Knowledge about First Aid among Medical, Nursing and Allied
Health Sciences Students of Rawalpindi Medical University,
Pakistan.
Wajeeha Fahim1, Aneeqa Sarwar1, Tayyab Rasool1, Sanabil Gul1, Mahnoor Bajwa1, Muhammad
Ahmed Haroon Janjua1, Zeeshan Ahmad1, Saleha Faheem1
1
Fourth Year MBBS Students at Rawalpindi Medical University.
Abstract
Introduction: First aid is an important life-saving skill that can make a profound impact in
emergency situations. It involves giving rapid medical care at the site of the accident. Medical
and nursing students often get training inside controlled hospital environments. However, the
scope of first aid education entails effectively responding to many emergency situations outside
the hospital.
Objectives: The objective of this study is to assess the knowledge of undergraduate students in
the fields of MBBS, Nursing, and Allied Health Sciences (AHS) with regards to first aid.
Materials and Method: A cross-sectional questionnaire-based study was conducted from April
2023 to August 2023 at Rawalpindi Medical University. A validated, self-structured 16 items
questionnaire regarding first aid was used to assess the knowledge of the students. Data analysis
was done using Microsoft Excel and SPSS version 26.
Results: The study included a total of 309 individuals enrolled in the MBBS, AHS, and Nursing
programs. The mean knowledge score among all students was 8.72 ± 1.878. Only 10 (3.23%)
students had High knowledge, 216 (69.9%) students had Moderate knowledge, and 83 (26.8%)
students had Low knowledge of first aid. Significant differences were observed in knowledge
scores among degree programs, with MBBS students (M = 9.02, SD = 1.61) scoring significantly
higher than AHS (M = 8.0, SD = 2.33) and Nursing students (M = 8.06, SD = 2.11). However,
no significant difference was found between AHS and Nursing students. A positive correlation
was identified between academic year and knowledge scores, indicating increasing proficiency
with each academic year.
Conclusion: This study sheds light on the current state of first aid knowledge among
undergraduate healthcare students and underscores the need for tailored educational strategies to
equip them with the essential knowledge for effective emergency response.
Keywords: First Aid, Knowledge, Medical Students, Allied Health Sciences, Nursing.
Introduction
First aid is a crucial life skill that can make all the difference in emergency situations. Whether
it's a minor cut or a major accident, having knowledge of first aid techniques can truly be a
lifesaver. Defined by the United States Department of Labor as "the provision of prompt
medical care following an injury, which is administered immediately after the incident and at the
site of occurrence," first aid involves simple and immediate treatments provided without
extensive technical assistance or specialized expertise. 1,2 The main objectives of first aid are
preserving life, alleviating suffering, preventing further illness or injury, and promoting
recovery.3 First aid includes cleansing minor cuts, bruises, or scratches; treating minor burns;
applying bandages and dressings; using over-the-counter medication; draining blisters; removing
contaminants from the eyes; massaging the affected area; and consuming fluids to alleviate heat
stress.4
While medical and nursing students are typically trained to handle emergencies in hospital
settings, first aid knowledge goes beyond these controlled environments. It involves the ability to
respond promptly to emergencies in any situation.5,6
A 2018 study conducted at the King Saud University found that only 68% of the medical students
answered the first aid questions correctly. Usually there is no significant difference between
students of 1st, 2nd, and 3rd years regarding first aid knowledge, however, final year students
exhibit a greater proficiency in their understanding of first aid concepts. 7 Similarly, another study
was conducted by Princess Norah University in 2019, involving a sample of 1000 female
students. The findings of the study revealed that a mere 34.7% of participants exhibited a
commendable level of first aid knowledge, while the majority, accounting for 57.5%, possessed a
moderate level of knowledge. However, a small proportion of 7.8%, demonstrated a deficient
understanding of first aid principles.8,9
Additionally, a study conducted in 2011 at a medical college in southern India reported that only
11% of students had prior experience in first aid training, with 13% exhibiting a high level of
knowledge, 68.4% demonstrating a moderate level, and 17.8% showing a low level of
understanding.5
Moreover, studies in Pakistan have also assessed first aid knowledge among medical and non-
medical students. One study conducted in 2010 at six different colleges in Karachi found that
only 17.8% of participants had prior first aid training, and medical students exhibited poor
knowledge in this area.10 Another study was conducted in 2011 comparing the skills of First aid
among trained and untrained medical students in Pakistan. It found that the level of first aid
knowledge among trained students was less than 50%, which is not satisfactory.11
Given the pivotal role that medical and nursing students will play as future healthcare
professionals, it is crucial to assess their knowledge of first aid. This survey-based study aims to
evaluate participants' understanding of first aid principles, their confidence in applying this
knowledge, and their perception of the importance of first aid.
