Cardiopulmonary resuscitation (CPR) and Basic Life Support (BLS) are essential emergency procedures aimed at maintaining circulation and ventilation in individuals experiencing cardiac or respiratory arrest. Timely and effective administration of BLS can significantly improve survival and neurological outcomes following cardiac arrest, especially in out-of-hospital settings (1,2). The success of resuscitation largely depends on the immediate actions taken by first responders, underscoring the importance of widespread training and awareness in these life-saving techniques.

Medical students, as future healthcare professionals, are expected to possess a foundational understanding of BLS and demonstrate readiness to respond to emergency situations. However, several studies have shown that knowledge and practical skills related to BLS among medical undergraduates are often inadequate, particularly in the early years of training (3,4). This knowledge gap may delay appropriate intervention and reduce the chances of survival in critical scenarios.

Positive attitudes toward learning and performing BLS have been observed among medical students, suggesting that with proper training, their competence in emergency care can be substantially improved (5). Integrating BLS training into the undergraduate medical curriculum at an early stage may enhance students’ preparedness and confidence, ultimately contributing to better patient outcomes (6,7).

This study aims to evaluate the current level of knowledge and attitude toward BLS and CPR among first-year MBBS students and assess the influence of prior exposure to training on their preparedness.

A descriptive, cross-sectional study was conducted to assess the knowledge and attitude regarding Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR) among first-year MBBS students at a tertiary care medical college. The study population consisted of all students enrolled in the first-year MBBS program during the academic session. A total of 45 students were approached, and 43 responded completely to the survey, yielding a response rate of 95.5%.

Data were collected using a structured, pre-validated questionnaire designed to assess two domains: knowledge and attitude. The knowledge section consisted of 15 multiple-choice questions focused on core BLS/CPR concepts such as chest compression depth, compression-to-ventilation ratio, and emergency response protocols. Each correct answer was awarded one point, resulting in a maximum score of 15. A score of 10 or more was considered indicative of adequate knowledge.

The attitude section included 10 statements rated on a 5-point Likert scale ranging from “strongly disagree” to “strongly agree.” These items evaluated students' willingness to learn and perform BLS/CPR, perceived importance of training, and confidence in applying BLS skills.

The questionnaire was distributed in paper format during a scheduled classroom session after obtaining verbal informed consent from the participants. Ethical clearance was secured from the Institutional Ethics Committee prior to data collection.

Data were entered into Microsoft Excel and analyzed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics including means, standard deviations, and percentages were used to summarize the data. Chi-square tests were employed to explore associations between prior BLS exposure and knowledge/attitude scores. A p-value of <0.05 was considered statistically significant.

Out of the 45 students approached, 43 completed the questionnaire, resulting in a response rate of 95.5%. The mean age of participants was 18.6 ± 0.8 years, with 25 (58.1%) males and 18 (41.9%) females.

The overall mean knowledge score was 8.3 ± 2.5 out of a maximum of 15. Only 18 students (41.9%) achieved a score of 10 or higher and were categorized as having adequate knowledge (Table 1). The remaining 25 students (58.1%) were found to have inadequate knowledge levels. No statistically significant difference was observed between males and females in terms of mean knowledge scores (p = 0.47).

Regarding attitudes toward BLS/CPR, 35 students (81.4%) demonstrated a positive attitude, agreeing with statements on the importance of training and willingness to perform CPR if needed. Only 8 participants (18.6%) displayed a neutral or negative attitude (Table 2). The attitude scores did not vary significantly between genders (p = 0.59).

A total of 12 students (27.9%) reported previous exposure to BLS training. Those who had undergone prior training showed significantly higher mean knowledge scores (10.1 ± 2.3) compared to those without prior training (7.5 ± 2.1), and the difference was statistically significant (p < 0.01) (Table 3). However, there was no significant association between prior BLS exposure and attitude scores (p = 0.23).

Table 1: Distribution of Knowledge Scores Among Participants (n = 43)

Table 2: Attitude toward BLS/CPR among Participants (n = 43)

Table 3: Association between Prior BLS Exposure and Knowledge Score (n = 43)

The findings of this study reveal a moderate level of knowledge and a generally positive attitude toward Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR) among first-year MBBS students. While only 41.9% of the participants demonstrated adequate knowledge, a significantly higher proportion (81.4%) exhibited a favorable attitude towards learning and performing BLS. These results align with previous research indicating a common disparity between attitude and actual knowledge levels in medical undergraduates (1,2).

Inadequate knowledge among first-year students is understandable, as most medical curricula introduce BLS training later during clinical exposure. Similar studies conducted in India and other countries have reported low baseline knowledge scores among preclinical medical students (3,4). Chandrasekaran et al. observed that only 11% of undergraduate students could correctly identify all BLS steps (5). This underscores the need for early and repeated reinforcement of life-saving skills.

Our study also found that prior exposure to BLS training significantly improved knowledge scores, a trend consistently documented in literature (6,7). Trained individuals often retain core concepts better and are more confident in performing CPR during emergencies (8). A study by Roshana et al. showed that students who had attended BLS workshops scored significantly higher in both knowledge and performance (9).

Interestingly, no significant differences were found in knowledge or attitude scores based on gender, indicating that both male and female students perceive the importance of BLS training equally. This aligns with the findings of Sharma and Attar, who found no gender bias in BLS interest or awareness (10). Positive attitude scores, although higher than knowledge levels, reflect a willingness among students to learn and apply life-saving measures, an encouraging trend noted in several studies (11,12).

