New Cochrane review confirms that first aid training probably improves knowledge and skills, but evidence is lacking on real-life impact

10/09/25

In our newly published Cochrane systematic review, we examined the effectiveness of physical first aid training for laypeople (i.e. individuals without formal healthcare education). Our goal was to assess whether such training improves health outcomes for recipients of first aid, enhances the quality of first aid provided, encourages helping behavior in real-life emergencies, and improves trainees' first aid-related knowledge, skills, self-efficacy, and self-reported willingness to help.

We included 36 randomized controlled trials involving over 15,000 participants. These studies compared physical first aid training with no such training, which could mean either no intervention or a different type of training (e.g., mental health first aid or HIV prevention). Seventeen studies focused on adults, while 19 involved children or adolescents. Among these, 19 studies focused exclusively on cardiopulmonary resuscitation (CPR) training and did not include other first aid topics. The studies were conducted in various countries, though only two were carried out in low- or lower-middle-income countries.

The results showed that first aid training of laypeople probably improves first aid-related knowledge, practical skills, and self-efficacy (belief in one's own ability to provide first aid) one month after training (based on moderate-certainty evidence). However, none of the studies reported on actual health outcomes for those receiving first aid or on the quality of first aid provided. Only one study examined whether trained individuals helped more in real-life emergencies, but its results were very uncertain. Similarly, evidence on self-reported willingness to help was inconclusive, as only two studies addressed this, and responses may have been influenced by social desirability.

We noted considerable variation in how training was delivered and how outcomes were measured. Many studies also had methodological limitations, such as missing data or insufficient details on how participants were randomized.

While our review supports the value of first aid education, it thus also highlights two significant research gaps: the lack of evidence on whether training improves real-life health outcomes and a lack of studies conducted in low- or lower-middle-income countries. To fully understand its impact, more rigorous research is needed, particularly studies that assess long-term effects of physical first aid training, standardize how first aid competences are measured across studies, and further explore the effects of first aid training in low-resource settings.