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Everyday EMS
by Greg Friese

CPR class instruction: 5 ways to make it great

I realized during the midst of my most recent CPR renewal that I had been continuously CPR certified for more than 20 years. My earliest CPR experience was as a Boy Scout and continued with my training as a lifeguard and wilderness guide.

I have had CPR certifications at three different organizations and have had several occasions where I had to take CPR more than once in a year.

Along the way I taught dozens of healthcare provider courses to groups ranging from police officers to manufacturing employees, from Sierra Club leaders to delinquent youth to college honors students.

Since I have spent more hours in CPR class than I care to remember, I tend to be a critical student. Fortunately my most recent healthcare provider recertification was memorable for all of the things the instructors did well.

1. Room set-up. Before class, the tables were pushed to the side of the room. Manikins were laid on the floor facing the screen. It was clear walking into the room that we would be expected to kneel on the floor to practice compressions on the manikins.

2. Ample equipment. The instructors prepared enough equipment so we never had more than two people to a manikin, BVM, or AED. Each student had their own pocket mask for the mask ventilation practice. Hands-on practice time was smooth with minimal downtime.

3. Timely and concise feedback. While we were following the timed practice with the video, the instructors were walking the room and providing timely and concise tips to improve compression rate, compression depth, or hand placement.

4. Stayed true to the AHA materials. Our instructors followed the AHA videos as they were designed to be played. I've heard too many instructors say, "You all probably know this, so we are going to skip ahead." Although CPR is regularly re-trained and practiced, it is rarely used. Regular refresher of knowledge and skills is crucial to effective performance.

5. Minimal story telling or extraneous information. Our instructors shared minimal "war stories." In the context of CPR, especially with healthcare providers that have low likelihood of actually providing CPR, I am not sure if stories about broken ribs, vomit, or dentures increase or decrease the provider's likelihood to take quickly take action should they see sudden cardiac arrest. Too often field anecdotes only inflate the storyteller's ego while adding little value to the course.

What are your tips for effective CPR instruction? As an instructor do you insert your own experiences into the curriculum and how does that enhance or detract from the student’s learning experience?

About the author

Greg Friese is Editor-in-Chief of He is an educator, author, paramedic, and marathon runner. Ask questions or submit tip ideas to Greg by e-mailing him at

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Justin Haagen Justin Haagen Thursday, February 16, 2012 7:04:40 PM Gosh I do all of these things and get really positive feedback. Thanks for sharing. Visit to find a really cool cpr instructor!
Mike Moses Mike Moses Thursday, February 16, 2012 8:36:49 PM Meeting standards of instruction is one thing; insuring that the students can do CPR correctly is another. Training should be tailored to the class and explanations, including war stories, that are used to convey essential information or correct problems should be used as needed. I have found that it is the case more than not that folks who should know how to do CPR routinely fail to get the green lights on the Preston manikins without coaching. Explanations on how the "pump" works and why continuous blood flow is vital can help folks to understand the why of what CPR attempts to teach and thus more effective students.
Greg Friese Greg Friese Friday, February 17, 2012 6:21:32 AM Thanks Mike, I agree that understanding pump function is important for understanding the best techniques to perform the skill.
Marcy Thobaben Marcy Thobaben Thursday, May 30, 2013 10:00:17 AM Thanks for the good info and perspective. Proper preparation enhances the students' experience, for sure. Having taught tens of thousands of students at the lay and HCP level, you're correct that very few do proper or effective compressions. Explaining clinical death and what to expect when "you push hard, fast and deep" however, tells them the truth about what to expect so they don't recoil from the sound of air going over the victim's vocal cords during compressions, the vomiting possibilities, and the knuckle-cracking, popping sounds made during a real attempt at resuscitation. I absolutely stand by telling the students what to expect, why they can't 'hurt and cause pain and suffering to a victim truly in SCA', why good technique will minimize the injury they are going to cause if doing correct compressions on an adult victim and that most will not survive, despite their best efforts...I realize there are many approaches to CPR instruction, but I have had overwhelmingly positive feedback saying that they often wondered about these issues but have not had an honest response to these issues because they were 'uncomfortable' to discuss or were told to "look up that information in their student manual" which, of course, will never happen. I always end on a positive note that a bystander found my very healthy, but extremely dehydrated, 40-year old brother (at the time), face down on the concrete in SCA, and the nurse refused to touch him due to the blood on his face from hitting the concrete face down (AIDS epidemic in 1990 and breathing was required), but that my brother's neighbor, the lay bystander, delivered very effective compressions until ALS arrived and successfully defibrillated him. Effective CPR and rapid use of an AED are the key and the students at least learn they can always do something. We may disagree on this approach but it has been helpful to a majority of my students, from what they've shared with me after or during class.
Madison Hicks Madison Hicks Thursday, June 12, 2014 12:27:48 PM i am going into CPR class right now! wish me some luck!:)