Abstract
OBJECTIVES: To evaluate the effectiveness of short-duration self-learning (SSL) and mastery learning (ML) strategies on the acquisition and 6-month retention of cardiopulmonary resuscitation (CPR) skills and basic life support (BLS) knowledge among hospital administrative staff in Thailand. DESIGN: Comparative assessment of two CPR training strategies. SETTING: Tertiary-level academic institution in Thailand. PARTICIPANTS: A total of 163 hospital administrative staff aged ≥18 years without prior BLS certification were enrolled and randomly allocated to either the SSL group (n=82) or the ML group (n=81). Participants with previous CPR certification, medical limitations preventing chest compressions or those unwilling to attend the 6-month retention test were excluded. 71 participants in each group completed the 6-month follow-up. INTERVENTIONS: All participants viewed an 8 min self-directed instructional video on BLS and subsequently performed CPR practice using real-time feedback manikins. The SSL group practised independently for up to five 1 min sessions, while the ML group practised until achieving a predefined mastery threshold (QCPR (Quality Cardiopulmonary Resuscitation) score >90%). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was CPR skill retention at 6 months, measured by QCPR overall performance score. Secondary outcomes included observational BLS performance (scene safety, responsiveness, emergency activation, breathing assessment and correct hand placement), knowledge retention scores and the number of attempts required to achieve mastery in the ML group. RESULTS: Both SSL and ML groups demonstrated significant improvement in CPR performance and BLS knowledge immediately after training (p<0.001). At 6 months, no statistically significant differences were found between groups in CPR skill retention (mean difference 0.7%, 95% CI -1.9% to 3.3%, p=0.62) or BLS knowledge retention (mean difference 0.2, 95% CI -0.4 to 0.8, p=0.51). Female participants required more attempts to achieve mastery compared with males (mean 3.0 vs 2.1, p=0.007). CONCLUSIONS: Both SSL and ML effectively enhanced CPR performance and knowledge retention among non-medical hospital staff. SSL offers a practical, resource-efficient and scalable approach for CPR training in large-scale community or institutional settings. Future studies should investigate the cost-effectiveness and optimal refresher frequency for sustaining CPR competency. TRIAL REGISTRATION NUMBER: TCTR20210521003.