Comparing the effect of self-instruction with that of traditional instruction in basic life support courses—A systematic review

AimThe efficacy of learning basic life support (BLS) through self-instruction is not clearly understood. The aim of our review was to compare the effect of self-instruction with that of traditional instruction on learners taking BLS courses.MethodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo and SCI-EXPANDED databases for randomized control trials (RCTs) or randomized cluster-controlled trials published from January 1, 1966 to April 25, 2015 which compared self-instruction with traditional instruction in BLS courses. Characteristics, participants, design and outcomes of included studies were extracted.ResultsThe search yielded 2119 unique articles, of which 19 RCTs and 3 randomized cluster-controlled trials were included. The learners were different across studies, including laypersons, parents and caretakers of children, university or high school students, medical, pharmacy and nursing students, and practicing nurses. Self-instructional material included DVD, videotapes, on-line learning or interactive computer programs accompanied with synchronous or asynchronous hands-on practice. There were no studies comparing clinical outcomes between the different instructional methods. In evaluating skill performance, there was variability among studies in the skill assessment tools utilized and time of assessment. Nevertheless, the most frequent conclusion of these studies was that self-instruction had similar performance compared with traditional courses. Four studies which measured cognitive knowledge outcomes all demonstrated similar outcomes between the two methods.ConclusionAlthough it remains inconclusive about which is superior between the two methods, considering the potential to train many more rescuers and to reduce resource utilization, well-designed self-instruction with hands-on practice may be an alternative to traditional BLS courses.