Efficacy and knowledge of conducting CPR through online learning during the COVID-19 pandemic: A literature review

  • Iil Dwi Lactona
    School of Nursing, Faculty of Medicine, University of Brawijaya, Malang, Indonesia.
  • Suryanto Suryanto
    School of Nursing, Faculty of Medicine, University of Brawijaya, Malang, Indonesia.


The COVID-19 pandemic has made it difficult to carry out face-to-face training activities in various higher institutions. This has led to a negative impact on the skills and abilities of nursing students in performing cardiopulmonary resuscitation (CPR) and the cessation of their clinical practice programs in hospitals. Therefore, the aim of this study is to determine the efficacy and knowledge of nursing students in performing CPR by implementing a blended learning program, through online learning platforms. The search for full-text articles was carried out in May 2020 and were reviewed to know whether they fit the theme using the ProQuest, ScienceDirect and PubMed databases with the keywords “BLS”, “CPR”, “Blended learning”, “Knowledge” and “Self-efficacy”. In addition, there were 15 articles that matched the criteria. The application of a blended learning program that integrates video and face-to-face lectures through online learning platforms in conducting effective CPR, increases the efficacy and knowledge of nursing students. The effectiveness of online learning greatly affects the efficacy and knowledge of nursing students in conducting CPR. Therefore, it was highly recommended during the COVID-19 pandemic.


Boada I, Rodriguez-Benitez A, Garcia-Gonzalez JM, et al. Using a serious game to complement CPR instruction in a nurse faculty. Comput Methods Programs Biomed 2015;122:282-91. DOI: https://doi.org/10.1016/j.cmpb.2015.08.006

Wong MA, Chue S, Jong M, et al. Clinical instructors ‘perceptions of virtual reality in health professionals' cardiopulmonary resuscitation education. SAGE Open Med 2018;6:050312118799602. DOI: https://doi.org/10.1177/2050312118799602

Liu X, Zhou J, Chen L, et al. Impact of COVID-19 epidemic on live online dental continuing education. Eur J Dental Educ 2020;24:786-9. DOI: https://doi.org/10.1111/eje.12569

Abidah A, Hidaayatullaah HN, Simamora RM, et al. The Impact of Covid-19 to Indonesian education and its relation to the philosophy of “Merdeka Belajar”. Stud Philos Sci Educ 2020;1:38-49. DOI: https://doi.org/10.46627/sipose.v1i1.9

Carlson SF. Cardiopulmonary resuscitation in schools: School nurses' perceptions of barriers and recommendations for integration. Phoenix: University of Phoenix; 2017.

Smereka J, Szarpak L, Czekajlo M, et al. The TrueCPR device in the process of teaching cardiopulmonary resuscitation: A randomized simulation trial. Medicine 2019;98:e15995. DOI: https://doi.org/10.1097/MD.0000000000015995

Sarin-Gulian L, Espinoza J, Lee TC, et al. Development and evaluation of a tele-education program for neonatal ICU nurses in Armenia. J Pediatr Nurs 2020:S0882-5963(20)30599-6.

Pivač S, Gradišek P, Skela-Savič B. The impact of cardiopulmonary resuscitation (CPR) training on schoolchildren and their CPR knowledge, attitudes toward CPR, and willingness to help others and to perform CPR: mixed methods research design. BMC Public Health 2020;20:1-1. DOI: https://doi.org/10.1186/s12889-020-09072-y

Moon H, Hyun HS. Nursing students' knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: a randomized controlled trial. BMC Med Educ 2019;19:414. DOI: https://doi.org/10.1186/s12909-019-1848-8

Hernández-Padilla J, Suthers F, Fernández-Sola C, et al. Development and psychometric assessment of the basic resuscitation skills self-efficacy scale. Eur J Cardiovasc Nurs 2016;15:e10-8. DOI: https://doi.org/10.1177/1474515114562130

