Simulation-based out-of-hospital cardiac arrest (OHCA) management training and its impact on knowledge, confidence, attitude, and reactiveness among railway police officers

Authors: Swapnil Vitthal Rahane, Dr. Ravindra HN Hebbasale

Keywords: Simulation-based training, CPR, OHCA, Railway police, Emergency response, First responders, India

Abstract: Abstract Aim: Out-of-Hospital Cardiac Arrest (OHCA) is a time-critical emergency with low global survival rates, primarily due to delays in cardiopulmonary resuscitation (CPR) initiation. In India, railway police officers frequently serve as first responders in public emergencies but often lack OHCA-specific training. This study aimed to evaluate the effectiveness of simulation-based OHCA management training in enhancing the cognitive, psychomotor, and behavioral preparedness of railway police officers. Method: A quasi-experimental one-group pre-test/post-test design was conducted with 200 railway police officers in Western India. A structured simulation-based training module focused on Out-of-Hospital Cardiac Arrest (OHCA) management techniques, emergency protocols, and scenario-based learning. Validated tools assessed knowledge, skills, willingness to help, self-confidence, and attitude before and after the intervention. Data were analyzed using paired t-tests and Chi-square tests (p < 0.05). Results: Post-training improvements were statistically significant across all domains (p < 0.0001). Mean knowledge scores increased from 12.48 to 15.11, and skill scores from 10.8 to 16.79. Good to excellent CPR performance rose from 1% to 76.5%. Willingness to help (86.5% to 100%), self-confidence (29% to 100%), and positive attitude (90.5% to 100%) also improved. Significant associations were found between willingness and gender (p = 0.043) and education (p = 0.028), and between attitude and religion (p = 0.015) and income (p = 0.002). Conclusion: Simulation-based training significantly enhances OHCA response readiness among railway police. Integrating such training into law enforcement curricula may improve India's pre-hospital emergency care system.