Abstract Body: Background:
Train the trainer models using lay teachers to empower educate students about cardiac arrest and cardiopulmonary resuscitation (CPR) has demonstrated effectiveness; however, the education necessary for teachers to become competent trainers is unclear.

Objective:
We sought to understand whether teachers with active CPR certification are more likely to demonstrate higher self-reported comfort teaching CPR, and higher aptitude on a cardiac arrest questionnaire, compared to teachers without active certification. We also wanted to understand whether self-reported comfort teaching CPR correlated with cardiac arrest aptitude.

Methods:
We collected primary data from 203 health and physical education teachers at a large public school district in the United States. The variables of interest included CPR certification in the past 2 years, self-reported comfort teaching CPR on a scale from 1 to 100 and test performance on a previously published cardiac arrest questionnaire.

Results:
203 teachers who interact with 64,524 students responded to the survey. 104 (51%) taught elementary school, 79 (39%) taught middle school, and 44 (21%) taught high school. 121 (59.6%) had active CPR certification. Teachers with up-to-date CPR certification were more likely to have higher self-reported comfort teaching CPR compared to those without active CPR certification (mean 65 vs 54 p=0.015). However, those with active CPR certification did not perform better on the cardiac arrest questionnaire (67.1% vs 60.7%, p=0.236). Also, interestingly there was only a weak correlation between self-reported comfort teaching CPR and test scores (r=0.08).

Conclusion:
Active CPR certification among teachers was associated with higher self-reported comfort teaching CPR. However, neither active CPR certification nor self-reported comfort teaching CPR translated to higher cardiac arrest aptitude. CPR in school train-the-trainer models, likely require specific curricula beyond certification to adequately equip teachers. Also, self-reported comfort does not reflect competence and may be a poor outcome for bystander CPR education research.