Knowledge, attitudes, and practices toward basic first aid skills among university students in China: a cross-sectional study

BACKGROUND: Basic first aid skills are essential for saving lives and reducing preventable injuries in daily emergencies. University students represent a key population who may frequently encounter emergencies. This study aimed to investigate the knowledge, attitude, and practice (KAP) of basic first aid skills among university students. METHODS: A web-based cross-sectional survey was conducted from October to December 2023 among students from four universities in China using convenience sampling. A self-designed questionnaire was used to assess knowledge, attitudes, and practices related to basic first aid skills, and it showed good reliability and validity in the pre-test. A total of 518 valid responses were collected. Descriptive statistics, t-tests, and one-way ANOVA were used to examine differences in KAP scores among demographic groups, and structural equation modeling (SEM) was applied to explore the relationships among KAP dimensions and demographic factors. Given its cross-sectional nature, the study could only provide associations rather than causal relationships. RESULTS: We analyzed 518 students (mean age 19.96 years; 51.2% male). Of all participants, 69.5% had received first aid training, and 22.8% were majoring in healthcare-related fields. Mean KAP scores were 18.59 ± 4.57 (knowledge), 31.72 ± 3.81 (attitude), and 14.53 ± 1.78 (practice). Female students showed significantly higher knowledge (p = 0.003) and attitude scores (p < 0.001), while healthcare-related majors had higher practice scores (p = 0.023). Knowledge and attitude were positively associated with practice. SEM indicated that knowledge positively influenced both attitude and practice, and that attitude further promoted practice. Prior training and female sex were linked to higher knowledge, while training showed a small negative direct effect on practice. CONCLUSIONS: The study found that most university students lacked sufficient first aid knowledge, although their attitudes were generally positive and their practical skills were moderate. These results suggest a need for universities to offer regular, practical training sessions and to include basic first aid as part of general education or extracurricular courses to improve students’ response ability in real emergencies. This study provides practical evidence that can support the development of targeted first aid training programs and inform educational policies aimed at improving students’ emergency response capabilities.