First aid education guidelines
The education section includes a selection of contexts for first aid education and an overview of modalities to deliver first aid education.
Education strategy essentials
Chain of survival behaviours
Central to the resilience of individuals and communities is the ability to respond effectively in a crisis. The Movement views first aid as one of the greatest humanitarian acts and first aid education as an integral part of building resilience. As such, it is the duty of the Movement to advocate for and provide effective first aid education that is accessible to everyone and engages learners to ultimately respond to an emergency appropriately.
The Chain of survival behaviours defines the broad domains of first aid education. Consider each first aid topic alongside the domains to decide where the emphasis and opportunity lie for that particular topic for your learners. For example, some topics, such as stroke, usually focus on recognition, while others such as bleeding, usually emphasise the first aid skills. The Chain of survival behaviours also gives a structure to the way we communicate education messages. For example, we can use media to prepare people for different emergencies. We can use visual aids to help people to recognise different conditions, scenarios and role play to practise first aid. We can use technology to alert people to imminent danger, or to signpost them access support.
The five domains
- The first domain emphasises the role of prevention and preparedness in reducing the impact of emergencies.
- The second domain emphasises early recognition of dangers environmentally and with the ill or injured person.
- The third domain of response has two actions that can take place at the same time, providing first aid and accessing help, depending on the number of first aid providers and resources.
- Last in the sequence is the domain of recovery that can be done with or without medical care.
Educational activities to develop these survival behaviours include awareness campaigns, training and certification, and just-in-time tools for disasters and crises. The 2020 Guidelines aim to empower and guide first aid education providers to be creative and flexible with their approach. Learners must be at the centre of all educational activities and be empowered to act. The aim of doing so is to fulfil the crucial aspects of educational effectiveness and local implementation.
Principles of first aid education
The principles of first aid education support programme designers in developing programs that match the needs of their learners. These principles should be applied to any first aid education intervention:
- Link to learners: Consider all aspects of the learner group (age, gender, responsibilities, needs etc). Adapt your approach so it is relevant and based on contexts they recognise. Ensure that suitable safeguarding precautions are in place.
- Variety: Use a variety of activities to engage the learner, develop their skills and construct their knowledge.
- Simplicity: Restrict content to what is necessary and keep learning messages simple: learners should not be overloaded with content, topics or techniques that they are unlikely to come across or would not be able to use.
- Discovery: Allow time for learners to explore and reflect on what they have learned in order to develop their attitude and confidence to help.
- Clarity: Use language that the learners understand and that builds confidence. Avoid scientific language or overly complex theories.
- Outcome-driven: Identify learner outcomes (such as knowledge and confidence) and measure how these change between the start and end of your education intervention.
Theories relating to emergency response behaviour
An individual’s response to an emergency will vary by demographic characteristics, culture, previous attitude towards an emergency, and exposure to other variables (e.g. media). First aid education must take these components into consideration to be relevant for short and long-term behaviour change. This theory is set out in Fishbein and Yzer’s Integrative Model of Behaviour Prediction.
Embedded in this theory are the Theory of Reasoned Action and the Theory of Planned Behaviour. Together these theories identify attitude, subjective norms, and perceived control to affect behaviour. They suggest that education will be most effective if the learner’s intention is known. By understanding learners’ motivation to help and incorporating messages which build on their understanding of their role and how they can make a difference, a learner’s self-confidence in their ability (and therefore likelihood) to help can be increased (Ajzen & Madden, 1986; Ajzen, 2011; Fishbein & Yzer, 2003, Miller & Pellegrino, 2018).
Organising first aid education in stages to support behaviour change also reflects the transtheoretical model of behaviour change. This theory suggests that it is beneficial for the educator to explore the needs and preferences of the learners before designing the learning approach in order to help inform obtainable goals. This also allows the learning design to take into account issues such as cost, literacy levels, technology access, and job requirements (Prochaska & DiClemente, 1983).
Outcomes measurement
Measuring the effectiveness of first aid education is essential to understanding how to make it better. While many education providers collect data about how many people they teach, it is knowing how well people learn that is much more valuable. This information can help secure funding to reach new audiences, be used to influence national policies on who should learn, and most importantly, will improve education so that learners are better able to save lives.
The core aim of education outcome measurement is to enable programme designers to understand the change made through the first aid education provided. By identifying which outcomes programmes are most likely to affect, and measuring how learners change, that data can be used as an indication of how effective the education programme is. The Outcomes measurement toolkit is a good place to start to consider how to measure education outcomes.
Feedback and reflection
Preparedness for a real-time response can be supported through educational practices which involve reflection and feedback. This process starts with the programme designer reflecting on who learners are and what they need to know and extends through the learning to exercises which give feedback to help the learner improve. Collaboration between learners and educators can make education both authentic and meaningful, both of which support deeper understanding and retention (Hattie, 2012; Foran et al., 2019). See also Feedback devices or Refresh and Retrain.
