Deliberate Practice of CPR Skills: A Strategy to Improve Nursing Student Confidence

Deliberate Practice of CPR Skills: A Strategy to Improve Nursing Student Confidence | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Deliberate Practice of CPR Skills: A Strategy to Improve Nursing Student Confidence Sheryll Go This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6822936/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study evaluated the effect of deliberate practice (DP) of basic life support (BLS) skills on the self-efficacy of first-year nursing students. Forty prelicensure BSN students participated in four weekly DP sessions during scheduled skills lab time. Each session consisted of 15 minutes of one-on-one, skills-based coaching using a psychomotor checklist. General Self-Efficacy Scale (GSES) scores were collected before and after the intervention. A paired samples t-test showed a significant increase in GSES scores following the practice sessions (p < .001), with a mean increase of 12.5 points. These results suggest that integrating brief, repeated practice opportunities into early nursing curriculum may improve students’ confidence in performing critical life-saving skills. Deliberate practice is a low-cost, faculty-directed strategy that may help bridge the gap between BLS certification and clinical readiness. Nursing Basic life support deliberate practice nursing students self-efficacy clinical readiness Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Introduction Basic life support (BLS) skills are critical for nursing students, yet evidence shows that skill decay begins within three months of initial certification. New graduates often enter clinical settings with low confidence in their ability to respond to cardiac arrest situations. Deliberate practice (DP) is a strategy that may help close the gap between certification and clinical readiness. This study examined the impact of DP on general self-efficacy scores among first-year nursing students. Methods A one-group pretest-posttest design was used. Forty first-year prelicensure BSN students participated in the intervention, which consisted of four weekly 15-minute BLS deliberate practice sessions. Sessions took place during regularly scheduled skills lab and followed a standardized psychomotor checklist based on American Heart Association (AHA) guidelines. Self-efficacy was measured using the General Self-Efficacy Scale (GSES), a 10-item validated instrument. Pre- and post-intervention scores were compared using a paired samples t-test. Results Participants showed a statistically significant increase in GSES scores after the DP sessions. The mean pretest score was 24.7 (SD = 3.63), and the mean posttest score was 37.2 (SD = 2.58), with a mean difference of 12.5 points (p < .001). These findings indicate that DP positively impacted students' perceived self-efficacy in performing BLS skills. Discussion This project supports previous literature showing that DP enhances skill performance and confidence. Bandura's self-efficacy theory suggests that repeated mastery experiences improve belief in one's capabilities. For novice nursing students, increased self-efficacy can reduce anxiety, improve clinical readiness, and support patient safety. The brief and targeted nature of the DP sessions makes them a practical addition to nursing skills labs. Limitations This study used a convenience sample from one institution and lacked a control group. The small sample size and non-random selection limit generalizability. However, the strong effect size suggests educational significance. Conclusion Incorporating short, structured BLS practice sessions into early nursing education may improve self-efficacy and skill retention. Nurse educators should consider adding DP to simulation and skills curricula as a way to enhance students' confidence in responding to emergencies. Declarations Ethics Approval Statement This study was reviewed and approved by the Institutional Review Board (IRB) of the American Sentinel College of Nursing & Health Sciences at Post University. Additional permission to conduct the study was granted by the Department of Nursing at the project site, a public university in Southern California. The study adhered to all institutional policies for the protection of human subjects. Participant Consent Statement All participants were informed of the nature, purpose, and voluntary nature of the study prior to enrollment. Written informed consent was obtained from each participant prior to data collection. To minimize potential coercion, a proxy—who was not involved in course grading—was used to obtain and manage consent, deliver instructions, and facilitate data collection. Participation had no impact on students’ grades or course standing. References Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191 Cheng, A., Nadkarni, V. M., Mancini, M. B., et al. (2018). Resuscitation education science: Educational strategies to improve outcomes from cardiac arrest. Circulation, 138(6), e82–e122. https://doi.org/10.1161/CIR.0000000000000583 Curran, V. R., Fleet, L., & Greene, M. (2012). An exploratory study of factors influencing resuscitation skills retention and performance among health providers. Teaching and Learning in Medicine, 24(3), 196–204. https://doi.org/10.1080/10401334.2012.692267 Knipe, G. A., Fox, S. D., & Donatello, R. A. (2020). Deliberate practice in simulation: Evaluation of repetitive code training on nursing students’ BLS team skills. Clinical Simulation