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Impact of Online CPR Training on Cardiopulmonary Resuscitation Knowledge among University Students in Nigeria

Abstract

Cardiac arrest is a life-threatening emergency that can occur in hospitals, homes, workplaces, educational institutions, public spaces, and other community settings. Immediate cardiopulmonary resuscitation (CPR) can help maintain circulation and oxygen delivery while professional emergency care is being mobilized. University students represent an important population for CPR education because they may witness emergencies within campuses, residences, transportation settings, workplaces, or communities. However, limited exposure to formal first-aid training, inadequate awareness of CPR procedures, fear of causing harm, and limited access to conventional practical training may contribute to inadequate CPR knowledge. Online CPR training has emerged as an accessible approach to providing emergency-response education through instructional videos, interactive lessons, demonstrations, quizzes, and digital learning platforms. Such training may improve students' understanding of CPR steps and increase preparedness to respond to cardiac emergencies. Against this background, this study investigates the impact of online CPR training on cardiopulmonary resuscitation knowledge among university students in Nigeria. The study will be anchored on Social Cognitive Theory, Technology Acceptance Model, and Protection Motivation Theory. Social Cognitive Theory emphasizes observational learning, self-efficacy, behavioural reinforcement, and the acquisition of skills through demonstration and practice. The Technology Acceptance Model explains how perceived usefulness, perceived ease of use, accessibility, and acceptance of online learning platforms may influence students' participation in digital CPR training. Protection Motivation Theory emphasizes perceived threat, response efficacy, self-efficacy, and perceived response costs in motivating individuals to acquire knowledge and prepare for emergency situations. Collectively, these theoretical perspectives provide a suitable framework for explaining how online CPR training may influence cardiopulmonary resuscitation knowledge among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, levels of study, and eligible participants. Online CPR training will be assessed using indicators such as exposure to online training sessions, duration and frequency of training, access to CPR instructional videos, demonstrations of chest compressions, rescue breathing where applicable, recognition of cardiac arrest, emergency activation procedures, use of automated external defibrillators where applicable, CPR sequence, compression rate and depth, hand positioning, safety considerations, and appropriate emergency-response procedures. CPR knowledge will be assessed using indicators such as recognition of cardiac arrest, assessment of responsiveness and breathing, activation of emergency medical assistance, correct sequence of CPR actions, chest-compression technique, compression rate, compression depth, hand placement, appropriate use of an automated external defibrillator, recognition of the importance of minimizing interruptions, and appropriate response to different emergency scenarios. Data will be collected using structured questionnaires, standardized CPR knowledge assessment instruments, scenario-based questions, online training completion records where accessible and appropriately consented to, and relevant university health or first-aid training records. Descriptive statistics will be used to summarize participants' characteristics, previous first-aid training, sources of CPR information, exposure to online CPR training, and levels of CPR knowledge. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of online CPR training on CPR knowledge. Where a quasi-experimental design is adopted, CPR knowledge scores before and after online training may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that online CPR training has a significant positive impact on cardiopulmonary resuscitation knowledge among university students in Nigeria. Students exposed to structured and evidence-based online CPR training are expected to demonstrate greater knowledge of cardiac-arrest recognition and appropriate CPR procedures than students without comparable training. Online demonstrations may improve students' understanding of chest-compression positioning, sequence, rate, depth, emergency activation, and appropriate use of an automated external defibrillator where available. Interactive quizzes and repeated access to instructional materials may reinforce knowledge and improve retention. Online training may also reduce barriers associated with geographical distance, scheduling, and limited access to conventional classroom-based training. However, online CPR education may have limitations because CPR is a practical skill requiring physical performance and feedback, and factors such as poor internet connectivity, limited access to appropriate learning materials, low digital literacy, lack of practical equipment, and insufficient hands-on practice may limit the extent to which knowledge translates into competent performance. The study therefore expects online CPR training, particularly when combined with practical demonstrations, simulation, or supervised hands-on sessions, to contribute significantly to improved CPR knowledge among university students in Nigeria. The study is expected to contribute to the literature on CPR education, emergency preparedness, first aid, online health education, digital learning, university student health, emergency response, community resuscitation, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, university health centres, emergency medical services, healthcare professionals, first-aid organizations, public health practitioners, student organizations, development partners, and policymakers regarding strategies for expanding CPR education. The study will also provide evidence-based recommendations for integrating online CPR training into university health and safety programmes, strengthening practical CPR and first-aid training, improving access to digital emergency-response education, providing simulation-based learning opportunities, developing standardized online CPR materials, and promoting a culture of emergency preparedness among university students across Nigeria.

Keywords: Online CPR training, cardiopulmonary resuscitation knowledge, CPR education, university students, first aid, emergency preparedness, cardiac arrest, digital health education, emergency response, Nigeria, public health.