The Value of Songs for Teaching and Learning Cardiopulmonary Resuscitation (CPR) Competencies: A Systematic Review

We sought to summarize, in a systematic review, the effectiveness of songs to support learning, performance, and recall of quality characteristics of cardiopulmonary resuscitation (CPR) compression rate, and depth. We systematically reviewed the literature from eight academic indexes from the fields of medicine, nursing, allied health, and education, from 2014 to 2020 to identify studies that evaluated an intervention of song use during CPR training against control and reported outcomes of compression rate and depth. There were 185 studies initially identified for review, eight met criteria for inclusion and analysis. For the critical outcome of compression depth, a pooled song group (n=446) when compared to a non-song group (n=443) demonstrated higher odds of being in the recommended range (OR 3.47). All studies, however, performed an average compression depth shallower than recommended guidelines in each arm. The available literature, we found, utilized heterogenous methodology and was at high risk of bias. When pooled, there were trends towards improved CPR metric performance in groups who were exposed to songs during treatment, though this only reached significance when groups were tested at >30 days from initial exposure. Findings of lower compression rates in the song groups suggest that song selection should favor beats per minute closer to the midpoint of the 100-120 ideal range to allow for variation when used as mental metronomes.