Five-Year Outcomes of an Undergraduate General-Education First Aid Course: A Ten-Semester Multi-Domain Evaluation of Knowledge, Skills, and Readiness

Background: University students are a scalable population for strengthening community first-aid capacity, but evaluations beyond CPR/AED outcomes remain limited. We assessed a general-education first-aid course using knowledge, observed skills, self-efficacy, and readiness-to-act outcomes. Methods: We conducted a repeated-cohort, single-group pre-post evaluation of an undergraduate elective course at Sun Yat-sen University (Guangzhou, China) across 10 consecutive semesters (2021-2025). Outcomes included pre/post theoretical knowledge (0-100), end-of-course four-station OSCE performance rated on a DOPS-based 1-5 scale, self-efficacy (five 1-5 Likert items; composite as mean), and willingness/intention (paired yes/no items). Pre/post changes were analyzed using paired tests appropriate to outcome type. Results: < 0.001). Conclusion: This university general-education first-aid course was associated with substantial end-of-course gains in knowledge, satisfactory observed competence, and improved confidence and readiness to act. These findings support embedding multi-domain first-aid training beyond CPR/AED within university general education as a scalable approach to strengthen community emergency preparedness.