Answer to comment about validity of Online and Blended CPR

by Roy Shaw -

closed-caption2Today I responded to a person’s comment regarding the validity of Online and Blended CPR. I felt as though the commenter was being sincere and therefore it deserved a proper reply. After I wrote the reply, I believed it would be of benefit to others as well.

The commenter stated:

As an instructor for over 20 years one of the worst groups to teach CPR (BLS) to are medical persons that have to recertify BLS. They don’t want to be in a class. Online BLS seams like a great option for these individuals. Outlined in the article above are numerous studies showing good retention rates.

Unfortunately, from my personal experience, I have noticed a decrease in hands on skills. While BLS and layperson CPR is about learning numbers and techniques it should primarily be about hands on skills. Unfortunately no online class can substitute for real life hands on.

I have heard the statement ” I have been certified 10 years I know CPR”. Unfortunately looking at the level of performance in real cardiac arrest situations many do not know how to do hands on CPR.

Blended BLS classes seem to be the answer but even then sometimes they have a problem. I have seen people at work open an online class and let the video run while they are on FaceBook or another site on another browser. How is this going to help educate someone to CPR.

To conclude, online may be OK for recertifying persons if it is a blended course but never for first time people. While I applaud all those agencies that are providing methods to make learning less difficult you have to question whether going to online only classes is the answer for BLS. While I may accept it in some cases for recertifying medical professions, in no way should it be allowed for first time learners, medical or otherwise.

My Reply:

Thank you for your thoughtful comment on the validity of online CPR being used as an effective training medium compared to hands on classroom. I thought it would be a good idea to respond and elaborate about your thoughts and feelings regarding this change in the way people are becoming educated today. Like all training, if the material is presented in a way that is not interesting, is too long, does not engage the learner, is complicated, confusing, or boring, then regardless of how the information is presented (ie. classroom, eLearning or blended), I too agree that the training’s effectiveness may be of concern.

However, when we look at the classroom as the only valid means for learning, a couple of different problems are apparent.

(1) Is the student able to concentrate, participate, communicate and integrate the skills that are being taught?

(2) Is the information, which includes many different skills (i.e. proper number sequences, landmarks, bag-valve mask use, AED training, PPE, and proper depth and pace), going to be retained in an extended 2-4 hour course, which far exceeds the average learner’s attention span? (supporting source)

Now consider the fact that the student may work in a field where they do not experience real CPR scenarios often enough and it may be 2 years before they ever hear, practice, or think about CPR and the proper skills required to increase survivability during cardiac arrest. These educational hurdles are constrained within the traditional “bricks and mortar” form of classroom education.

I’d like to break down each of these from my eLearning philosophy and see if any of it makes sense to you.

1. The student may be distracted by many things, such as sitting in the back of the class by other students, the instructor’s mannerisms and story telling, phone messages, emails, FaceBook and Twitter feeds, what they are going to do when they get home, etc. This is especially true if the class follows a long shift or is being held during a time when the student believes she should be somewhere else but is being forced to attend out of a requirement to become certified by a certain date. Then, consider that there are usually multiple students from different medical backgrounds and that some learn quickly and others learn more slowly. We all know that the pace and continuity of a course is dictated by the lowest common denominator in the classroom. This also contributes to some students disengaging and becoming bored and disinterested.(supporting source)

If there are a number of students in a class and the lecture took too long, the time for manikin practice is often cut short. There are time constraints that must be followed. When a student must practice and skill test on an infant, child, and adult, doing CPR compressions, airway management, pulse checks, bag valve mask use, and AED, this can leave just a few minutes per student to actually practice on a manikin. And even if the whole class time could be spent on manikins, one still has to ask, is this adequate for skill mastery and skill retention when it’s the only time the student will practice CPR every two years?