Materials and Method
This was a cross-sectional questionnaire-based study conducted for a duration of six months i.e.
from April 2023 to August 2023. The study participants included 309 undergraduates medical,
AHS and nursing students of Rawalpindi Medical University. Ethical approval was obtained
from the ethical review board of Rawalpindi Medical University, Rawalpindi. Informed consent
was taken from the students before the study.
A self-structured 16 items questionnaire regarding first aid was used to assess the knowledge of
the students. For every correct answer, participants were given a score of 1 and for incorrect
answers a score of 0. A knowledge score of 13-16 was considered High knowledge, while 8-12
score was considered Moderate knowledge, and 0-7 score was considered Low knowledge. The
validity of the questionnaire was checked by two experts and modifications were made
accordingly before the start of the study.
The questionnaire was distributed among the study participants by investigators, and it was
collected back on the same day. Data was entered in a Microsoft excel sheet and analysis was
done using SPSS version 26. Comparison of means was done by using T test and one way
ANOVA.
Results
A total of 309 students from three different degree programs of Rawalpindi Medical University
participated in the study. 216 (69.9%) students participated from MBBS, 60 (19.4%) students
participated from Allied Health Sciences and 33 (10.7%) students participated from BS Nursing
as shown in table 1. Majority of students participated from fourth year i.e. 131 (42.4%). Female
population was dominant i.e. 237 (76.7 %).
Mean knowledge score of all students regarding First Aid was 8.72 ± 1.878. Only 10 (3.23%)
students had High knowledge, 216 (69.9%) students had Moderate knowledge, and 83 (26.8%)
students had Low knowledge as shown in table 2. An independent samples t-test was conducted
to assess the difference in mean knowledge scores between male and female students at
Rawalpindi Medical University. The t-test revealed no statistically significant difference in
knowledge scores between male (M = 8.89, SD = 2.11) and female (M = 8.67, SD = 1.80)
students, t (307) = -0.862, p = .389. A one-way analysis of variance (ANOVA) with Welch test
was conducted to examine the differences in mean knowledge scores among students of three
degree programs (MBBS, AHS, and Nursing) at Rawalpindi Medical University refer to table 3.
A statistically significant difference of mean knowledge scores between MBBS, AHS and
Nursing students was found, as determined by one way ANOVA, F(2, 306) = 9.788, p = .001.
Post-hoc Tukey HSD tests were conducted to further explore the pairwise comparisons. The
results of the Tukey HSD test indicated significant differences in knowledge scores among
degree programs. Specifically, MBBS students (M = 9.02, SD = 1.61) had significantly higher
knowledge scores compared to AHS students (M = 8.0, SD = 2.33), p < .001, and Nursing
students (M = 8.06, SD = 2.11), p = .014. However, there was no significant difference in
knowledge scores between AHS and Nursing students, p = .987 (Table 3).
A Pearson correlation analysis was conducted to examine the relationship between Academic
Year and knowledge scores among students at Rawalpindi Medical University. The correlation
analysis revealed a significant positive correlation between Academic Year and knowledge
scores (r = .144, p = .011).
Table-I: Showing distribution of participants from MBBS, AHS and Nursing programs.
Frequency Percentage
1. MBBS:
Total 216 69.9
Male 60 19.4
Female 156 50.5
2. AHS:
Total 60 19.4
Male 50 16.2
Female 10 3.2
3. Nursing:
Total 33 10.7
Male 31 10
Female 2 0.6
Table-II: Showing distribution of students having High, Moderate and Low knowledge
scores
Knowledge Score Frequency Percentage
High Score 10 3.2
Moderate Score 216 69.9
Low Score 83 26.8
Table-III: One way ANOVA for Comparison of Mean Knowledge Scores of students from
MBBS, AHS and Nursing.
Degree Program Mean ± SD P-value
MBBS 9.02 ± 1.61 p < 0.001
AHS 8.0 ± 2.33
Nursing 8.06 ± 2.11
Mean Knowledge Scores
9.40 9.29
9.20
8.95
9.00
8.80
8.62
8.60 8.48
8.40 8.26
8.20
8.00
7.80
7.60
1st Year 2nd Year 3rd Year 4th Year 5th Year
Figure 1: Bar chart showing Mean Knowledge scores of students from various academic
years of MBBS, AHS and Nursing Programs
Scores of students w.r.t Degree
90 Program
80
70
60
50 48.48
50 45 45.45
40
30
18.51
20
10 5 6.06
2.31
0
MBBS AHS Nursing
High Score (%) Moderate Score (%) Low Score (%)
Figure 2: Bar chart showing percentage of students with High, Moderate and Low
Knowledge Scores from MBBS, AHS and Nursing Programs
Table IV: Showing correct response of students from MBBS, AHS and Nursing.
