From classroom to emergency: knowledge acquisition and retention following nurse-led simu-lation-based BLSD education in secondary schools

Abstract

Introduction: Out-of-Hospital Cardiac Arrest (OHCA) remains a major public health challenge in which early Cardiopulmonary Resuscitation (CPR) and automated external defibrillator (AED) use are critical determinants of survival. Despite international recommendations promoting Basic Life Support and Defibrillation (BLSD) education in schools, first-aid training is not systematically implemented in Italian secondary education. This study evaluated the effectiveness of a nurse-led simulation-based BLSD training program in improving theoretical knowledge and medium-term retention among high school students. Materials and Methods: a total of 430 final-year students attended an Italian Resuscitation Council (IRC)-based BLSD course including interactive lectures, realistic simulations, and structured debriefing. Knowledge was assessed using a standardized 20-item questionnaire administered before training (T0), immediately after training (T1), and four months later without prior notice (T2). Results: mean correct responses increased from 42.34% at T0 to 77.02% at T1 (p < 0.001). At follow-up, scores remained significantly higher than baseline (70.44%; p < 0.001), despite a moderate decline compared with immediate post-training results. No gender-related differences emerged. Conclusions: simulation-based BLSD education appears effective in promoting both knowledge acquisition and medium-term retention in adolescents. These findings support the potential value of nurse-led BLSD training programs in secondary schools and suggest that their integration into school curricula may represent an important educational and public health strategy.