Insights from a multinational survey on ERC courses: a cross-sectional analysis of participant and instructor perspectives

Background: European Resuscitation Council (ERC) life support courses are delivered internationally to standardise resuscitation. Given advances in educational science, evolving learner needs, and rapid technological innovation, ongoing evaluation is required to ensure these courses continue to meet expectations. This study aimed to identify priorities for course delivery, teaching and assessment strategies, and to inform future course development. Methods: From May to June 2025, the ERC Course Strategy Taskforce conducted two web-based surveys among course participants and instructors (10 and 22 items, respectively). The surveys included single-response items, Likert-scale ratings, and open-text questions addressing teaching background, course delivery, assessment practices, and views on course structure and materials. Data were analysed using a mixed-methods approach, with descriptive statistics applied to quantitative data and inductive thematic analysis to qualitative responses. Results: Responses from 13,989 participants and 1923 unique instructors across all ERC course types were analysed. Participant satisfaction was high (mean 9.13/10); 92.8% reported increased confidence in real-life resuscitation, and 99.5% rated the on-site component positively. Instructors favoured continuous assessment for evaluating technical skills (95.2%), non-technical skills (92.5%), and professional attitudes (96.2%), with 87.1% supporting its combination with a summative endpoint. Pre-course multiple choice question testing (85.7%) and mandatory instructor preparation (90.8%) were widely endorsed. Qualitative findings highlighted the need to further develop the ERC Course System, expand specialised content, and enable more personalised delivery formats. Conclusion: ERC courses are highly valued and should evolve towards competency-based assessment, structured faculty development, and enhanced digital infrastructure to maintain relevance, inclusivity, and educational impact.