Development and Validation of First Aid Self-Efficacy Scale
Author(s):
Gülçin Gülmez-Dağ (presenting / submitting) Yeşim Çapa-Aydın
Conference:
ECER 2015
Format:
Paper

Session Information

09 SES 10 B, Developing and Validating Instruments for Teacher Assessments

Paper Session

Time:
2015-09-10
15:30-17:00
Room:
328. [Main]
Chair:
Ariane S. Willems

Contribution

Among all individuals, children are more prone to risks due to their curiosity, increased level of activity and lack of defence, self-protection, and awareness (Galal, 1999). Each year, every one of ten children is known to consult health care services as a result of accidents (Romer & Manciaux, 1991) and accidents constitute the leading causes of child death especially for school-age children (5-14 years) (Erkan & Goz, 2006).

Appropriately trained bystander response is known to be critical in cases of emergency (Anderson & Gaetz, 2008). Since there does not exist a health unit in a majority of schools, teacher intervention becomes inevitable in providing life supporting first aid to school-age children (Sahin, 2011). Research has consistently shown that trained individuals are more competent than untrained individuals (Abbas, Bukhari & Ahmad, 2011; Anderson & Gaetz, 2008; Bollig, Wahl & Svendsend, 2009) and offering first aid training to laypersons and children was found to be significantly efficient in producing sound first aid practices (Berkebile, Benson, Ersoz, Barnhill & Safar, 1975; Bircher & Safar, 1983; Fleischhackl et al., 2009). Currently in Turkey, first-aid education has a place in high school curriculum, and is also offered through courses constructed by Ministry of Health, public training centres, and driving schools (Sahin, 2011). On the other hand, an easy and manageable shortcut for reaching a considerable level of knowledge and awareness appears to embed this initiative into teacher education programs. This would ensure that all prospective teachers are informed by structured, organized, and informative training, which, in the future, would govern their students and others in need.

At another end, measuring self-efficacy beliefs yields information about how capable persons believe themselves to produce certain behaviours (Bandura, 1997) such as lending first aid assistance in emergency cases. Self-efficacy beliefs are particularly significant since “most courses of action are initially shaped in thought” (Bandura, 1993, p. 118) and they are predictive of the nature of action taken, the amount of effort put in given tasks, the outcomes produced by these efforts, and resilience to difficulties (Bandura, 2000). If persons believe they do not have the capability to produce certain ends, they even do not attempt at trying to make them happen (Bandura, 1997). Low self-efficacy is expected to hinder the application of first aid knowledge even if the person is knowledgeable and skilful (Maibach, Scheiber, & Carroll, 1996).

It can be inferred from the evidenced literature that the prospective teachers’ thoughts about their capabilities carry important hints for their future course of action in given emergency settings and determine their success in their efforts to save lives. Empirically speaking, there is only one study that investigated first aid self-efficacy, however, it concentrated on parental self-efficacy for first aid (Wei et al., 2013). The research related to teachers rather heavily concentrated on their first aid knowledge levels (Li, Jiang, Xingming Jin, Qiu & Shen, 2012; Nayir et al., 2011; Slabe & Fink, 2013; Wiśniewski & Majewski, 2007). Except for Slabe and Fink (2013), these studies concluded that teachers lacked ample knowledge of first aid and indicated a need for sound educational foundation. It is clear that proper training can potentially contribute immediate medical response coming from the teachers (Kano, Siegel, & Bourque, 2005) and the study of first-aid self-efficacy is promising in identifying the beliefs and thus hints of performances of future teachers. 

Method

The data to the study came from pre-service teachers (n = 320) studying at a public university in Turkey. The exact half of the participants had no previous experience with first aid while the other half received some form of first aid education either through Traffic and First-Aid course offered at high school (47.1%), driving courses (40.1%), or elective courses (3.8%). The number of those who reported a lack of interest in receiving further first aid training was found quite considerable (n = 70). The First Aid Self-Efficacy Scale has been developed for assessing pre-service teachers’ beliefs in their first aid skills. First aid and basic life support (BLS) skills comprise of procedures including cardiopulmonary resuscitation (CPR), positioning for shock and unconsciousness, stabilization of wounds and injuries, and controlling bleeding (Eisenburger & Safar, 1999; Segen, 2012). As proposed by the European first aid guidelines (Van de Velde et al., 2007), first aid additionally includes skills as ensuring personal safety and the safety of both the casualty and the bystanders, comforting the casualty, communicating with potential help-providers, and being careful about infection risks. Based on the accumulated literature on first aid, an initial pool on five domains: (1) approach to casualty, (2) examination of the casualty, (3) treatment, (4) psychological support, and (5) hygiene was formed. Since self-efficacy beliefs are measured on 9-point scales (Bandura, 1997), participants were expected to rate each item on a scale from 1 to 9, 1 standing for incompetent and 9 referring to quite competent; higher rating indicates higher first aid self-efficacy. To validate the content, scholarly opinion was requested from a first-aid expert. In the light of feedback received, some of the items were altered in terms of clarity and content, extra items were added, and some were dismissed either because the language was not clear enough or it did not reflect the scope of the content. The scale was further enhanced through the use of two cognitive interviews; no major changes about the scale were indicated by the interviewees. A final number of 26 items were obtained after these scale finalization procedures. Example items can be found below: “I can cooperate with bystanders in order to maintain the order of the accident scene.” “I can implement cardiopulmonary resuscitation when the casualty has no heartbeat.” “I can help relieve the anxiety of the casualty.” “I can take necessary precautions to reduce the risk of infections.”

