Online learning refers to self-directed or facilitator-led interactive learning tools accessed on digital devices, such as tablets, phones or computers. Approaches include digital education programmes, mobile apps, online games and multimedia. Online learning is suitable for a variety of audiences because of its accessibility and flexibility.
Guidelines
- Online learning is a beneficial tool and could be as effective as face-to-face learning for adult audiences. *
- Online learning may improve learners’ knowledge of asthma treatment, burns treatment and CPR techniques, but may not lead to an improvement in skills. *
- Given the increased use of social media and smartphones, as well as technological expertise, online learning may be a cost-effective method to spread public information campaigns to a broad audience. *
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NOTE
While the evidence available is specific to the treatment of an asthma attack or burns as well as CPR techniques, it is likely the guideline above also applies to other first aid topics, but evidence is not yet available.
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Chain of survival behaviours
Online learning has been shown to increase knowledge (Burgess et al., 2015; Luckie et al., 2018). While there is no conclusive evidence whether this method improves the performance or retention of first aid skills, knowledge is critical in building confidence and a willingness to act. Therefore, this method can be used in the domains of prevent and prepare, early recognition and access help.
Online learning may contribute to improving learners’ skills when combined with other facilitation methods, such as physical practise.
Education considerations
Context considerations
- Online learning is most effective when the appropriate technical resources are available. This factor may present a barrier in areas without these resources or when regulation exists for limiting access as learners may be unable to access the information. Consider how learners will access online learning, including the availability for offline access (e.g., through an app).
- Online learning can make learning more accessible to people who cannot attend a course and can be used to reach large numbers of learners.
- The cost of online learning and the equipment needed to complete it may create issues of discrimination and exclusion.
- The content communicated in online learning will need to be adapted to the local context, just like any other form of education.
- The evidence supporting the effectiveness of online learning may be used to support advocacy campaigns for extending first aid learning to more people.
Learner considerations
- Learners’ age, as well as cultural and socioeconomic backgrounds, may influence their confidence and ability to complete online learning. Many learner groups, particularly younger generations, are more familiar and comfortable with online learning.
- Adequate safeguarding measures should always be implemented, especially for more vulnerable learners. Consider how you will maintain a safe online learning environment.
- Online learning may be used by a variety of learner audiences such as military service personnel, workplace staff, youth, parents and caregivers.
Facilitation tips and tools
- Use online learning to support other approaches (such as face-to-face facilitation) to improve learners’ knowledge and skills. See Blended learning. Note that while there is evidence that online learning can improve learners’ knowledge, there is not enough evidence to suggest it can be used as a standalone tool for developing skills.
- Encourage learners to return to the online content and use it as a reference tool. This effort may help them to retain knowledge for a longer period of time.
- Online learning can improve first aid knowledge through a variety of delivery methods such as mobile apps, Gamification, and multimedia (e.g., 3D videos, augmented or virtual reality).
- Online learning can have social benefits if learners can interact and collaborate.
Scientific foundation
A literature review identified seven relevant papers that looked into whether online learning impacts the learner or the person in need of care. The papers referenced learners who were parents, employees completing first aid education, and students.
Burgess et al. (2015) used a randomised control trial to evaluate Cool Runnings, an app designed to increase parents’ knowledge of burn risks to children (specifically burns caused by hot drinks) and the correct first aid treatment. Through a single-blind randomised control trial, 121 participants used the app and demonstrated a statistically significant increase in burn knowledge compared to the control group with 123 participants (p<.001).
Conversely, Krogh et al. (2015) used a randomised non-inferiority study to assess the impact of a 17-minute Paediatric Basic Life Support online course, compared to a facilitator-led course. The intervention group had 67 participants, while the control group had 71. Online learning was non-inferior to the facilitator-led course (difference in pass rate −4%; 95% CI −9:0.5). Pass rates were 100 per cent among those who took the facilitator-led course and 96 per cent among those who completed the online learning.
A randomised control trial by Luckie et al. (2018) assessed the impact of a 60-minute online asthma management program. They compared asthma treatment knowledge and skills in 78 university students before and after completing the training. Asthma first aid knowledge scores improved significantly after the online asthma training. The median increased from 64 per cent pre-learning to 79 per cent post-learning, and the mean skills score increased from 55 per cent to 79 per cent pre- to post-learning. However, three weeks after the learning, participants were required to explain to evaluators how they would act in an asthma attack scenario and only 29 per cent of participants demonstrated a level of competency sufficient to save the life of a child experiencing a severe asthma attack. This evidence suggests that online sessions increased knowledge but did not translate into application in a scenario setting.
Mancini et al. (2009) conducted a randomised control trial to assess the difference between learning CPR with a facilitator compared to a self-directed learning kit (consisting of a DVD and manikin pack) using test scenarios, theory and practice. The results showed that online learning was non-inferior to the facilitator-led learning (difference −4; 95% CI−9:0.5). However, the self-directed intervention group scored lower when performing effective compressions and safely using a defibrillator, which could compromise the outcome for the ill or injured person.
The evidence is unclear what type of online learning is best suited to specific audiences or the critical elements to include to make an online learning programme effective. We recommend testing different online programmes with specific audiences to determine which is most suitable.
References
Burgess, J., Watt, K., Kimble, RM., & Cameron, C. M. (2018). Combining technology and research to prevent scale injuries (the Cool Runnings intervention): Randomised controlled trial. Journal of Medical Internet Research, 10(20), e10361. doi.org/10.2196/10361
https://www.jmir.org/2018/10/e10361/
Luckie, K., Bandana, S., Galstaun, V., Kritkos, V., Collins, J. C., & Moles, J. R. (2018). The effectiveness of an online training programme to prepare teachers to provide first aid. Journal of Paediatrics and Child Health,54(12), 1348−1352. doi.org/10.1111/jpc.14080
https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.14080
Mancini, M. E., Cazzell, M., Kardong-Edgren, S., Cason, C. L., Berryman, P., & Lukes, E. (2009). Improving workplace safety training using a self-directed CPR-AED learning program. AAOHN Journal, 57(4), 159-169.
https://journals.sagepub.com/doi/pdf/10.1177/216507990905700406
Nishiyama, C., Shimamoto, T., Kiyohara, K., Kawamura, T., Kitamura, T., Sakamoto, T., & Iwani, T. (2017). Effectiveness of a one-minute self-retraining for chest compression-only cardiopulmonary resuscitation: Randomized controlled trial. AEM Education and Training, 1(3), 200−207. doi.org/10.1002/aet2.10034
https://onlinelibrary.wiley.com/doi/pdf/10.1002/aet2.10034
Planchon, J., Vacher, A., Comblet, J., Rabatel, E., Darses, F., Mignon, A., & Pasquier, P. (2018). Serious game training improves performance in combat life-saving interventions. Injury, 49, 86−92.
https://doi.org/10.1016/j.injury.2017.10.025
Krogh, L. Q., Bjornshave, K., Due Vestergaard, L. D., Sharma, M. B., Rasmussen, S. E., Nielson, H. V., Thim, T., & Lofgren, B. (2015). E-learning in paediatric basic life support: A randomised controlled non-inferiority study. Resuscitation, 90, 7−12. doi.org/10.1016/j.resuscitation.2015.01.030
https://www.sciencedirect.com/science/article/abs/pii/S0300957215000489
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Published: 15 February 2021
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