Cardiac Arrest, Out-Of-HospitalNCT05908500
Gathering Evidence on Best Practices for Lay Rescuer CPR Training
A study testing CPR Training and CPR Manikin Type in people with Cardiac Arrest, Out-Of-Hospital, run by University of Nevada, Reno at 1 site in United States.
Trial summary
The goal of this prospective trial is to compare CPR skill and attitudes in lay rescuers. The main question[s] it aims to answer are: What is the optimal training timing, duration, and frequency for lay rescuers that leads to CPR skill retention? What is the impact of CPR manikin type (high-fidelity, inflatable… Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Cardiac Arrest, Out-Of-Hospital
- What is being tested?
- CPR Training and CPR Manikin Type
- Type of treatment
- Medical device, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2,100 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Apr 2026to 31 Mar 2031
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- All students at participating schools
Who cannot join
- Previous CPR training (will be included in the CPR training but excluded from analysis)
- Physical injury which prevents performing CPR
- Student or parent opt-out
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
University of Nevada Reno
Reno, Nevada, 89557
Lorrel Toft, 4103028456, ltoft@unr.edu
Lorrel Toft, MD
About this study
Official title: Generating Evidence to Optimize Lay Rescuer Cardiopulmonary Resuscitation (CPR) Training: a Longitudinal Study of Frequency, Modality, and Design Features Impacting Skill Retention
The goal of this prospective trial is to compare CPR skill and attitudes in lay rescuers. The main question[s] it aims to answer are:
- What is the optimal training timing, duration, and frequency for lay rescuers that leads to CPR skill retention?
- What is the impact of CPR manikin type (high-fidelity, inflatable, nontraditional objects) on skill retention?
- How do specific features of training modality -- such as contextualization, gamification, and emotional engagement -- impact skill proficiency, knowledge retention, and attitudes about CPR?
Read more
Participants will
- Answer pre-training questionnaires
- Participate in CPR training
- Participate in CPR skills testing
- Answer post-training questionnaires
Researchers will compare different methods of training, different frequencies of training, and different manikin types.
Read the detailed description
Out-of-hospital cardiac arrest (OHCA) remains a major public health crisis in the United States, with over 350,000 cases annually and low survival rates. Lay rescuer cardiopulmonary resuscitation (CPR) can double survival, yet widespread gaps in training access, skill retention, and emotional readiness persist. While most U.S. states mandate high school CPR training, implementation quality varies, and traditional formats have remained unchanged for over 60 years. These methods are often time-consuming, expensive, and poorly suited for adolescents, leading to low participation and rapid skill decay.
This study addresses these critical gaps by comparing various CPR training methods and procedures. The project tests the effectiveness of different training frequencies, durations, and delivery modes-including traditional instructor-led sessions, brief refreshers, and a novel, emotionally immersive serious game. The serious game leverages gamification, competition, and scenario-based learning to build "emotional muscle memory" and prepare students for real-world emergencies.
Participants are enrolled from two high schools-one rural, one suburban-and randomized by class or individual into training arms with varied schedules and compression practice tools. These tools range from high-fidelity manikins to low-fidelity devices and improvised household objects. Outcomes include CPR performance metrics (compression rate, depth, recoil, and hand placement), knowledge retention, emotional engagement (measured via validated psychometric scales), and confidence in responding to cardiac arrest.
Training sessions are delivered during the academic year, and students are assessed immediately after training and again at annual follow-up points. Data are collected in a de-identified format using school-issued ID numbers, ensuring participant confidentiality. Analysis will use generalized estimating equations and mixed-effects models to assess the impact of training method and frequency on skill retention and psychosocial readiness. The study also explores the role of contextualization, emotional engagement, and gamification as mediators of improved CPR performance.
Ultimately, this multi-year trial aims to identify scalable, cost-effective strategies that optimize CPR training outcomes for lay rescuers. By improving technical skill retention and emotional preparedness, the study addresses key priorities for public health impact and aligns with NHLBI's strategic goals to reduce mortality from sudden cardiac arrest.