The gap between attitude and actual knowledge can be addressed by incorporating BLS training sessions into the early medical curriculum. Evidence suggests that even brief, structured courses can significantly enhance students’ skills and retention (13). Simulation-based training and periodic refresher sessions have proven to be effective in sustaining long-term competence (14). Moreover, the use of modern e-learning platforms and peer-assisted teaching can further support BLS training in resource-limited settings (15).

This study had a few limitations. The small sample size limits the generalizability of the findings. Additionally, practical skills were not assessed, which are equally critical in emergency care. Future research should include skill-based evaluations and follow-up assessments to determine knowledge retention.

The present study highlights a moderate level of knowledge but a predominantly positive attitude toward Basic Life Support and Cardiopulmonary Resuscitation among first-year MBBS students. Prior exposure to BLS training was significantly associated with higher knowledge scores, reinforcing the need for early and structured life support education in the medical curriculum. Given the critical role of BLS in emergency response, integrating practical training sessions at the undergraduate level can help bridge knowledge gaps and enhance students’ confidence and readiness to act in real-life scenarios. Future studies should assess long-term retention and skill competence following formal training

1. Albadi S, Al-Hadi H, Nadar SK. Knowledge and Attitudes toward Basic Life Support among Medical Students in Oman. Indian J Crit Care Med. 2020 Jul;24(7):599–600. doi:10.5005/jp-journals-10071-23475. PMID: 32963449.
2. Al-Mohaissen MA. Knowledge and Attitudes Towards Basic Life Support Among Health Students at a Saudi Women's University. Sultan Qaboos Univ Med J. 2017 Feb;17(1):e59–65. doi:10.18295/squmj.2016.17.01.011. PMID: 28417030.
3. Chandran KV, Abraham SV. Basic Life Support: Need of the Hour—A Study on the Knowledge of Basic Life Support among Young Doctors in India. Indian J Crit Care Med. 2020 May;24(5):332–5. doi:10.5005/jp-journals-10071-23442. PMID: 32728324.
4. Alkarrash MS, Shashaa MN, Kitaz MN, Rhayim R, Ismail M, Swed S, et al. Basic life support awareness among medical undergraduate students in Syria, Iraq, and Jordan: a multicenter cross-sectional study. Int J Emerg Med. 2023 Jul 24;16(1):44. doi:10.1186/s12245-023-00521-0. PMID: 37482609.
5. Al Bahri R, Al-Balushi A, Balkhair A. Knowledge and Attitudes of Undergraduate University Students in Oman With Regard to People Living With HIV. 2024 Aug 16;16(8):e67006. doi:10.7759/cureus.67006. PMID: 39280526.
6. Al-Azri M, Al-Saidi S, Al-Musilhi J, Al-Mandhari Z, Panchatcharam SM. Knowledge and Experiences of Final Year Medical and Nursing Students with Regard to Palliative Care at Government University in Oman: A Questionnaire Based Study. J Cancer Educ. 2021 Aug;36(4):747–54. doi:10.1007/s13187-020-01699-0. PMID: 32020520.
7. Ghanem E, Elgazar M, Oweda K, Tarek H, Assaf F, Ahmed El-Husseny MW, et al. Awareness of Basic Life Support among Egyptian Medical Students: a Cross-Sectional Study. Emerg (Tehran). 2018;6(1):e36. PMID: 30009238.
8. Zaheer H, Haque Z. Awareness about BLS (CPR) among medical students: status and requirements. J Pak Med Assoc. 2009 Jan;59(1):57–9. PMID: 19213385.
9. Ssewante N, Wekha G, Iradukunda A, Musoke P, Kanyike AM, Nabukeera G, et al. Basic life support, a necessary inclusion in the medical curriculum: a cross-sectional survey of knowledge and attitude in Uganda. BMC Med Educ. 2022 Mar 3;22(1):140. doi:10.1186/s12909-022-03206-z. PMID: 35241065.
10. Willmore RD, Veljanoski D, Ozdes F, Stephens B, Mooney J, Crumley SG, et al. Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support? World J Emerg Med. 2019;10(2):75–80. doi:10.5847/wjem.j.1920-8642.2019.02.002. PMID: 30687442.
11. Alghamdi YA, Alghamdi TA, Alghamdi FS, Alghamdi AH. Awareness and attitude about basic life support among medical school students in Jeddah University, 2019: A cross-sectional study. J Family Med Prim Care. 2021 Jul;10(7):2684–91. doi:10.4103/jfmpc.jfmpc_2557_20. PMID: 34568155.
12. Awadalla NJ, Al Humayed RS, Mahfouz AA. Experience of Basic Life Support among King Khalid University Health Profession Students, Southwestern Saudi Arabia. Int J Environ Res Public Health. 2020 Jul 4;17(13):4822. doi:10.3390/ijerph17134822. PMID: 32635499.
13. Berland N, Fox A, Tofighi B, Hanley K. Opioid overdose prevention training with naloxone, an adjunct to basic life support training for first-year medical students. Subst Abus. 2017 Apr–Jun;38(2):123–8. doi:10.1080/08897077.2016.1275925. PMID: 28027016.
14. Shivakumar S, Doddawad VG, Shetty SK, Shivanagappa M, Narayanaswamy CS, Shetty A, et al. Effectiveness of basic life support training course intervention among dental practitioners and students - An experimental study. Natl J Maxillofac Surg. 2024 Jan–Apr;15(1):87–92. doi:10.4103/njms.njms_59_22. PMID: 38690236.
15. Onabanjo SO, Ibu FO, Adeyeye AA, Akodu BA, Adaramola OG, Popoola AO. An evaluation of basic life support training among medical students in Southwest Nigeria: A web-based study. Afr J Emerg Med. 2023 Jun;13(2):114–9. doi:10.1016/j.afjem.2023.04.004. PMID: 37228447.