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Table of Contents
Year : 2022  |  Volume : 11  |  Issue : 4  |  Page : 276-278

Preparing teacher to be a lifesaver: A preexperimental study

1 Modern University College, West Bank, Palestine
2 Department of Community Health Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
3 Department of Nursing, Faculty of Health Profession, Al-Quds University, Abu Dis, Jerusalem, Palestine

Date of Submission04-Aug-2022
Date of Decision14-Nov-2022
Date of Acceptance29-Nov-2022
Date of Web Publication18-Jan-2023

Correspondence Address:
Nawaf Amro
Modern University College, West Bank
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/nms.nms_56_22

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Background: Injuries and accidents are essential issues in public health, where the school teachers are considered the first caregivers in schools. Objective: The purpose of this study was to assess the effectiveness of an educational program on first aid (FA) knowledge, cardiopulmonary resuscitation (CPR) skills, and teacher self-confidence among school teachers. Methods: One-group pretest–posttest preexperimental design was conducted. Three schools were enrolled using simple random sampling, and 40 teachers were participated. The Wilcoxon signed-ranks test was performed to compare the pre- and posttests' mean scores. Results: The mean posttest scores of FA knowledge, CPR skills, and self-confidence were significantly higher than the mean pretest scores (P < 0.01). Conclusion: The educational program was effective in improving FA knowledge, CPR skills, and teachers' self-confidence.

Keywords: Effectiveness, First aid, Resuscitation, Self-confidence, Teachers

How to cite this article:
Amro N, Kamel AM, Khatib S. Preparing teacher to be a lifesaver: A preexperimental study. Nurs Midwifery Stud 2022;11:276-8

How to cite this URL:
Amro N, Kamel AM, Khatib S. Preparing teacher to be a lifesaver: A preexperimental study. Nurs Midwifery Stud [serial online] 2022 [cited 2023 Jan 28];11:276-8. Available from: https://www.nmsjournal.com/text.asp?2022/11/4/276/368012

  Introduction Top

Injuries and sudden illnesses are essential issues in public health.[1] These injuries are initially treated by nonhealth-care providers due to the absence of health-care providers at the scene.[2] The International Federation of Red Cross defined first aid (FA) as the immediate assistance provided to a sick or injured person by the first responder/provider until the professional help arrives.[3]

Injuries may occur at school. Students are vulnerable to unintentional playground injuries and fall in their schools. In school, children in armed conflict areas are affected by violence, abuse, gas bombs, gunshots, and exploitation. The World Health Organization (WHO) reported that in Palestine, children are at risk to get harmed, injured, and die in their school life. Some Palestinian students are also have to walk through up to four military checkpoints just to reach their schools.[4]

A previous study recommended that teachers should have the knowledge, self-confidence, willingness, and skills to deal appropriately with health emergencies when a victim needs such critical and timely care.[5] Consequently, training in FA and cardiopulmonary resuscitation (CPR) can be useful to decrease morbidity and mortality of children and increase survival rates, improve the prognosis of acute illnesses, and assist in symptom resolution.[6]


The purpose of this study was to examine the effectiveness of an education program on FA and CPR among school teachers in Hebron City, Palestine.

  Methods Top

Study design

A one-group pretest–posttest preexperimental design was used. Teachers employed in governmental schools in Hebron, Palestine, were enrolled. The sample size was 27 subjects as calculated according to Cohen's formula. Additional 13 subjects were included to have an adequate sample size in case of subject attrition. Three schools were selected to achieve the required sample size. Then, 40 teachers were randomly recruited from the selected schools.

Data collection instruments

The 38-item, self-administered School Staff FA Knowledge Test (SSFAKT) was used to assess the teachers' FA knowledge.[7] The SSFAKT items are rated as “yes,” “no,” and “I don't know.” Each item is scored 1 for a correct answer and 0 for a wrong or “I don't know” answers. The total score is 38. The Cronbach's alpha reliability of the SSFAKT was 0.79. The original version of the CPR checklist from the American Heart Association was used to measure the CPR skills.[8] A horizontal line visual analog scale (VAS) was used to measure the subjects' confidence in FA and CPR. The VAS has the following descriptors at the edges: “0” for “not confident” and “10” for “totally confident.”[9] The study instruments were piloted on 10 teachers before the main study. Completion of the SSFAKT and VAS scales generally took 20 minutes, and the CPR observation checklist took 15 minutes.


The training program was designed to cover two main areas: knowledge of general FA and CPR skills. The sequence of the educational program was as follows: on the 1st day, teachers' CPR skills were pretested before the general FA knowledge because some questions in the SSFAKT can be used by teachers during CPR skills procedures. On the 2nd day, teachers received FA knowledge through lectures and group discussions. In addition, CPR skills were demonstrated on a SimMan manikin. On the 3rd day, the CPR skills and FA knowledge were posttested, respectively.

Ethical considerations

Ethical approval was obtained from the Ethics Committee, IRB number (2019-2018/365/03). In addition, official letters were sent to the Directorate of Education/South Hebron and to the principals of each school to have their permission to conduct the study. The informed consent form was distributed on the first day of each subject.

Data analysis

Data were analyzed using SPSS version 26 (Armonk, NY: IBM Corp). Descriptive statistics were calculated, and the Wilcoxon signed-rank test was used to compare the differences between the pretest and posttest mean scores.

  Results Top

The mean subjects' age and work experience were 38.9 ± 10.3 and 11.7 ± 9.7 years, respectively. Of the 40 teachers, 29 (72.5%) were female, the vast majority (85%) held bachelor's degree, and in scientific specialties 75%.

