Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: ‘student*’, ‘nurs* student*’, ‘cardiopulmonary resuscitation (CPR)’, ‘Basic Life Support (BLS)’, ‘Advanced Life Support (ALS)’, ‘Advanced Cardiac Life Support (ACLS)’, and ‘Retention’. Results: The initial database search yielded a total of sixty-seven articles; of which, nine articles met the inclusion criteria and were utilized in the final analysis. The articles analyzed explored the effectiveness of different training modalities including: self-directed, CD-based, low-fidelity simulation, high-fidelity simulation, collaborative high-fidelity simulation, and deliberate practice. Conclusion: Current training is ineffective both in promoting long-term retention and in delaying the decay of previously learned information. The most effective training modality identified was high-fidelity simulation in conjunction with deliberate practice. The use of collaborative simulation through ‘mock codes’ maximizes the acquisition and retention of CPR knowledge and skill by providing the highest degree of fidelity. Deliberate practice was the only modality, which resulted in improvement of knowledge and skill over time. The absence of individualized feedback diminishes the effects of repeated practice. Practical experience is also susceptible to the detrimental effects exerted by the lack of feedback.

Thesis Completion




Thesis Chair/Advisor

Gonzalez, Laura


Bachelor of Science in Nursing (B.S.N.)


College of Nursing




Orlando (Main) Campus



Access Status

Open Access

Release Date

August 2016