 July 2019

early abstract:

Background: In Scotland, approximately five percent of out-of-hospital cardiac arrest patients survive to hospital discharge. Improving bystander cardiopulmonary resuscitation (CPR), especially in rural areas, could have a significant effect on the numbers of lives saved.

Objectives: To systematically review whether non-classroom based bystander CPR training is as effective as classroom based training.

Methods: A database search for RCTs, which compared classroom based to non-classroom based training in bystanders (non-medical professionals) was performed in Medline and Embase with no date restrictions. Relevant studies were critically appraised. Differences in the efficacy of CPR training between the two study arms of non-classroom and classroom based training were measured by outcomes of compression depth, compression rate and correct hand-positioning in order

Results: Eight studies in total met the inclusion criteria. Thirteen out of a total of fifteen outcomes showed non-classroom based CPR training to be as effective as or more effective than classroom based training. A high risk of bias was identified in every study.

Conclusion: From the available evidence, non-classroom based training appears at least as effective as classroom based training for CPR. This could have significant implications for delivery of CPR training nationally, especially in remote and rural areas. However, due to the variation in how outcomes were measured, and the high risk of bias present in each of the studies, further research into CPR training strategies is strongly recommended.