Of 40 teachers, 75% reported that they were ready to provide FA and CPR procedures, but the majority of them (97.5%) declared that they had inadequate FA-related information. In addition, 30 (75%) teachers reported that they faced situations that required FA in the school context. The source for obtaining FA and CPR knowledge was mainly the Internet 16 (40%).

The mean scores for FA knowledge and CPR skills were higher in the posttests than in the pretests (P < 0.01) [Table 1]. The subject's self-confidence mean score to provide FA and CPR was significantly higher in the posttest than in the pretest (P ≤ 0.01) [Table 2].
Table 1: The Wilcoxon signed-ranks test of pre-and posttests of the first aid knowledge and cardiopulmonary resuscitation skills

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Table 2: Effects of an educational program on the school teachers' self-confidence

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  Discussion Top

In the present study, subjects showed readiness to provide FA in the schools' environment, because they frequently faced different incidents that required an immediate intervention for their students whether inside or outside the school boundaries. However, they admitted that they are not adequately prepared to provide such critical interventions. Several studies have shown that teachers frequently face numerous injuries in the school environment and that they have insufficient information and inadequate preparation regarding FA.[10]

It was found that the posttest FA knowledge was higher than the pretest. This means that the educational program has met its intended aims of improving teachers' FA knowledge, including how to deal with bleeding, fractures, burns, and procedures. These results are in harmony with previous studies.[10],[11] The improvement in FA knowledge was attributed to several reasons: First, teachers felt responsible for dealing with injuries and illnesses specifically in the school context and generally in public areas. Second, teachers believed that they could improve prognosis through early intervention.

CPR skills were enhanced after the educational program. The effective acquisition of CPR skills in this study could be attributed to the performance of CPR through face-to-face demonstration, group learning, the research team, and the continuous immediate feedback given to the subjects for each step of the procedure. These findings were in harmony with the findings of previous studies.[11],[12]

It was found that teachers' self-confidence in performing FA and CPR was greater in the posttest than in the pretest. These findings are in line with previous studies.[12],[13] The reason for the increase in subjects' self-confidence could be referred to as positive changes in subjects' behavior and self-awareness after education.

  Conclusion Top

The intervention improved teachers' FA knowledge, CPR skills, and self-confidence in performing FA and CPR. The researchers recommend urgent courses in FA and CPR in different settings to improve teachers' FA knowledge, CPR skills, and self-confidence to save students' lives.


The authors would like to thank the school teachers who took part in this study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Alharbi MM, Horaib YF, Almutairi OM, Alsuaidan BH, Alghoraibi MS, Alhadeedi FH, et al. Exploring the extent of knowledge of CPR skills among school teachers in Riyadh, KSA. J Taibah Univ Med Sci 2016;11:497-501.  Back to cited text no. 1
Mobarak AS, Afifi RM, Qulali A. First aid knowledge and attitude of secondary school students in Saudi Arabia. Health 2015;7:1366.  Back to cited text no. 2
IFRC. International First Aid and Resuscitation Guidelines 2016. Geneva: IFRC; 2016. p. 15.  Back to cited text no. 3
World Health Organization. Emergency Trauma Response to the Gaza Mass Demonstrations 2018-2019 - “A One-Year Review of Trauma Data and the Humanitarian Consequences”. 2019. Available from: https://reliefweb.int/report/occupied-palestinian-territory/emergency-trauma-response-gaza-mass-demonstrations-2018-2019.  Back to cited text no. 4
Singletary EM, Charlton NP, Epstein JL, Ferguson JD, Jensen JL, MacPherson AI, et al. Part 15: First aid: 2015 American Heart Association and American red cross guidelines update for first aid. Circulation 2015;132:S574-89.  Back to cited text no. 5
Adib-Hajbaghery M, Kamrava Z. Iranian teachers' knowledge about first aid in the school environment. Chin J Traumatol 2019;22:240-5.  Back to cited text no. 6
Alexandropoulou M. Development and testing of the school staff first aid knowledge test (SSFAKT). Int J Caring Sci 2013;6:446.  Back to cited text no. 7
AHA. Heartsaver® Child CPR and AED Skills Testing Checklist; 2016. Available from: https://www.cprconsultants.com/wp-content/uploads/2016/10/Child-CPR-Checklist-2016.pdf.  Back to cited text no. 8
Zonta JB, Eduardo AH, Okido AC. Self-confidence for the initial management of health issues in schools: Construction and validation of a visual analogue scale. Esc Anna Nery 2018;22:e2018010.  Back to cited text no. 9
Masih S, Sharma RK, Kumar A. Knowledge and practice of primary school teachers about first aid management of selected minor injuries among children. Int J Med Public Health 2014;4:458-62.  Back to cited text no. 10
  [Full text]  
Arli SK, Yildirim Z. The effects of basic first aid education on teachers' knowledge level: A pilot study. Int J Caring Sci 2017;10:813-8.  Back to cited text no. 11
Lee J, Oh WO. Effects of a first aid coaching program on first aid knowledge, confidence, and performance of child care teachers. Child Health Nurs Res 2018;24:310-8.  Back to cited text no. 12
Hirose T, Iwami T, Ogura H, Matsumoto H, Sakai T, Yamamoto K, et al. Effectiveness of a simplified cardiopulmonary resuscitation training program for the non-medical staff of a university hospital. Scand J Trauma Resusc Emerg Med 2014;22:31.  Back to cited text no. 13


  [Table 1], [Table 2]


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