in Nursing, 48, 8–14. https://doi.org/10.1016/j.ecns.2020.08.001 Oermann, M. H., Kardong-Edgren, S. E., & Odom-Maryon, T. (2011). Effects of monthly practice on nursing students’ CPR psychomotor skill performance. Resuscitation, 82(4), 447–453. https://doi.org/10.1016/j.resuscitation.2010.11.022 Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). NFER-NELSON. Tsao, C. W., Aday, A. W., Almarzooq, Z. I., et al. (2022). Heart disease and stroke statistics—2022 update: A report from the American Heart Association. Circulation, 145(8), e153–e639. https://doi.org/10.1161/CIR.0000000000001052 Tables Table 1. Paired Samples Statistics Time Point Mean Standard Deviation Pre-Intervention 24.7 3.63 Post-Intervention 37.2 2.58 Note. This table shows the mean and standard deviation of GSES scores before and after the deliberate practice intervention. Table 2. Paired Samples Test Mean Difference t-value df p-value 12.5 19.8 39 < .001 Note. This table provides the results of the paired samples t-test comparing pre- and post-intervention GSES scores. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6822936","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":466621733,"identity":"afc1d8ff-a311-4309-85d6-65c1081931bd","order_by":0,"name":"Sheryll Go","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYDACCRBRYAEkmA+AmAlAbECEFgMQyZZAshYeA+K0yM9uPvaZB6hF3r3n48efbXV5DOzN2yTwaTG4cyx5NkiL4Zmzm6V52w4XM/AcK8OvRSLHmBmsZUbuNmbGtgOJDRI5Zni1yM/I/wzVkvOMEeiwxAb5N/i1MNzIYQZrkZfIYWPgbWMG2sKDX4vBjTRjxjkGEjwGPMeMpXnOHS5m40krtsDvsOTHDG8qbOTk25sffvxRVpfHz3544w28DgMCJh5QpByA8tgIKQcBxh8g6xqIUToKRsEoGAUjEgAAXmo/pXFKAhEAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0008-1072-9862","institution":"California State University San Bernardino","correspondingAuthor":true,"prefix":"","firstName":"Sheryll","middleName":"","lastName":"Go","suffix":""}],"badges":[],"createdAt":"2025-06-04 18:13:15","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6822936/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6822936/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84274775,"identity":"383a8adb-dce2-48be-aafc-d2bdfa880f51","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":28320,"visible":true,"origin":"","legend":"\u003cp\u003eHistogram\u003c/p\u003e\n\u003cp\u003eNote. Visual interpretation of the data presented in the form of a histogram. The histogram’s curve is peaked at the center and tapers off at each end, suggesting a reasonably normal distribution.\u003c/p\u003e","description":"","filename":"Figure1Histogram.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/2b694594e2d1795fdb3cd1fe.jpg"},{"id":84274774,"identity":"c4f63732-2202-4f76-b8de-54a586ad5fcf","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":30383,"visible":true,"origin":"","legend":"\u003cp\u003eNormal Q-Q Plot of Change Variable\u003c/p\u003e\n\u003cp\u003eNote. A scatterplot where each score is plotted against the expected value from a normal distribution. A straight-line pattern suggests that the data are normally distributed.\u003c/p\u003e","description":"","filename":"Figure2NormalQQ.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/c3d5f1ff5dcc94a8e8ccf200.jpg"},{"id":84275541,"identity":"cc62aa79-8cdf-4486-a1d3-23a6b61e8715","added_by":"auto","created_at":"2025-06-10 05:37:27","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":19957,"visible":true,"origin":"","legend":"\u003cp\u003eBox Plot of Change Variable\u003c/p\u003e\n\u003cp\u003eNote. Box plot showing the distribution of the GSES change variable. The median line is centered, with symmetrical whiskers, indicating a normal distribution and no outliers.\u003c/p\u003e","description":"","filename":"Figure3BoxPlot.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/7f4376105a91887ac97e7a13.jpg"},{"id":84275542,"identity":"4d5d98ac-f419-4c50-a686-244411f231c8","added_by":"auto","created_at":"2025-06-10 05:37:27","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":34677,"visible":true,"origin":"","legend":"\u003cp\u003eAge Range of Participants\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e N = 40. The 18-25 age group matched the 26-30 age group as the largest groups represented each with n = 13 (32.5%) participants. The 31-35 age group had n = 11 (27.5%) of the participants and the 36-40 age group consisted of n = 2 (5.0%), while the 41 and older age group represents the smallest group represented with n = 1 (2.5%) participant.\u003c/p\u003e","description":"","filename":"Figure4AgeRange.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/12983f2169e070778fec0c81.jpg"},{"id":84274780,"identity":"60d2b39d-312c-41a4-9ad2-631b8be7ccd7","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":29460,"visible":true,"origin":"","legend":"\u003cp\u003eGender Distribution\u003c/p\u003e\n\u003cp\u003eNote. Statistical software provides calculations for frequency and percentage of the males and females who participated in the data collection process. The sample was made up of 15% (n = 6) males and 85% females (n = 34). The total sample population was 40 participants (N = 40).\u003c/p\u003e","description":"","filename":"Figure5Gender.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/828726f6c9059d4a9e98a73b.jpg"},{"id":84274783,"identity":"4583aefb-7006-4b35-9616-c81a1c3f482b","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":45249,"visible":true,"origin":"","legend":"\u003cp\u003ePie Chart Depicting the Race of Participants\u003c/p\u003e\n\u003cp\u003eNote. Pie chart showing the racial demographics of the study sample. The largest group was Hispanic (52.5%), followed by Caucasian (20%), Asian (17.5%), two or more races (7.5%), and American Indian or Alaska Native (2.5%).