For a lot of organizations, CPR training still centres on periodic certification. This means that staff attend a course, pass an assessment, receive a certificate, and return months later to repeat the process. As a model, this often satisfies compliance requirements but does little to support long-term resuscitation skill retention in real-world settings.
There is a growing number of education and cognitive studies that show rapid decay in CPR competence without consistent reinforcement.
A sustainable CPR competence program takes a different approach.
CPR is a perishable cognitive skill that relies on structured maintenance and should not be treated as a one-off achievement. That means designing training systems that support ongoing CPR training, are educationally robust, and can be managed and documented at scale.
Why Do CPR Skills Decay?
Skill decay in CPR is well documented. Multiple studies have shown measurable deterioration in compression depth, rate, recoil, and ventilation techniques within months or even weeks of initial training. This is not a failure of learners or trainers; it reflects how human memory works. Complex motor skills degrade when they are not rehearsed, and this is amplified when real-life exposure is rare.
Irregular BLS Refresher Training is Insufficient
Research in resuscitation education consistently demonstrates that traditional annual or biennial recertification is not sufficient for maintaining CPR competence. Even those who perform well immediately after training often fall outside guideline targets within three to six months.
This has a huge impact on program design. If the goal is CPR competence, rather than certification alone, training frequency and feedback quality matter more than course length.
In virtually any educational setting, short, frequent practice sessions outperform infrequent, intensive training. This necessitates a shift from episodic teaching to a framework built around continuous support and ongoing CPR training.
Refocusing from Certification to CPR Competence
A competence-based CPR program focuses on what learners can reliably do over time, as opposed to something that can be demonstrated once.
This requires three core elements.
1. Clear Standards
All performance standards need to be clearly defined and in line with current resuscitation guidelines. Learners need objective benchmarks for compression depth, rate, recoil, and ventilation, rather than subjective instructor judgment alone.
2. Regular Practice Opportunities
These need not be long or disruptive. In fact, evidence suggests that brief, focused sessions are much more effective for resuscitation skill retention than longer, infrequent classes.
3. Meaningful Feedback
Without feedback, practice only reinforces existing habits; it is indiscriminate as to whether they are correct or incorrect. Real-time, objective feedback allows learners to self-correct and build accurate motor patterns.
Looking for Training Tools to Support Sustainable CPR Competence?
Equipping yourself with the right training tools is crucial if you are going to see a consistent improvement in CPR competence. At Innosonian, we develop solutions specifically intended to support ongoing competence rather than one-off certification.
Find out more about our intuitive manikins and VivusCardio Connect App, or get in touch with any questions.
Low-Dose, High-Frequency Practice in Action
Low-dose, high-frequency CPR training focuses on short practice sessions delivered regularly, often embedded into normal working routines. It is particularly effective at targeting the specific skills most vulnerable to decay.
Five-minute micro drills.
This could take the form of five-minute micro-drills conducted weekly or every two weeks, either with a single learner or a small group. Inviting learners to perform chest compressions on a feedback-enabled manikin, followed by an immediate review of performance metrics, is a simple, seamless way to incorporate regular BLS refresher training into the working day.
Rotation practice is another useful option.
A manikin placed in the staff area allows team members to complete a brief drill at a time that is convenient for them. Data from each session can be logged using an online platform like VivusCardio Connect, so learners have access to their CPR competence levels and can identify areas for improvement.
Find out more about VivusCardio Connect.
Crucially, low-dose sessions work best when they are normalized. If short CPR practice becomes routine rather than exceptional, engagement improves, and skills stabilize.
“With as little as two minutes of refresher training every month, there is the potential to increase pCPR performance and retain the skills for longer.”
Resuscitation Plus, Volume 12, December 2022
Feedback-Led CPR Rehearsal
Feedback quality is one of the strongest predictors of skill acquisition and retention. In CPR training, visual and numerical feedback on compression depth, rate, and recoil has been shown to improve immediate performance and slow decay.
Feedback-led rehearsal lets learners adjust their techniques in real-time, rather than relying on delayed instructor comments. Over repeated sessions, this supports motor learning by reinforcing correct patterns and reducing variability. It also enables self-directed learning, where individuals can take ownership of their development.
From a governance perspective, feedback data provides you with objective evidence of participation and performance. This is especially valuable in large organizations where manual record-keeping is not always practical.
Designing a Sustainable CPR Competence Program
Educational Robustness and Governance
A sustainable CPR competence program needs to be educationally robust and well-governed. Educational robustness comes from alignment with learning science, consistent performance standards, and the structured use of assessment and feedback to support skill development over time. Governance ensures training can be monitored, reviewed, and adapted as needs change, supporting ongoing CPR training rather than one-off certification.
Refresher Intervals and Auditability
Refresher intervals should reflect role, risk, and exposure rather than fixed annual cycles. Staff in higher-risk environments might need more frequent BLS refresher training to support reliable resuscitation skill retention.
Auditability is equally important, as organizations need clear evidence that training is delivered, accessed, and maintained. This is best supported through a digital system that captures practice frequency as well as performance data.
Scaling Without Diluting Quality
As programs scale across sites or learner groups, consistency becomes a critical concern. Standardized equipment, shared benchmarks, and centralized data collection help maintain alignment while still allowing for local delivery. Again, digital platforms make it much easier to identify trends, gaps, and areas for improvement.
Want to Improve CPR Competency with Industry-Leading CPR Training Tools?
At Innosonian, we design our training solutions around how CPR skills are actually learned, practiced, and maintained over time.
Using the Brayden range of feedback-enabled manikins, you can optimize frequent, skills-focused practice using intuitive LED blood-flow displays. Alongside this, our digital learning platform, VivusCardio Connect, allows CPR training to be delivered consistently at scale, with impartial, objective feedback clearly communicated to learners and trainers.
Get in touch with our team to find out more about how we can help you boost CPR competence.
FAQs
What is resuscitation skill retention?
Resuscitation skill retention refers to how well CPR skills are maintained over time after training, particularly compression quality and technique.
How often should BLS refresher training take place?
Evidence shows that those who take monthly BLS refresher training courses significantly outperform those who carry out less frequent training.
What is low-dose, high-frequency CPR training?
It involves brief practice sessions, often no more than ten minutes, delivered regularly to reinforce key CPR skills.
Can I track CPR competence objectively?
Yes. Feedback-enabled manikins, like the Brayden range, and digital platforms like VivusCardio Connect can deliver immediate, visual feedback or objective performance data, respectively.
Is ongoing CPR training suitable for non-clinical settings?
Yes. The same principles apply to healthcare, workplace, and community training environments.
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