The train the trainer model for the propagation of resuscitation knowledge in limited resource settings: A systematic review

Resuscitation. 2018 Jun;127:1-7. doi: 10.1016/j.resuscitation.2018.03.009. Epub 2018 Mar 12.


Background: The Train the Trainer (TTT) model is increasingly used in limited resource settings as a mechanism to disseminate resuscitation knowledge and skills among providers. Anecdotally, however, many resuscitation programs that use this model fail to achieve sustainability.

Objective: We aim to systematically review the literature to describe the evidence for the TTT method of knowledge dissemination for resuscitation courses in limited resource settings.

Methods: We conducted a systematic review of the literature in accordance with PRISMA guidelines of the PubMed, Cochrane Library, MEDLARS online (MEDLINE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.

Results: Eleven manuscripts met inclusion criteria, the majority (7/11) focused on neonatal resuscitation. We found strong evidence for the TTT model for imparting knowledge and skills on providers, however, little evidence exists for the impact of these programs on patient outcomes or long term sustainability. Facilitators associated with successful programming include the use of language and resource appropriate materials, support from the Ministry of Health of the country, and economic support for supplies and salaries.

Conclusion: While the TTT model of programming for the dissemination of resuscitation education is promising, further research is necessary especially relating to sustainability and impact on patient outcomes. Familiarity with the local environment, language, culture, resources and economic realities prior to the initiation of programming is key to success.

Keywords: Limited resource settings; Resuscitation education; Train the trainer model.

Publication types

  • Systematic Review

MeSH terms

  • Cardiopulmonary Resuscitation / education*
  • Developing Countries
  • Global Health
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Outcome Assessment, Health Care*