Knowledge and Attitude on Cardiopulmonary Resuscitation Education of Primary and Secondary Schoolteachers in China

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Knowledge and Attitude on Cardiopulmonary Resuscitation Education of Primary and Secondary Schoolteachers in China

Every year, out-of-hospital cardiac arrest (OHCA) threatens thousands of lives—but early bystander cardiopulmonary resuscitation (CPR) can double or triple survival rates. That’s why global health groups like the World Health Organization (WHO) strongly recommend teaching CPR to schoolchildren. For this to work, schoolteachers—who interact with kids daily—are critical: trained teachers can deliver consistent, accessible CPR education. But how prepared are Chinese teachers for this role? A 2019 study from researchers at Zhejiang University set out to find out.

Why Teachers Matter for CPR Education

Bystander CPR saves lives, but only if people know how to act. The WHO and other organizations argue that schools are the best place to teach CPR: kids learn early, retain skills, and can spread knowledge to families. Teachers are ideal instructors—if they have the right training and confidence. A 6-year study even found that teachers who took a 60-minute CPR course could effectively train students. But in China, little was known about teachers’ CPR knowledge or willingness to teach—until this survey.

How the Study Worked

The research team, led by Zhong-Hua Chen and Xiang-Ming Fang from Zhejiang University’s First Affiliated Hospital and Sir Run Run Shaw Hospital, conducted an anonymous online survey via WeChat (China’s most popular social media platform). They collected responses from January 24 to February 8, 2018, targeting primary and secondary schoolteachers. Of 5,556 total responses, 5,324 were valid (2,329 from primary schools, 2,995 from secondary schools).

The survey asked about:

  1. Demographics (age, school type).
  2. CPR awareness and past training.
  3. Attitudes toward attending CPR training or teaching it.
  4. Specific CPR knowledge (e.g., chest compression depth, AED use).

Key Findings: Awareness, Training, and Gaps

Nearly all teachers (96.8%) had heard of CPR—most from TV (70%) or the internet (58.1%), while just 39.1% learned from newspapers. Over half (54%) had previous CPR training, with a clear age trend:

  • Teachers aged 30–39 had the highest training rates (60.7%).
  • Those 50+ had the lowest (36.6%).

This suggests 30–39-year-olds are the most ready to act as CPR instructors—a useful insight for schools planning training.

But knowledge gaps were big:

  • Most knew how to check if someone is conscious (71.9%) or breathing (51.1%).
  • Most could correctly place their hands for chest compressions (77.4%) or use the right hand posture (80.9%).
  • But only 18% knew the correct compression depth (2–2.4 inches for adults), 29% knew the right rate (100–120 compressions per minute), and 28% knew the compression-ventilation ratio (30:2 for adults).
  • Few (16.2%) knew how to use an automated external defibrillator (AED), and just 12.7% could name where AEDs are located in their neighborhood.

Teachers Want to Learn and Teach

The most promising result? Chinese teachers are highly motivated to engage with CPR education:

  • 96.4% said they’d like to attend CPR training.
  • 93.1% supported adding CPR to school curricula.
  • 91.8% were willing to teach CPR to students.

This is far higher than in other countries: in Barcelona, 69% of secondary teachers were willing to teach CPR; in Denmark, teachers hesitated unless they had prior training. For China, this means school-based CPR programs could succeed—if supported by policies, clear curricula, and equipment (like manikins or AED trainers).

Comparing to Global Trends

International studies back up the importance of teacher training:

  • A 2013 Belgian survey found Flemish primary teachers had high interest in teaching CPR.
  • A 2016 Barcelona study found 83% of teachers saw schools as the best place for CPR training.

But Chinese teachers’ willingness stands out—they’re ready to teach, even with some knowledge gaps. The key next step? Filling those gaps with structured, hands-on training.

What This Means for China

Chinese primary and secondary schoolteachers have a basic understanding of CPR but need more precise, evidence-based knowledge. Over half have some training, and nearly all want to learn more or teach. For schools, this is a golden opportunity: with the right support (policies, curricula, equipment), teachers could turn every classroom into a place where kids learn life-saving skills.

doi.org/10.1097/CM9.0000000000000236

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