• White, L. (2024). First aid training and CPR skills retention. Canadian Standards Association, Toronto, ON.

Executive Summary

First aid training is a requirement in many workplaces in Canada and internationally. To have personnel with first aid skills readily available in case of a medical emergency, these workplaces should consider the efficacy of staff first aid training.

This report reviews recently published literature on the retention of first aid skills, specifically cardiopulmonary resuscitation (CPR), following initial training and the effectiveness of refresher training. The recommended interval between initial training and recertification is currently two to three years, although research shows a significant decline in CPR skills retention soon after initial training.

A review of about 20 peer-reviewed articles on adult training in resuscitative first aid and basic life support skills that include CPR showed that CPR skills retention begins to decline less than six months after initial training. However, short-interval refresher training involving hands-on practice using a manikin, with or without instructor guidance, or via self-paced smartphone application videos can help retain CPR skills beyond six to 12 months. Simply retesting trainees’ CPR skills can contribute to skills retention.

This review also examined whether shorter, simpler initial training can be as effective as conventional training to learn first aid skills. Further research is needed to identify the most effective type of both initial and refresher training to optimize skills retention.

Based on the evidence presented in this report, a future edition of CSA Z1210-17 First aid training for the workplace – Curriculum and quality management for training agencies should recommend more frequent recertifications as well as refresher training within 6 to 12 months of initial conventional CPR training to enhance skills retention. Further research is required to identify the ideal frequency of refresher training to promote long-term CPR skills retention as well as the optimal type of refresher training to support retention between recertifications.