Knowledge, willingness, and self-efficacy in CPR: A two-phase study of prevalence and preliminary peer-led workshop in a Malaysian tertiary institution

Background Out-of-hospital cardiac arrest remains a major public health concern, and early cardiopulmonary resuscitation (CPR) by bystanders is crucial for improving survival outcomes. University students represent an important target population for CPR education because they are socially active, highly accessible, and capable of disseminating lifesaving knowledge within the wider community. However, inadequate CPR knowledge, low willingness to perform CPR, and poor self-efficacy remain common among university students in Malaysia. Objectives This two-phase study aims to determine the prevalence of self-reported CPR-related knowledge, willingness, and self-efficacy among students in a Malaysian tertiary institution (Phase 1) and to explore the preliminary changes in these outcomes following a peer-led CPR workshop (Phase 2). Methods In Phase 1, a cross-sectional survey was conducted at a tertiary institute in Selangor, Malaysia using a validated questionnaire on knowledge, attitudes, behavioral intention, and self-efficacy (KABSE) (N = 431). In Phase 2, a two-hour peer-led workshop, delivered by medical students, targeted students without CPR training in the past two years, and pre–post KABSE changes were measured (N = 33). Results Phase 1 baseline findings revealed CPR knowledge and self-efficacy levels were relatively lower than attitudes and willingness to perform CPR. Females showed higher knowledge and attitudes, while males reported greater self-efficacy. Older and married participants demonstrated better attitudes, and those with a healthcare-related background had higher knowledge, attitudes, and self-efficacy, though similar behavioral intention. Higher scores were also linked to AED awareness, AED usage capability, and recent CPR training. Statistical analysis revealed significant associations among the KABSE domains. Following the peer-led workshop, the participants showed significant gains in self-reported knowledge (p < 0.001), attitude (p < 0.001), behavioral intention (p < 0.01), and self-efficacy (p < 0.001). Conclusion Although participants displayed positive attitudes toward CPR, baseline knowledge and self-efficacy were limited. The peer-led workshop demonstrated feasibility as a proof-of-concept intervention, generating significant short-term gains in self-reported knowledge and confidence.