What does work in school first aid? The impact of innovative teaching methodologies and resources for children aged 3 to 12 years: a systematic review and meta-analysis.

INTRODUCTION: The lack of evidence, which would serve as a structure for a legal framework for the implementation of first aid (FA) training in the school setting, justifies this systematic review. The aim was to analyze the effectiveness of learning methods in improving FA knowledge and skills in children aged 3-12 years. PATIENTS AND METHODS: Systematic review and meta-analysis. A literature search was conducted in MEDLINE, EMBASE and Web of Science. The risk of bias was assessed through the Cochrane and Joanna Briggs Institute tools. The probability of acquiring knowledge in each of the outcomes was analyzed through relative risks, which were calculated for each different type of training methodology as an estimate of effect size (ES). We used the DerSimonian and Laird random-effects method to calculate pooled ES estimates with the corresponding 95% confidence intervals (CI). RESULTS: Six studies, with 1038 schoolchildren from 5 to 12 years, were included. The targeted knowledge areas included emergency recognition and call, quality of cardiopulmonary resuscitation, foreign body airway obstruction, injury, or bleeding. The ES for innovative training on emergency call (correct information), compared to control group, was 1.28 (95% CI, 1.10-1.47). On emergency call, compared to traditional training, it was 1.18 (95% CI, 1.08-1.28). CONCLUSIONS: Innovative methodologies appeared to be equally or more effective than traditional training in teaching FA to schoolchildren aged 3-12 years, especially with age-appropriate resources. Still, the heterogeneity of the applied methodologies and the lack of robust evidence call for further studies which could elucidate the identified gaps in knowledge.