With or without an instructor, brief exposure to CPR training produces significant attitude change.

Background: A common reason for bystanders' failure to perform CPR in real or hypothetical situations is their lack of confidence in themselves. CPR self-training, which uses learner-operated virtual media rather than a live instructor, has not been assessed for its ability to influence learners' attitudes toward performing CPR in a real emergency. The aim of this study was to compare attitude effects associated with traditional, live instruction versus self-training or no instruction.

Method: Data from 1069 lay learners were collected. Learners were assigned randomly to a traditional instructor-led course, a video-based self-training course, or a no-training control group. All learners completed pre-training and post-training questionnaires that assessed competence, confidence, and willingness to perform CPR. Learners' objective performance of CPR was also assessed, post-training, via a recording manikin.

Results: ANOVA revealed that, in all 3 groups, all 3 attitudes changed significantly from pre- to post-questionnaire; further, the amount of attitude change did not differ reliably among the 3 groups (P<.05). Of the objective measures, ventilation performance was the only one consistently and positively correlated with attitudes (P<.05). Despite focus group comments that suggested self-trained learners' concerns about the rudimentary nature of their training, these concerns did not manifest as a hindrance to positive attitude change.

Conclusions: Live training does not pose any measurable advantage for developing learners' positive attitudes. The counterintuitive finding that controls experienced similar levels of attitude change suggests that mere exposure to CPR testing can have positive effects on attitudes.