- Conditions
- Cardiac Arrest, Out-Of-Hospital
- Being tested
- CPR Training, CPR Manikin Type
- Keywords
- Cardiopulmonary Resuscitation, cardiopulmonary resuscitation training, Lay Rescuer cardiopulmonary resuscitation, lay rescuer cardiopulmonary resuscitation training
- Medical subject headings
- Out-of-Hospital Cardiac Arrest
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CPR TrainingBehavioural
Various durations and frequencies of CPR training
CPR Manikin TypeDevice
Various types of CPR manikins are compared
| Study group | Role | What they receive |
|---|---|---|
| Every 2 year standard CPR training | Active comparator | Receives two 60-minute instructor-led CPR trainings: once in 9th grade and again in 11th grade Receives: Behavioral: CPR Training |
| Annual Standard CPR training | Active comparator | Receives a 60-minute instructor-led CPR training each year for three years. Receives: Behavioral: CPR Training |
| High-Frequency, Blended Training | Active comparator | Starts with a 30-minute serious game-based session, followed by 10-minute refreshers every semester for four years (8 total sessions). Receives: Behavioral: CPR Training |
| Annual Serious Game Training | Active comparator | Receives a 30-minute serious game-based training session once per year for three years. Receives: Behavioral: CPR Training |
| Control | No intervention | No CPR training |
| Standard High-fidelity Manikin | Active comparator | Uses a commercially available torso manikin with realistic chest mechanics and feedback. Serves as the gold standard comparator for CPR training. Receives: Device: CPR Manikin Type |
| Low-Fidelity Manikin | Active comparator | Uses a basic inflatable torso manikin with minimal feedback or resistance. Represents a low-cost, commonly used alternative in schools and communities. Receives: Device: CPR Manikin Type |
| No-Head Manikin (Prototype) | Active comparator | Uses a custom-built spring-based device with a silicone topper and realistic force-displacement properties that closely mimic the human chest. Tests whether an affordable, biomechanically accurate prototype can improve compression quality. Receives: Device: CPR Manikin Type |
| Non-Traditional Object | Active comparator | Uses improvised materials (e.g., toilet paper rolls) to simulate chest compressions. Evaluates the feasibility and effectiveness of ultra-low-cost CPR practice tools Receives: Device: CPR Manikin Type |
What is being measured
The primary outcome is the main question the study is designed to answer.
CPR Skill Retention
High-quality CPR as measured by compression rate (per minute), depth (inches), and correct hand placement. High-quality CPR is defined as correct rate (100-120/min) AND >70% of compressions at appropriate depth (2-2.4inches) with appropriate hand placement.
Measured: 1-4 years
Secondary outcomes (4)
CPR Attitudes
Participant confidence and intention to perform CPR, measured using Likert-scale items and validated engagement questionnaires.
Measured: 1-4 years
CPR Knowledge Retention
Percentage of correct answers on a standardized multiple-choice test assessing CPR knowledge and AED use.
Measured: 1-4 years
Emotional Profile
Emotional responses captured by the Positive and Negative Affect Schedule (PANAS), measuring affective realism and readiness.
Measured: 1-4 years
Learner Engagement
Subjective engagement and perceived relevance of CPR training, measured via Likert scales and the Narrative Engagement Scale.
Measured: 1-4 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jun 2023
- Study start1 Apr 2026 (estimated)
- Primary completion31 Mar 2030 (estimated)
- Study completion31 Mar 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cardiac Arrest, Out-Of-HospitalStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Aim 1: A 4-year, cluster-randomized trial at a rural high school evaluates the impact of CPR training frequency and duration on skill retention, confidence, and emotional readiness. Students (N\~1,200) are assigned by class year to different training schedules using standard, gamified, or brief refresher formats. CPR skills, knowledge, and psychosocial outcomes are assessed annually. Aim 2: A 2-year, individually randomized trial at a suburban high school compares four chest compression practice tools: high-fidelity manikin, low-fidelity manikin, a novel "no-head" manikin, and improvised objects. Ninth-grade students (N\~432) are assessed post-training and at 1 year for CPR skill quality (rate, depth, recoil, hand placement) using objective measurement tools.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 2,100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Nevada, Reno
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Lorrel Toft, University of Nevada, Reno
- Investigators
- Lorrel Toft, Principal investigator, University of Nevada, Reno
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05908500
- Sponsor's protocol ID
- Lay Rescuer CPR Training 2026
- Status last verified
- May 2025
- First submitted
- 13 Jan 2023
- Last updated
- 4 Jun 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: All data is gathered and reported in de-identified, aggregate form, per IRB and school official direction.
