Strides in Development of Medical Education

Document Type : Original Article


1 Medical Informatics Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran

3 Health in Emergency and Disaster Research Center and Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

4 Health Services Management Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran


Background Training of human resources, especially nurses, is a profitable investment for hospitals with major economic return if properly planned and implemented. Objectives The present study aimed to evaluate the effectiveness of a cardiopulmonary resuscitation (CPR) course as an in-service training program, based on the Kirkpatrick model. Methods This interventional study was conducted at Afzalipour Hospital of Kerman, Iran from October 2014 to May 2015. The study sample consisted of 45 nurses, including 20 nurses in the case group and 25 nurses in the control group. The case group participated in a four-hour CPR training workshop. The Kirkpatrick model was used to determine the effectiveness of the CPR course. Data were collected using three questionnaires and hospital records. Results The participants were satisfied with the training course, and a significant difference was observed in the mean score of three intervals of learning levels evaluation (P < 0.0001). Based on the findings, CPR training affected the learning level of nurses from the case group; however, the average learning score was not significantly different between the two groups (P = 0.26). In addition, the difference in the mean score of behavior level was not significant before and after training (P = 0.91). The results of Chi-square test also showed that CPR training did not affect the forth level (P = 0.54). Finally, the overall effectiveness of the CPR training course was estimated at 32.51%. Conclusions This study indicated that effectiveness of in-service training is not at a desirable level. Since organizations allocate a lot of their resources to such training courses every year, it is essential to reconsider planning and implementation processes.


  1. Eidi A, Alipour M, Abdolahi J. [Evaluating the effectiveness of educational cources]. J Tadbir. 2009; 200(19):26–32. Persian.
  2. Bazargan A, Kharazi K, Jamalifar M. [The comparative study of continuing education for empowerment of human resources]. J Labour Soc.2012;150:4–12. Persian.
  3. Griscti O, Jacono J. Effectiveness of continuing education programmes in nursing: Literature review. J Adv Nurs. 2006;55(4):449–56.doi: 10.1111/j.1365-2648.2006.03940.x. [PubMed: 16866840].
  4. Lin PC, Chiang HW, Chiang TT, Chen CS. Pain management: Evaluating the effectiveness of an educational programme for surgical nursing staff. J Clin Nurs. 2008;17(15):2032–41. doi:10.1111/j.1365-2702.2007.02190.x.
  1. Habibi S, Rezaei Hachesoo P, Tabaghi R. [Enhancing information literacy as a base of developing evidence-based nursing]. Health Inform Manag. 2010;7(3):371–8. Persian.
  2. Blake SC, Kohler SS, Culler SD, Hawley J, Rask KJ. Designing effective healthcare quality improvement training programs: Perceptions of nursing and other senior leaders. J Nurs Educ Pract. 2013;3(5):66–77. doi: 10.5430/jnep.v3n5p66.
  1. Arthur W Jr, Bennett W Jr, Edens PS, Bell ST. Effectiveness of training in organizations: A meta-analysis of design and evaluation features. J Appl Psychol. 2003;88(2):234–45. doi: 10.1037/0021-9010.88.2.234. [PubMed: 12731707].
  1. Mokhtari Nori J, Saghafinia M, Kalantar Motamedi MH, Khademol Hosseini SM. CPR training for nurses: How often is it necessary? Iran Red Crescent Med J. 2012;14(2):104–7. [PubMed: 22737563]. [PubMed Central: PMC3372042].
  2. Bakhsha F. Assessing the need and effect of updating the knowledge about cardio-pulmonary resuscitation in experts. J Clin Diagn Res. 2010;4(3):2512–4.
  3. Khorasani A, Dosti H. [Measuring training effectiveness of in service engineering education by ROI methodology]. Iran J Eng Educ. 2012;13(52):103–22. Persian. doi: 10.22047/IJEE.2012.1799.
  4. Jafarzadeh M. [Return of capital, a tool for evaluating of educational effectiveness]. J Tadbir. 2007;18(180):35–9. Persian.
  5. Sabaghyan Z, Akbari S. Organizational comperehensive education (adult education approach). Tehran: Samt; 2010. 628 p.
  6. AlYahya MS, Norsiah BM. Evaluation of effectiveness of training and development: The Kirkpatrick model. Asian J Bus Manag Sci. 2013;2(11):14–24.
  7. Bates R. A critical analysis of evaluation practice: The Kirkpatrick model and the principle of beneficence. Eval Program Plann. 2004;27(3):341–7. doi: 10.1016/j.evalprogplan.2004.04.011.
  8. Khorasani A, Zarrabi HH. [Exploring the evaluation patterns reviewing the patterns of Kirk Patrick and Helton]. Proceedings of the First Virtual Training Sessions. Tehran, Iran. 2013. p. 1–12. Persian.
  9. Kirkpatrick DL, Kirkpatrick JD. Implementing the four levels: A practical guide for effective evaluation of training programs. 1st ed. San Francisco, California: Berrett-Koehler Publishers; 2009.
  10. Alinaghian M, Safdarian A, Alinaghian M. Evaluation of training course effect of working with electro shock device to nursing cadre of Feiz Therapeutic Educational Center based on Kirkpatrick model in 2014. Int J Rev Life Sci. 2015;5(7):651–7.
  11. Mohan DR, Prasad MV. Impact of training session on biomedical waste management for a group of nurses-an analysis. Narayana Med J. 2012;1(1):25–8.
  12. Mohamed R, Alias AAS. Evaluating the effectiveness of a training program using the four level Kirkpatrick model in the banking sector in malaysia. International Conference on Business and Economic Research. Bandung, Indonesia. 2012.
  13. Mollahoseini A, Farjad S. Assessment effectiveness on the job training in higher education (case study: Takestan University). Procedia-Social and Behavioral Sciences. 2012;47:1310–4. doi:10.1016/j.sbspro.2012.06.817.
  14. Borimnejad L, Rasoli M, Nikbakht Nasrabadi A, Mohammadi Mohammadi H, Ahmadzadeh M. [The effect of cardiopulmonary resuscitation workshop on nurses’ sustained learning]. Iran J Med Educ. 2008;7(2):209–15. Persian.
  1. Shahrakivahed A, Masinaienezhad N, Shahdadi H, Arbabisarjou A, Asadibidmeshki E, Heydari M. The effect of CPR workshop on the nurses’ level of knowledge and skill. Int Arch Med. 2015;8(108):1–10. doi:10.3823/1707.
  2. Hojjati H, Mehralizadeh Y, Farhadirad H, Alostany S, Aghamolaei M. [Assessing the effectiveness of training outcome based on Kirkpatrick model: Case study]. Q J Nurs Manag. 2013;2(3):35–42. Persian.
  3. Raeisi H, Torabizadeh K, Makoulati N. [Studying the effect of CPR knowledge and skill retention reeducation course on nursing students]. J Rescue Relief. 2012;4(1):11–9. Persian.