Disability
In its idealised form, a first aid skill should be universally acceptable. However, there may be situations in which you must adapt the skill to specific physical needs of the learners. The key is to focus on the desired outcome of the technique (e.g., we perform chest compressions and rescue breaths to pump blood and oxygen around the body) and work with learners to develop an approach that works for them and meets these desired outcomes. The ideal technique should allow the first aid provider to perform the principles of the method safely and effectively, be safe for the ill or injured person and be quick to start.
References
Ajzen, I. (2011). The theory of planned behaviour: Reactions and reflections. Retrieved from: https://www.tandfonline.com/doi/pdf/10.1080/08870446.2011.613995
Ajzen, I., and Madden, T. (1986). Prediction of goal directed behaviour: Attitudes, intentions and perceived behavioural control.
Darley, J. M., and Latané, B. (1968). Bystander intervention in emergencies: diffusion of responsibility. Journal of personality and social psychology, 8(4p1), 377.
http://www.communicationcache.com/uploads/1/0/8/8/10887248/bystander_intervention_in_emergencies_diffusion_of_responsibility.pdf
Fishbein, M., and Yzer, M. C. (2003). Using theory to design effective health behavior interventions. Communication theory, 13(2), 164-183.
Foran, A., Young, D., Kraglund-Gauthier, W. L., Hubley, D., Doyle, B., Doucette, J., …Redmond, P. (2018). The 7 Rights: an active reflection tool to develop risk awareness for outdoor first aid education. International Journal of First Aid Education, 2(1) 5. DOI: 10.21038/ijfa.2018.0013. Retrieved from: https://oaks.kent.edu/ijfae/vol2/iss1/7-rights-active-reflection-tool-develop-risk-awareness-outdoor-firstaid-education
Hattie, J. (2012). Visible learning for teachers: Maximizing impact on learning. Routledge. Retrieved from: https://hozir.org/pars_docs/refs/26/25322/25322.pdf
Levine, M., Prosser, A., Evans, D., Reicher, S. (2005). Identity and emergency intervention: How social group membership and inclusiveness of group boundaries shape helping behavior. Personality and social psychology bulletin, 31(4), 443-453.
https://www.almendron.com/tribuna/wp-content/uploads/2016/12/Identity-and-Emergency-Intervention.pdf
Levine, M. and Crowther, S. (2008). The responsive bystander: How social group membership and group size can encourage as well as inhibit bystander intervention. Journal of personality and social psychology, 95 (6), 1429. Retrieved from:
https://www.researchgate.net/profile/Simon_Crowther/publication/23489266_The_Responsive_Bystander_How_Social_Group_Membership_and_Group_Size_Can_Encourage_as_Well_as_Inhibit_Bystander_Intervention/links/02e7e52d9398a1987e000000/The-Responsive-Bystander-How-Social-Group-Membership-and-Group-Size-Can-Encourage-as-Well-as-Inhibit-Bystander-Intervention.pdf
Miller, B., and Pellegrino, J. L. (2018). Measuring intent to aid of lay responders: survey development and validation. Health Education & Behavior, 45(5), 730-740.
https://www.researchgate.net/profile/Jeffrey_Pellegrino/publication/322024878_Measuring_Intent_to_Aid_of_Lay_Responders_Survey_Development_and_Validation/links/5e1226b4299bf10bc3927d41/Measuring-Intent-to-Aid-of-Lay-Responders-Survey-Development-and-Validation.pdf
Moncur, L., Ainsborough, N., Ghose, R., Kendal, S. P., Salvatori, M., & Wright, J. (2016). Does the level of socioeconomic deprivation at the location of cardiac arrest in an English region influence the likelihood of receiving bystander-initiated cardiopulmonary resuscitation? Emergency Medicine Journal, 33(2), 105-108. Retrieved from: https://emj.bmj.com/content/33/2/105.short
Prochaska, J. O., and DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of consulting and clinical psychology, 51(3), 390. Retrieved from:
https://www.researchgate.net/profile/Carlo_Diclemente/publication/16334721_Stages_and_Processes_of_Self-Change_of_Smoking_-_Toward_An_Integrative_Model_of_Change/links/0deec51ba01390a356000000.pdf
Hot topics
Blended learning
Use blended learning to increase the flexibility of first aid learning.
Pandemic context
Protect first aid learners and facilitators with protective practices such as wearing personal protective equipment and hand washing.
Media learning
Use media to raise awareness, change attitudes and beliefs, and motivate people to learn or recall basic first aid knowledge and skills.
Explore the guidelines
First aid
Explore the first aid recommendations for more than 50 common illnesses and injuries. You’ll also find techniques for first aid providers and educators on topics such as assessing the scene and good hand hygiene.
First aid education
Choose from a selection of some common first aid education contexts and modalities. There are also some education strategy essentials to provide the theory behind our education approach.
About the guidelines
Here you can find out about the process for developing these Guidelines, and access some tools to help you implement them locally.