Study at a glance
From the registry record, last updated by the sponsor on 4 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Generating Evidence to Optimize Lay Rescuer Cardiopulmonary Resuscitation (CPR) Training: a Longitudinal Study of Frequency, Modality, and Design Features Impacting Skill Retention
- ClinicalTrials.gov ID
- NCT05908500
- Acronym / sponsor ID
- Lay Rescuer CPR Training 2026
- Conditions
- Cardiac Arrest, Out-Of-Hospital
- Keywords
- Cardiopulmonary Resuscitation, cardiopulmonary resuscitation training, Lay Rescuer cardiopulmonary resuscitation, lay rescuer cardiopulmonary resuscitation training
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 2,100 participants (estimated)
- Lead sponsor
- University of Nevada, RenoUniversity, hospital or other
- Study start
- 1 Apr 2026 (estimated)
- Primary completion
- 31 Mar 2030 (estimated)
- Study completion
- 31 Mar 2031 (estimated)
- First posted
- 18 Jun 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this prospective trial is to compare CPR skill and attitudes in lay rescuers. The main question[s] it aims to answer are:
- What is the optimal training timing, duration, and frequency for lay rescuers that leads to CPR skill retention?
- What is the impact of CPR manikin type (high-fidelity, inflatable, nontraditional objects) on skill retention?
- How do specific features of training modality -- such as contextualization, gamification, and emotional engagement -- impact skill proficiency, knowledge retention, and attitudes about CPR?
Participants will
- Answer pre-training questionnaires
- Participate in CPR training
- Participate in CPR skills testing
- Answer post-training questionnaires
Researchers will compare different methods of training, different frequencies of training, and different manikin types.
Detailed description
Out-of-hospital cardiac arrest (OHCA) remains a major public health crisis in the United States, with over 350,000 cases annually and low survival rates. Lay rescuer cardiopulmonary resuscitation (CPR) can double survival, yet widespread gaps in training access, skill retention, and emotional readiness persist. While most U.S. states mandate high school CPR training, implementation quality varies, and traditional formats have remained unchanged for over 60 years. These methods are often time-consuming, expensive, and poorly suited for adolescents, leading to low participation and rapid skill decay.
This study addresses these critical gaps by comparing various CPR training methods and procedures. The project tests the effectiveness of different training frequencies, durations, and delivery modes-including traditional instructor-led sessions, brief refreshers, and a novel, emotionally immersive serious game. The serious game leverages gamification, competition, and scenario-based learning to build "emotional muscle memory" and prepare students for real-world emergencies.
Participants are enrolled from two high schools-one rural, one suburban-and randomized by class or individual into training arms with varied schedules and compression practice tools. These tools range from high-fidelity manikins to low-fidelity devices and improvised household objects. Outcomes include CPR performance metrics (compression rate, depth, recoil, and hand placement), knowledge retention, emotional engagement (measured via validated psychometric scales), and confidence in responding to cardiac arrest.
Training sessions are delivered during the academic year, and students are assessed immediately after training and again at annual follow-up points. Data are collected in a de-identified format using school-issued ID numbers, ensuring participant confidentiality. Analysis will use generalized estimating equations and mixed-effects models to assess the impact of training method and frequency on skill retention and psychosocial readiness. The study also explores the role of contextualization, emotional engagement, and gamification as mediators of improved CPR performance.
Ultimately, this multi-year trial aims to identify scalable, cost-effective strategies that optimize CPR training outcomes for lay rescuers. By improving technical skill retention and emotional preparedness, the study addresses key priorities for public health impact and aligns with NHLBI's strategic goals to reduce mortality from sudden cardiac arrest.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 9
- Model description
- Aim 1: A 4-year, cluster-randomized trial at a rural high school evaluates the impact of CPR training frequency and duration on skill retention, confidence, and emotional readiness. Students (N~1,200) are assigned by class year to different training schedules using standard, gamified, or brief refresher formats. CPR skills, knowledge, and psychosocial outcomes are assessed annually. Aim 2: A 2-year, individually randomized trial at a suburban high school compares four chest compression practice tools: high-fidelity manikin, low-fidelity manikin, a novel "no-head" manikin, and improvised objects. Ninth-grade students (N~432) are assessed post-training and at 1 year for CPR skill quality (rate, depth, recoil, hand placement) using objective measurement tools.
