“I’d love to use online BLS certification, but my boss told me it is our policy not to allow online certifications. What am I supposed to do?”

Reports of certain hospitals preventing the use of online BLS courses for recertification may be causing confusion regarding the validity of accredited, blended BLS courses. While busy nurses and other healthcare professionals are being encouraged to find more efficient ways to complete their daily tasks, they are being prevented, or in some cases even suspended, for finding affordable and time saving ways to update their BLS. Even though online courses are promoted by organizations such as the American Heart Association [1], these online courses are still forbidden by many hospital policies.

In the past, the only way to certify or renew BLS certification was to attend a 4 or 8 hour classroom course with an instructor. Problems with classroom BLS certification are that the time between certifications is long and there is low retention of skills resulting from too much information in one sitting.

The BLS skill retention problem was first addressed around late 2005 with the introduction of self-paced online BLS courses. Video-based courses allow students to learn at their own speed and schedule, and at a time that is convenient for them. Additionally, online BLS courses such as those provided by ProTrainings offer students weekly refresher emails to keep their rescue skills fresh throughout the year. Despite these advantages, some CPR instructors, practitioners, and health care administrators hold to the belief that the only accredited and acceptable certification is one that is provided in a classroom format. A popular reason for this stance is the belief that online training is inherently not as effective as classroom training [2].

As an illustration of this viewpoint, one nursing schools’s website responds to the question, “What type of CPR certification is needed for the School of Nursing, where can we get certified, and when do we have to obtain the certification?” And the answer — “The Basic Life Support for HealthCare Providers Course covering the adult, infant, child, and two man CPR (Hospital Level Provider-2 year) is required. All BSN students must complete CPR classes prior to enrollment. Documentation (copy of CPR card) must be presented at orientation. Classes may be taken through the American Heart Association or the Red Cross. Online courses do not meet this requirement and cannot be accepted.” (utmb)

This type of response doesn’t look good for online BLS certification acceptance. However, as technology develops and online BLS training and certification become more convenient and more time efficient, I wonder whether those hospitals with classroom-only policies will eventually need to allow online certification to stay competitive. If the rate of technology keeps moving as swiftly as it has, I believe the answer is a resounding, “Yes.”

In the meantime, ProTrainings continues to work with progressive organizations that see the value in self-paced e-learning for their staff. And I continue look forward to the day when hospitals decide to trust their hard working nurses and healthcare practitioners enough to allow them the freedom to choose whom they use for their training and certification.



1 “The American Heart Association’s BLS for Healthcare Providers Online Part 1 Course, Web-based and accessible 24 hours a day, provides a flexible alternative to classroom training. Through case-based scenarios, interactive activities and videos, this course teaches the concepts of both single-rescuer and team basic life support.”


2 Numerous studies have been conducted to measure the effectiveness of CPR taught through video-based and e-learning methods versus classroom methods. Several such studies include:

Todd KH, Braslow A, Brennan RT, Lowery DW, Cox RJ, Lipscomb LE, Kellermann AL: Randomized, controlled trial of video self-instruction versus traditional CPR training. Ann Emerg Med March 1998;31:364-369.

Todd KH, Heron SL, Thompson M, Dennis R, O’Connor J, Kellermann AL: Simple CPR: A randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in an African American church congregation. Ann Emerg Med December 1999;34:730-737.

Lynch B, Einspruch EL, Nichol G, Becker LB, Aufderheide TP, Idris A: Effectiveness of a 30-min CPR self-instruction program for lay responders: a controlled randomized study. Resuscitation. 2005 Oct;67(1):31-43.

Reder S, Cummings P, Quan L: Comparison of three instructional methods for teaching cardiopulmonary resuscitation and use of an automatic external defibrillator to high school students. Resuscitation. 2006 Jun;69(3):443-53. Epub 2006 May 5.


  1. Rebeka Anderson

    I can’t believe that hospitals won’t allow online learning, I am a certified lifeguard and its hard for me to find a classroom setting course for lifeguard, I found a lot of classes online, but no classes in my area, so if there are no classes offered in my area, how am I suppose to get re certified if there only online courses available for me right now. I also got my rectification for CPR online because I couldn’t find a course in my area.

    1. pat w

      As an AHA BLS instructor, I can also add with great confidence MANY (if not most) hospitals require AHA certification only (NOT RED CROSS). We often have students come to us for certification AFTER having gone to a Red Cross class and having been told by their employers that they do not accept Red Cross certifications. Unfortunately, the student will pay them and then come to US for AHA training. Why? I have been unable to determine. But I can assure you that MANY (if not most) hospitals and other health-care facilities will only accept AHA BLS certification!


  2. Conor

    As an instructor for over 20 years one of the worst groups to teach CPR (BLS) to are medical persons that have to recertify BLS. They don’t want to be in a class. Online BLS seams like a great option for these individuals. Outlined in the article above are numerous studies showing good retention rates.

    Unfortunately, from my personal experience, I have noticed a decrease in hands on skills. While BLS and layperson CPR is about learning numbers and techniques it should primarily be about hands on skills. Unfortunately no online class can substitute for real life hands on.

    I have heard the statement ” I have been certified 10 years I know CPR”. Unfortunately looking at the level of perfornace in real cardiac arrest situations many do not know how to do hands on CPR.

    Blended BLS classes seem to be the answer but even then sometimes they have a problem. I have seen people at work open an online class and let the video run while they are on facebook or another site on another browser. How is this going to help educate someone to CPR.

    To conclude, online may be OK for recertifying persons if it is a blended course but never for first time people.

    While I applaud all those agencies that are providing methods to make learning less difficult you have to question whether going to online only classes is the answer for BLS. While I may accept it in some cases for recertifying medical professions, in no way should it be allowed for first time learners, medical or otherwise.

    1. Author

      Thank you for your thoughtful comment on the validity of online CPR being used as an effective training medium. I thought it would be a good idea to respond and dialogue about your thoughts and feelings regarding this change in the way people are becoming educated today. Like all training, if the material is presented in a way that is not interesting, is too long, does not engage the learner, is complicated, confusing or boring, then I too agree that the training may be of concern. When we look at the classroom as the primary means for learning a couple inherent problems come to mind.

      1. Is the student able to concentrate, participate, communicate and integrate the educational subject at hand?

      2. Is the information including proper number sequences, landmarks, bag-valve mask use, AED training, PPE and proper depth and pace going to be retained in an extended 2-4 hour course when we know that the average learner has approximately 10-15 minutes of attention span before they become distracted. Then consider the fact that this student may work in a field that does not experience real CPR scenarios often and it may be 2 years before they ever hear, practice or think about CPR and the proper skills required to increase survivability during cardiac arrest.

      I have written a full reply to this comment which can be found on ProCPRBlog.com under reply to comment about Online CPR validity.

  3. michele

    I really like the CPR training program on line. I have been a CPR instuctor for several years. The online course allows the students work at there own pace and allows them the freedom to review areas they are unclear on . I work for a health care facility who accepts the online training but requires a skills evaluation.

  4. Eileen S.

    I recertified in CPR through classroom presentations for 40 years. Your on-line course was superior in every way. The last skills evaluator I had had never actually done CPR on a live person who had a cardiac arrest.

  5. Rae

    What I don’t understand is why hospitals and nursing schools, at least around where I live (Tacoma, WA), will only accept AHA’s BLS and not Red Cross’s cert for healthcare providers. I’ve taken both courses and the ARC training seemed far superior to AHA’s. It makes me wonder if the hospitals get a kick back in some way by only taking the BLS. And if that’s the case, they certainly aren’t going to entertain independent organizations. The Red Cross training is far better than AHA’s.

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