Akhu-Zaheya LM, Gharaibeh MK, Alostaz ZM. Effectiveness of simulation on knowledge acquisition, knowledge retention, and self-efficacy of nursing students in Jordan. Clin Simulat Nurs 2013;9:e335-42. DOI: https://doi.org/10.1016/j.ecns.2012.05.001

Na JU, Lee TR, Kang MJ, et al. Basic life support skill improvement with a newly designed renewal program: cluster randomized study of small-group-discussion method versus practice-while-watching method. Emerg Med J 2014;31:964-9. DOI: https://doi.org/10.1136/emermed-2013-202379

Park JY, Woo CH, Yoo JY. Effects of blended cardiopulmonary resuscitation and defibrillation e-learning on nursing students' self-efficacy, problem solving, and psychomotor skills. Comput Inform Nurs 2016;34:272-80. DOI: https://doi.org/10.1097/CIN.0000000000000227

Chien CY, Fang SY, Tsai LH, et al. Traditional versus blended CPR training program: A randomized controlled non-inferiority study. Sci Rep 2020;10:1-8. DOI: https://doi.org/10.1038/s41598-020-67193-1

Drummond D, Delval P, Abdenouri S, et al. Serious game versus online course for pretraining medical students before a simulation-based mastery learning course on cardiopulmonary resuscitation: A randomised controlled study. Eur J Anaesthesiol 2017;34:836-844. DOI: https://doi.org/10.1097/EJA.0000000000000675

DeFilippis EM, Ranard LS, Berg DD. Cardiopulmonary resuscitation during the COVID-19 pandemic: A view from trainees on the front line. Circulation 2020;141:1833-5. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.047260

Napp A, Kosan J, Hoffend C, et al. Implementation of basic life support training for school children: Online education for potential instructors? Results of a cluster randomised, controlled, non-inferiority trial. Resuscitation 2020;152:141-8. DOI: https://doi.org/10.1016/j.resuscitation.2020.04.041

Nord A, Svensson L, Claesson A, et al. The effect of a national web course “Help-Brain-Heart” as a supplemental learning tool before CPR training: a cluster randomised trial. Scand J Trauma Resusc Emerg Med 2017;25:93. DOI: https://doi.org/10.1186/s13049-017-0439-0

Johnson AL. Exploration of factors affecting the self-efficacy of asynchronous online learners: a mixed methods study. Blacksburg: Virginia Tech; 2017.

Boada I, Rodriguez-Benitez A, Thio-Henestrosa S, et al. How the gender of a victim character in a virtual scenario created to learn CPR protocol affecting student nurses' performance. Comput Methods Programs Biomed 2018;162:233-41. DOI: https://doi.org/10.1016/j.cmpb.2018.05.019

Tobase L, Peres HH, Gianotto-Oliveira R, et al. The effects of an online basic life support course on undergraduate nursing students’ learning. Int J Med Educ 2017;8:309. DOI: https://doi.org/10.5116/ijme.5985.cbce

Twohig CJ, Singer B, Grier G, et al. A systematic literature review and meta-analysis of the effectiveness of extracorporeal-CPR versus conventional-CPR for adult patients in cardiac arrest. J Intensive Care Soc 2019;20:347-57. DOI: https://doi.org/10.1177/1751143719832162

Lau Y, Nyoe RS, Wong SN, et al. Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials. Resuscitation 2018;131:14-23. DOI: https://doi.org/10.1016/j.resuscitation.2018.07.033

Zhou T, Huang S, Cheng J, et al. The distance teaching practice of combined mode of massive open online course micro-video for interns in emergency department during the COVID-19 epidemic period. Telemed J E Health 2020;26:584-8. DOI: https://doi.org/10.1089/tmj.2020.0079

Nori JM, Saghafinia M, Motamedi MK, et al. CPR training for nurses: how often is it necessary? Iranian Red Crescent Med J 2012;14:104.

Nas J, Thannhauser J, Vart P, et al. Rationale and design of the Lowlands Saves Lives trial: a randomised trial to compare CPR quality and long-term attitude towards CPR performance between face-to-face and virtual reality training with the Lifesaver VR app. BMJ Open 2019;9:e033648.