\u003c/p\u003e","description":"","filename":"Figure6PieChartRace.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/e79cb9d8ffda51b1030fd91d.jpg"},{"id":84274785,"identity":"e8929acc-8681-4c0a-b2b7-501f042211f2","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":17055,"visible":true,"origin":"","legend":"\u003cp\u003eExperience in Health Care\u003c/p\u003e\n\u003cp\u003eNote. N = 40. Half of the participants have experience in healthcare n = 20 (50%) and the other half of the participants n = 20 (50%) did not have experience in healthcare.\u003c/p\u003e","description":"","filename":"Figure7PrevWorkExp.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/18884c31e64825728930b200.jpg"},{"id":84274778,"identity":"503ba5a2-ae81-4158-a7c7-f7b48bbbdabc","added_by":"auto","created_at":"2025-06-10 05:29:27","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":16348,"visible":true,"origin":"","legend":"\u003cp\u003eCPR Practice\u003c/p\u003e\n\u003cp\u003eNote. Bar chart showing that 72.5% of participants had no recent CPR practice, while 27.5% had prior practice since certification.\u003c/p\u003e","description":"","filename":"Figure8CPRPractice.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/b1cc46cbcddbd3bcc9784de3.jpg"},{"id":84275557,"identity":"3e9c2806-9122-4d80-b0ae-7d7487b9fda2","added_by":"auto","created_at":"2025-06-10 05:37:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":520817,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6822936/v1/5aee12a5-cb69-48b2-a2bb-c16e6bd8fba3.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eDeliberate Practice of CPR Skills: A Strategy to Improve Nursing Student Confidence\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBasic life support (BLS) skills are critical for nursing students, yet evidence shows that skill decay begins within three months of initial certification. New graduates often enter clinical settings with low confidence in their ability to respond to cardiac arrest situations. Deliberate practice (DP) is a strategy that may help close the gap between certification and clinical readiness. This study examined the impact of DP on general self-efficacy scores among first-year nursing students.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA one-group pretest-posttest design was used. Forty first-year prelicensure BSN students participated in the intervention, which consisted of four weekly 15-minute BLS deliberate practice sessions. Sessions took place during regularly scheduled skills lab and followed a standardized psychomotor checklist based on American Heart Association (AHA) guidelines. Self-efficacy was measured using the General Self-Efficacy Scale (GSES), a 10-item validated instrument. Pre- and post-intervention scores were compared using a paired samples t-test.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eParticipants showed a statistically significant increase in GSES scores after the DP sessions. The mean pretest score was 24.7 (SD\u0026thinsp;=\u0026thinsp;3.63), and the mean posttest score was 37.2 (SD\u0026thinsp;=\u0026thinsp;2.58), with a mean difference of 12.5 points (p\u0026thinsp;\u0026lt;\u0026thinsp;.001). These findings indicate that DP positively impacted students' perceived self-efficacy in performing BLS skills.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis project supports previous literature showing that DP enhances skill performance and confidence. Bandura's self-efficacy theory suggests that repeated mastery experiences improve belief in one's capabilities. For novice nursing students, increased self-efficacy can reduce anxiety, improve clinical readiness, and support patient safety. The brief and targeted nature of the DP sessions makes them a practical addition to nursing skills labs.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThis study used a convenience sample from one institution and lacked a control group. The small sample size and non-random selection limit generalizability. However, the strong effect size suggests educational significance.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIncorporating short, structured BLS practice sessions into early nursing education may improve self-efficacy and skill retention. Nurse educators should consider adding DP to simulation and skills curricula as a way to enhance students\u0026apos; confidence in responding to emergencies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by the Institutional Review Board (IRB) of the American Sentinel College of Nursing \u0026amp; Health Sciences at Post University. Additional permission to conduct the study was granted by the Department of Nursing at the project site, a public university in Southern California. The study adhered to all institutional policies for the protection of human subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Consent Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants were informed of the nature, purpose, and voluntary nature of the study prior to enrollment. Written informed consent was obtained from each participant prior to data collection. To minimize potential coercion, a proxy\u0026mdash;who was not involved in course grading\u0026mdash;was used to obtain and manage consent, deliver instructions, and facilitate data collection. Participation had no impact on students\u0026rsquo; grades or