Local medical students can be instructors for life-saving first-aid courses for lay people: a descriptive study from Gaza

Background Bystanders can initiate a chain of survival in emergency situations by recognising the situation, calling for help, and initiating basic life support (BLS) and first aid. The lay population of Gaza has had little if any access to systematic BLS and CPR training. This study aimed to find out whether medical students could act as instructors to train 3000 lay people in BLS and CPR. Methods We selected 82 medical students from Al Azhar University to train as BLS and CPR instructors. Student volunteers who were in their third, fifth, and sixth year of medical school were chosen based on sex (to achieve equal numbers of males and females) and geography (for approximately even geographical distribution). Their training included 12 hours of BLS and CPR skills and 4 hours of didactic instruction, with a view to delivering 1–2 hours of basic training for lay people. Students responded to a written questionnaire with details of their demographics, training experience, motivation, and expectations. Teaching materials and methods were based on the European Resuscitation Council guidelines and followed a similar training model as that at The Arctic University of Norway (UiT). The board of the Faculty of Medicine at Al Azhar University approved the training and the study. Findings 82 medical students completed training (mean age 21·7 years [SD 1·25]; 54% [44 of 82] female, 46% [38 of 82] male). Following training, 87% of students (71 of 82) responded to the questionnaire and 76% (62 of 82) took part in training lay people. Of those who completed the questionnaire, five reported having lost family members during Israeli military operations in Gaza (the questionnaire section on demographics included the impact of warfare on the students' lives). Almost two-thirds (54 of 71) had no previous practical first aid training. 49 of 71 (69%) described a sense of belonging and duty to the community as their most important motivation, and 56 of 71 (79%) hoped that their training would contribute to increased capacity and skills in the community's response to emergencies, especially during attacks. 55 training sessions have been completed so far, involving 1222 lay participants, mostly school students (including students at vocational schools) aged 13–20 years (75%; 922 of 1222). 62 student instructors have been active, with a ratio of 5·4 lay trainees to each student instructor. Of the trainees, 45% were male (546 of 1222) and 55 % female (676 of 1222). Interpretation We have shown that local medical students are willing and capable of being trained as volunteer instructors to teach BLS and CPR, targeting lay people in serious conditions. The effects of such training on local resilience and patient outcomes need further study. Funding The Palestine Children Relief (PCRF) funded the travel expenses of the trainers and provided medical students with first aid kits. Contributors AI, MAR, MS, RAH, HH-L, GV, and MG contributed to the project idea, planning, and development. AI, MAR, MS, and RAH recruited and selected the student instructors, and collected the data. HH-L and MG were responsible for instructor training. MG designed the study. AI wrote the Abstract, and HH-L, GV, and MG revised the Abstract. All authors have seen and approved the final version of the Abstract for publication. Declaration of interests We declare no competing interests. Acknowledgments We thank the students and the Dean of the Faculty of Medicine at Al Azhar University, Gaza, for their enthusiasm and support; the Laerdal Medical Foundation and Palestine Children Relief Fund (PCRF) for practical and logistical support; and the teachers and club leaders of the trainees for allowing us to conduct training in their classes.