| Arm | Type | Receives |
|---|---|---|
| Every 2 year standard CPR training | Active comparator | Behavioral: CPR TrainingReceives two 60-minute instructor-led CPR trainings: once in 9th grade and again in 11th grade |
| Annual Standard CPR training | Active comparator | Behavioral: CPR TrainingReceives a 60-minute instructor-led CPR training each year for three years. |
| High-Frequency, Blended Training | Active comparator | Behavioral: CPR TrainingStarts with a 30-minute serious game-based session, followed by 10-minute refreshers every semester for four years (8 total sessions). |
| Annual Serious Game Training | Active comparator | Behavioral: CPR TrainingReceives a 30-minute serious game-based training session once per year for three years. |
| Control | No intervention | –No CPR training |
| Standard High-fidelity Manikin | Active comparator | Device: CPR Manikin TypeUses a commercially available torso manikin with realistic chest mechanics and feedback. Serves as the gold standard comparator for CPR training. |
| Low-Fidelity Manikin | Active comparator | Device: CPR Manikin TypeUses a basic inflatable torso manikin with minimal feedback or resistance. Represents a low-cost, commonly used alternative in schools and communities. |
| No-Head Manikin (Prototype) | Active comparator | Device: CPR Manikin TypeUses a custom-built spring-based device with a silicone topper and realistic force-displacement properties that closely mimic the human chest. Tests whether an affordable, biomechanically accurate prototype can improve compression quality. |
| Non-Traditional Object | Active comparator | Device: CPR Manikin TypeUses improvised materials (e.g., toilet paper rolls) to simulate chest compressions. Evaluates the feasibility and effectiveness of ultra-low-cost CPR practice tools |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- All students at participating schools
Key exclusion criteria (3 listed)
- Previous CPR training (will be included in the CPR training but excluded from analysis)
- Physical injury which prevents performing CPR
- Student or parent opt-out
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CPR TrainingVarious durations and frequencies of CPR training | Behavioural | Annual Serious Game Training, Annual Standard CPR training, Every 2 year standard CPR training, High-Frequency, Blended Training |
| CPR Manikin TypeVarious types of CPR manikins are compared | Device | Low-Fidelity Manikin, No-Head Manikin (Prototype), Non-Traditional Object, Standard High-fidelity Manikin |
Primary outcome
CPR Skill Retention
Time frame: 1-4 years
High-quality CPR as measured by compression rate (per minute), depth (inches), and correct hand placement. High-quality CPR is defined as correct rate (100-120/min) AND >70% of compressions at appropriate depth (2-2.4inches) with appropriate hand placement.
4 secondary outcomes
CPR Attitudes
Time frame: 1-4 years
CPR Knowledge Retention
Time frame: 1-4 years
Emotional Profile
Time frame: 1-4 years
Learner Engagement
Time frame: 1-4 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Jun 2025.
- Individual participant dataSharing planned: No. All data is gathered and reported in de-identified, aggregate form, per IRB and school official direction.
Related trials for Cardiac Arrest, Out-Of-Hospital
Not yet recruitingObservational study
CAROTID DOPPLER AND CEREBRAL OXIMERY IN POST CARDIAC ARREST ICU PATIENTS
Cardiac Arrest (CA), Carotid Doppler
Active, not recruitingPhase 3
The Danish Out-of-Hospital Cardiac Arrest Study
Out-Of-Hospital Cardiac Arrest, Post-Cardiac Arrest Syndrome
Not yet recruiting
Compression-Only Versus Standard Basic Life Support Training in Nursing Students
Cardiopulmonary Resuscitation, Out-of-Hospital Cardiac Arrest
Not yet recruiting
Execution of Prehospital Transesophageal Echocardiography During Cardiopulmonary Resuscitation in Patients With Out-of-hospital Cardiac Arrest
Out-of-hospital Cardiac Arrest (OHCA)
Active, not recruiting
The REVIVE-PEEP Trial: Positive End-expiratory Pressure Versus Sham Valve/Zero End-expiratory Pressure in Cardiopulmonary Resuscitation During Manual Ventilation to Improve Neurological Outcomes at Discharge in Adult Patients Suffering an Out-of-hospital Cardiac Arrest
Cardiac Arrest, Out-Of-Hospital
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Lorrel Toft principal investigator
University of Nevada, Reno
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing CPR Training and CPR Manikin Type in people with Cardiac Arrest, Out-Of-Hospital, run by University of Nevada, Reno at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 4 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Lorrel Toft, MD (4103028456, ltoft@unr.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
CPR Skill Retention (time frame: 1-4 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jun 2025.