Strengthening Community Emergency Response: Effectiveness of Integrated Lecture–Simulation Training Among Lay Responders and Paramedics in Batu City

Abstract

Out-of-hospital cardiac arrest remains a major public health challenge with persistently low survival rates, particularly in where early emergency response capacity is limited. In Indonesia, insufficient community knowledge and practical skills continue to hinder effective pre-hospital management. Strengthening community-based emergency training is therefore essential to enhance early response and improve patient outcomes. This study employed a quasi-experimental two-group pretest–posttest design to evaluate the effectiveness of an emergency training programme conducted by the Batu City Health Department. A total 45 participants met the inclusion criteria, consisted of 30 trained-lay-responders from Indonesian Red Cross, regional disaster management, and fire service personnel, and 15 paramedics from primary healthcare centres. The two-day intervention integrated structured lectures, hands-on skill stations, and disaster simulation exercises. Data were analysed using paired and independent T-tests, with significance set at p<0.05. Overall knowledge scores improved significantly following the intervention (mean difference = 22.889; p<0.001), demonstrating a large effect size (Cohen’s d = −1.34). Despite baseline differences (p=0.004), both groups showed significant improvements. Paramedics achieved higher post-test scores than trained-lay-responders (p<0.001; Cohen’s d = −1.39). These findings indicate that integrated lecture–practice training effectively strengthens emergency knowledge across multidisciplinary responders and supports its implementation in regional capacity-building strategies.