CPR Certification vs. Competence: Evaluating Teacher Preparedness in Train-the-Trainer Models

Cardiopulmonary resuscitation (CPR) training in schools is a proven strategy to improve survival after out-of-hospital cardiac arrest (OHCA). Many programs use “train-the-trainer” models in which teachers instruct students, but the level of CPR proficiency needed for teachers to teach effectively remains unclear.

In a study that we presented at #AHA25, we surveyed 203 school teachers from a large, predominantly minority urban school district to assess whether active CPR certification correlates with greater knowledge and comfort performing or teaching CPR. Of the respondents, 60% had current certification. Certified teachers reported significantly higher comfort performing and teaching CPR (mean scores 70.4 vs. 61.6 and 65.0 vs. 54.0, respectively; p < 0.05). However, CPR knowledge scores did not differ significantly between actively certified teachers and teachers with inactive CPR certification (67.1% vs. 60.7%; p = 0.236), and correlations between comfort and knowledge were weak (ρ = 0.19-0.21).

These findings suggest that while certification boosts confidence, it does not necessarily improve objective knowledge. Traditional biennial certification may create a false sense of preparedness. Reframing CPR training as a continuous learning process rather than a checkbox certification could more effectively prepare teachers and, by extension, their students to respond confidently and competently in real-life emergencies. Our work continues to focus on how to improve high- quality, lifesaving CPR in schools and in the community.