Age-stratified effectiveness of blended versus traditional Basic Life Support training: a prospective study

Out-of-hospital cardiac arrest (OHCA) remains a critical public health challenge; early bystander cardiopulmonary resuscitation (CPR) is pivotal for survival. Although blended learning has emerged as an alternative to traditional instructor-led Basic Life Support (BLS) training, evidence regarding its comparative effectiveness across diverse age groups remains limited. This retrospective analysis of a prospectively maintained education registry evaluated 1,202 community participants (adolescents: <18 years; adults: 18–65 years; older adults: >65 years) trained in Taiwan’s IGOGO BLS program between 2022 and 2024. Participants received either blended or traditional instruction. Outcomes included written test scores, objective CPR quality metrics (compression depth, rate, and recoil), and self-reported willingness to perform CPR. Multivariable logistic regression and generalized estimating equations (GEE) identified predictors of first-pass success and post-retraining improvement. Adults achieved the highest initial skill scores (93.7 ± 9.1), whereas older adults scored the lowest (77.6 ± 19.7, p < 0.001). The overall first-pass success rate was 13.8%, with the lowest rate observed among older adults (8.2%). Older age, absence of prior CPR training, and lack of regular exercise were independently associated with lower success. Course modality (blended versus traditional) was not an independent predictor. Following a brief 15-to-30-minute retraining session, objective performance converged across all age groups (~90% achieving adequate compression metrics). Age and individual learner characteristics, rather than the instructional modality, are the primary determinants of initial CPR skill acquisition. Older learners and those without regular exercise habits face greater challenges in achieving baseline competency. However, structured, feedback-guided retraining can substantially reduce these age-related performance disparities. Therefore, community Basic Life Support programs should prioritize targeted retraining and account for baseline learner characteristics, rather than focusing primarily on the delivery format.