course standing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191\u0026ndash;215. https://doi.org/10.1037/0033-295X.84.2.191\u003c/li\u003e\n \u003cli\u003eCheng, A., Nadkarni, V. M., Mancini, M. B., et al. (2018). Resuscitation education science: Educational strategies to improve outcomes from cardiac arrest. Circulation, 138(6), e82\u0026ndash;e122. https://doi.org/10.1161/CIR.0000000000000583\u003c/li\u003e\n \u003cli\u003eCurran, V. R., Fleet, L., \u0026amp; Greene, M. (2012). An exploratory study of factors influencing resuscitation skills retention and performance among health providers. Teaching and Learning in Medicine, 24(3), 196\u0026ndash;204. https://doi.org/10.1080/10401334.2012.692267\u003c/li\u003e\n \u003cli\u003eKnipe, G. A., Fox, S. D., \u0026amp; Donatello, R. A. (2020). Deliberate practice in simulation: Evaluation of repetitive code training on nursing students\u0026rsquo; BLS team skills. Clinical Simulation in Nursing, 48, 8\u0026ndash;14. https://doi.org/10.1016/j.ecns.2020.08.001\u003c/li\u003e\n \u003cli\u003eOermann, M. H., Kardong-Edgren, S. E., \u0026amp; Odom-Maryon, T. (2011). Effects of monthly practice on nursing students\u0026rsquo; CPR psychomotor skill performance. Resuscitation, 82(4), 447\u0026ndash;453. https://doi.org/10.1016/j.resuscitation.2010.11.022\u003c/li\u003e\n \u003cli\u003eSchwarzer, R., \u0026amp; Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, \u0026amp; M. Johnston (Eds.), Measures in health psychology: A user\u0026rsquo;s portfolio. Causal and control beliefs (pp. 35\u0026ndash;37). NFER-NELSON.\u003c/li\u003e\n \u003cli\u003eTsao, C. W., Aday, A. W., Almarzooq, Z. I., et al. (2022). Heart disease and stroke statistics\u0026mdash;2022 update: A report from the American Heart Association. Circulation, 145(8), e153\u0026ndash;e639. https://doi.org/10.1161/CIR.0000000000001052\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Paired Samples Statistics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003eTime Point\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003eMean\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003eStandard Deviation\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003ePre-Intervention\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e24.7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e3.63\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003ePost-Intervention\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e37.2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e2.58\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. This table shows the mean and standard deviation of GSES scores before and after the deliberate practice intervention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Paired Samples Test\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003eMean Difference\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003et-value\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003edf\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003ep-value\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e12.5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e19.8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e39\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\u0026lt; .001\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. This table provides the results of the paired samples t-test comparing pre- and post-intervention GSES scores.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"California State University San Bernardino","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Basic life support, deliberate practice, nursing students, self-efficacy, clinical readiness","lastPublishedDoi":"10.21203/rs.3.rs-6822936/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6822936/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study evaluated the effect of deliberate practice (DP) of basic life support (BLS) skills on the self-efficacy of first-year nursing students. Forty prelicensure BSN students participated in four weekly DP sessions during scheduled skills lab time. Each session consisted of 15 minutes of one-on-one, skills-based coaching using a psychomotor checklist. General Self-Efficacy Scale (GSES) scores were collected before and after the intervention. A paired samples t-test showed a significant increase in GSES scores following the practice sessions (p\u0026thinsp;\u0026lt;\u0026thinsp;.001), with a mean increase of 12.5 points. These results suggest that integrating brief, repeated practice opportunities into early nursing curriculum may improve students\u0026rsquo; confidence in performing critical life-saving skills. Deliberate practice is a low-cost, faculty-directed strategy that may help bridge the gap between BLS certification and clinical readiness.\u003c/p\u003e","manuscriptTitle":"Deliberate Practice of CPR Skills: A Strategy to Improve Nursing Student Confidence","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-10 05:29:15","doi":"10.21203/rs.3.rs-6822936/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"69a36905-741b-47e5-a3c2-2f99bf6737ad","owner":[],"postedDate":"June 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49544693,"name":"Nursing"}],"tags":[],"updatedAt":"2025-06-10T05:29:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-10 05:29:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6822936","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6822936","identity":"rs-6822936","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}