This goes back to the first problem I mentioned. If a class is being slowed by a few first-time CPR students or a student who likes to monopolize the class with “stories,” the last thing any other busy student wants is to slow the class even more by asking questions. This severely hampers the effective learning and engagement of students who have legitimate questions and concerns about the content being presented. This point was highlighted in another article, which stated, “A teacher cannot encourage questions solely by standing at the front of the class and asking, ‘Are there any questions?’ There is so much pressure forcing students NOT to ask questions that it cannot be overcome by this single act.” (supporting source).

Implementing the material learned into mock scenarios takes a good bit of time, but the student must be able to engage in the questions, the comments, and the role playing in order to implement and integrate the CPR training into their personal and professional lives. If the student is hindered to ask questions, limited to time constraints to participate, and doesn’t review the information on a regularly set interval, the information and skills will be weak at the end of the class, more ineffective within 1-2 weeks, and even less effective after 2 months. With regular weekly review, even cognitive review, the student begins to move back-of-mind information to front-of-mind, which may trigger possible scenarios and then reinforce skills obtained. (supporting source).

2. Any content presented in too long of a presentation, including a classroom setting, is not designed correctly in order for absorption and retention of the information presented. This is such a well researched point that I’ll simply include a link to explain the problem more clearly.(

In conclusion, you have to ask, with all the benefits that self paced eLearning has to offer, is online CPR training and certification insufficient for people to learn CPR skills and become a life saving resource or is it merely difficult for traditional trainers to see a paradigm shift occurring? Are instructors truly concerned that students are not learning how to perform CPR correctly and effectively or could they be afraid that they will lose their training business? Is it that people cannot learn how to recognize cardiac arrest or life threatening emergencies and learn how to provide effective CPR until help arrives via eLearning or is it that training organizations simply are afraid they won’t be able to compete in an online world?

I’m not suggesting this is the case for this commenter, but I’m quite sure it may be true of many other eLearning/online opponents.


  1. Clare

    Yes, I am concerned about the student learning good skills. The things you have listed about classroom training are true in any classroom – even your Paramedic classroom. But you still took the course. The bottom line is that in order to do CPR and use an AED adequately, it requires developing a skill. That takes time and practice.

    The same boredom can exist sitting in front of a computer screen. Reducing and reducing and reducing doesn’t make it better. Using a cardboard box and blowing into a bag without a movable mouth or open nostrils is a disservice to the student.

    No, I’m not afraid of losing my training business – I was actually interested in what you had to offer. But, what I see from the videos and testimonials are people without prior knowledge (lay responders) believing that what they have learned is adequate. If this were the case, then why don’t we do this type of teaching for everything?

    1. Paul Martin

      Hello Clare,

      What you’ve probably seen is only a small sampling of our testimonials. We’ve been doing this for 12 years and taught hundreds of thousands of people at every level, not just lay responders or people without prior knowledge. We have thousands of testimonials from professionals like yourself, not to mention approvals of our program that state that what our students learn is adequate.

      Why don’t we do this type of teaching for everything? We are starting to see this type of training more often, in more professions. We haven’t seen it much before the last few years because of the lack of technology at our fingertips. As that continues to change, more training programs like ours will be popping up, and more do every day.

      SUMO, our manikin that we offer, can provide all of the same demonstrations that other similar manikins provide. The head is movable for the head-tilt/chin-lift, and with our skill evaluation, the student is getting the same amount of practice as they would in a classroom. But here’s the difference: our students get to keep their SUMO and practice any time they want, and watch and re-watch our videos any time, at no cost.

      We also offer completely free training for high school students. Check out the program at

      We appreciate your comments, Clare, as it is comments like yours that help us to keep improving.

  2. Lenny

    Hi, thankyou so much for providing online course for CPR. After several researches online I found out that my dad died of difficulty breathing that lead to cardiac arrest. He was having a difficulty breathing until finally went limp, unresponsive with no pulse. If only I learned about CPR back then he might have a better chance to survive. Now realizing how important knowing CPR, I tried to find a training course here in Indonesia, but were disappointed to find that there is very limited CPR training classes available and are very expensive.
    After I found the ProCPR training video from youtube, I found out that learning it online is much better than nothing at all and hopefully more ppl aware of how important it is to learn CPR.

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