Knowledge Question Correct Answer MB A Nursi
BS HS ng N
N N (%)
(%) (%)
1. First step in severe Cover with clean cloth 78 (36.1) 33 (55.0) 9 (27.3)
bleeding?
2. Correct rate of 100 compressions per 83 (38.4) 29 (48.3) 13 (39.4)
compressions? minute
3. Anaphylactic shock Give water 25 (11.6) 8 (13.3) 9 (27.3)
management? immediately
4. Depth of chest 2-3cm 85 (39.3) 31 (51.6) 10 (30.3)
compressions:
5. Management of broken Put an Arm sling 70 (32.4) 22 (36.6) 12 (36.3)
arm?
6. Time to cool a burn with 5 min 94 (43.5) 21 (35.0) 22 (66.7)
cold water:
7. Steps for nose bleeding? Sit down, lean forward 160 (74.1) 30 (50.0) 22 (66.6)
and pinch nose
8. Help someone choking? Perform 180 (83.3) 28 (46.6) 12 (36.3)
Heimlich
maneuver
9. First aid measure given Individual moved 98 (45.37) 23 (38.3) 11 (33.3)
during a seizure? to safe place and
is not restricted
10. Manage a hypoglycemic Give sugary drinks 146 (67.6) 33 (55.0) 18 (54.5)
attack?
11. Manage an asthmatic Make the patient sit 192 (88.9) 41 (23.3) 20 (60.6)
patient? comfortably and
Nebulize with
Bronchodilators
12. Time to check breathing Not more than 10 sec 91 (42.1) 27 (45.0) 14 (42.4)
for unconscious casualty:
13. Medical emergency 1122 205 (94.9) 54 (90.0) 31 (93.9)
number:
14. Allergy casualties carry Adrenaline (EpiPen) 86 (39.8) 22 (36.6) 15 (45.4)
all the time
15. CPR ratio: 30:2 167 (77.3) 37 (61.6) 25 (75.7)
16. First response to a Break electric source 189 (87.5) 41 (68.3) 23 (69.7)
casualty electric burn? contact
Discussion
The present study aimed to investigate the knowledge of first aid among students from various
degree programs at Rawalpindi Medical University. The findings shed light on several key
aspects of first aid knowledge within this student population.
The study included a total of 309 students from three distinct degree programs: MBBS, Allied
Health Sciences (AHS), and BS Nursing. MBBS students constituted the largest portion of the
sample, with the majority of students being in their fourth year of study. A notable gender
disparity was observed, with a higher representation of females.
Majority of students had Average score regarding first aid knowledge. The study identified
significant differences in knowledge scores among students of different degree programs. MBBS
students demonstrated significantly higher knowledge scores compared to AHS and Nursing
students. This discrepancy might be attributed to variations in curriculum emphasis, clinical
exposure, or training methods across these programs. The findings underscore the importance of
addressing these disparities to ensure that students across all degree programs acquire essential
first aid knowledge.
Interestingly, the study found no significant difference in knowledge scores between male and
female students. This suggests that, within the context of this study, gender did not influence the
level of first aid knowledge. This finding is encouraging, as it indicates that both male and
female students have an equal opportunity to acquire first aid knowledge.
The study revealed a positive correlation between academic year and knowledge scores. As
students progressed through their academic years, their knowledge of first aid skills tended to
improve. This finding suggests a cumulative effect of educational experiences over time in
enhancing their understanding of first aid concepts.
The study also explored students' attitudes towards first aid training. It was observed that a
substantial portion of students lacked confidence in providing first aid, potentially due to a lack
of prior training. However, a majority of students expressed a strong desire to include first aid
training in their undergraduate curriculum, highlighting the importance of such education.
Furthermore, a significant number of students expressed their willingness to take action, such as
calling emergency services or performing CPR, when encountering an unconscious and non-
breathing adult.
Conclusion
In conclusion, this study provides valuable insights into the knowledge of first aid among
students at Rawalpindi Medical University. The findings emphasize the importance of
curriculum standardization and continuous education to ensure that students across different
degree programs acquire essential first aid knowledge. Additionally, the study highlights the
positive impact of educational interventions and the willingness of students to play an active role
in emergency situations. It is imperative for educational institutions to consider these findings
when designing and implementing first aid education programs to produce competent healthcare
professionals and responsible citizens. Further research can explore the long-term impact of first
aid education on students' practical skills and preparedness to respond to real-life emergencies.
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