Expected Outcomes

Participants’ ratings showed that they had lowest self-efficacy for implementing CPR, making an age-appropriate distinction for first-aid intervention and for dealing with broken bones and burns, etc. On the other hand, they felt relatively efficacious in describing the case upon calling the emergency phone number, protecting the casualty from heat or cold, and cooperating with bystanders to maintain the order of the accident scene. This finding indicated that there is a need for educating pre-service teachers for more challenging first aid skills than skills that are less complex. The results of the exploratory factor analysis showed that the FASES was composed of two dimensions: self-efficacy for first aid and basic life support skills and self-efficacy for elementary skills for first aid. The two-factor structure explained almost 60% of variance, a substantially sufficient percentage for social sciences. A reliability of .96 and .90 was found for each factor respectively and these coefficients indicated that the FASES was a reliable instrument to measure first aid self-efficacy beliefs. Additionally, the scale successfully differentiated between people with experience and those with no experience, which is consistent with Bandura’s stance that, persons with more experience hold higher self-efficacy. Yet, those with previous first aid experience also differed among the types of encounter; individuals who volunteered to receive special training, which indicates a positive attitude towards the knowledge of first aid, reported stronger beliefs than those who received first aid as a must course or as part of the driving course. This indicates the significance of promoting the interest towards first aid and also a need for the improvement of must and driving courses. The scale also differentiated between genders; males reporting higher first aid self-efficacy, in line with the findings of Wei et al. (2013) and Lee and Chen (2009).

References

Wei, Y. L., Chen, L. L., Li, T. C., Ma, W. F., Peng, N. H., & Huang, L. C. (2013). Self-efficacy of first aid for home accidents among parents with 0- to 4-year-old children at a metropolitan community health center in Taiwan. Accident Analysis and Prevention, 52, 182-187. Wiśniewski J., & Majewski W. D. (2007). Assessment of knowledge about first aid among the teachers of chosen high schools in the Western Pomerania region [Abstract]. Annales Academiae Medicae Steninentis, 53(3), 114-123. Slabe, D., & Fink, R. (2013). Kindergarten teachers’ and their assistants’ knowledge of first aid in Slovenian kindergartens. Health Education Journal, 72(4), 398-407. Kano, M., Siegel, J. M., & Bourque, L. B. (2005). First-aid training and capabilities of the lay public: A potential alternative source of emergency medical assistance following a natural disaster. Disasters, 29(1), 58−74. Lee, C. S., & Chen, C. Y. (2009). A study of the junior high school students’ knowledge, attitude, self-efficacy, and behavioural intention toward first aid in Keelung City, Taiwan [Abstract]. Chinese Journal of School Health, 54, 69-89. Li, F., Jiang, F., Jin, X., Qiu, Y., & Shen, X. (2012). Pediatric first aid knowledge and attitudes among staff in the preschools of Shanghai, China. BMC Pediatrics, 12, 121. Maibach, E. W., Schieber R. A., & Caroll, M. F. (1996). Self-efficacy in pediatric resuscitation: Implications for education and performance. Pediatrics, 97(1), 94-99. Eisenburger, P., & Safar, P. (1999). Life supporting first aid training of the public: Review and recommendations. Resuscitation, 41, 3-18. Berkebile, P., Benson, D., Ersoz, C., Barnhill, B., & Safar, P. (1975). Public education in heart-lung resuscitation. Evaluation of three self-training methods in teenagers. In Proceedings of the National Conference on Standards for Cardiopulmonary Resuscitation and Emergency Cardiac Care. Dallas: American Heart Association. Anderson, G., & Gaetz, M. (2008). CPR and first aid skill retention. Retrieved from http://www.worksafebc.com/contact_us/research/funding_decisions/assets/pdf/2006/rs2006_ig06.pdf Abbas, A., Bukhari, S. I., & Ahmad, F. (2011). Knowledge of first aid and basic life support amongst medical students: A comparison between trained and un-trained students. Journal of Pakistan Medical Association, 61(6), 613-616. Bandura, A. (1993). Perceived self-efficacy in cognitive development and functioning. Educational Psychologist, 28(2), 117-148. Erkan, M., & Goz, F. (2006). Öğretmenlerin ilk yardım konusundaki bilgi düzeylerinin belirlenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 9(4), 63-68.

Author Information

Gülçin Gülmez-Dağ (presenting / submitting)
Middle East Technical University
Educational Sciences
Ankara
Middle East Technical University, Turkey

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