Literature Review
Students spend a considerable part of their time in school settings, which puts a large share of responsibility on schools in general and teachers in particular. Because school students are under their educators’ guidance during the school day, the latter have to be aware of the possible health-related risks and the ways of managing them. However, the current situation in this respect cannot be described as satisfactory.
In the majority of countries, there are no specialized training courses for students that would allow mitigating risks of emergency events that occur when they are at school. Meanwhile, the rapid growth of technology and weapons serve as additional risks to learners’ health at every point of their day (Al-Hashem, 2016). This creates the need for schools to adopt measures of preventing health-related issues within their environment by incorporating first-aid education as a mandatory class.
Ideally, the responsibility of any learning institution is to educate students and ensure that they create a safe environment in order to make this possible. This involves making learners understand the importance of managing or mitigating health risks, especially in school settings, where students are most injury-prone. As such, there is a need for schools to come up with ways of minimizing health-related problems. In Saudi Arabia, much attention is paid to the development of health education and first-aid care. The increase in activities was initially observed during the 1990s due to the creation of specific prevention and control programs (Al-Hashem, 2016).
However, this dimension of health-related educational programs is focused on students as opposed to school teachers. While the consideration of health studies in the country has elicited sufficient interest on the part of the government, the focus on schools and participants of the study process has not garnered a similar level of concern.
Moreover, like any other part of the world, students spend a lot of time in school settings, which makes it essential to take precautionary measures to prevent any potential health-related issues. As such, first-aid care is imperative for school settings. Unfortunately, as research indicates, the majority of school teachers cannot cope with underlying health issues despite being capable of identifying significant health-related problems among school children (Qureshi, Khalid, Nigah-e-Mumtaz, Assad, & Noreen, 2018).
At the same time, inadequate safety regulations lead to teachers’ inability to help students and provide them with the requisite knowledge about precautionary and preventive health-related measures. Hence, it is highly important to resolve this issue and provide suitable conditions for teachers to obtain knowledge on first aid besides sharing it with their students.
However, schools must understand the importance of health education in order to incorporate it into schools. According to research, there is limited focus on the lack of first aid education in the curriculum of Saudi Arabian schools. On the other hand, stomachache, dental health issues, asthma attacks, and menses are the most frequent health-related problems observed among students in Saudi Arabia (Farsi, Farghaly, & Farsi, 2004).
Teachers need to be ready to assist young people in unpredictable cases while preparing them to deal with similar problems alone, but to begin with, their perspectives about incorporating first-aid education in classrooms are necessary to understand how effective its implementation will be in schools. Therefore, this paper explores the perspectives of high school teachers on adding first-aid education as a mandatory class, with a focus on Saudi Arabian Schools.
Theoretical Framework
To improve the system of education in Saudi Arabian schools in terms of first aid education, there is a need to make changes in the current state of affairs. A planned organizational change is required to recognize the significance of first aid knowledge for both teachers and students by utilizing available resources and opportunities. There are many ways of understanding organizational change, and the model developed by Kurt Lewin is one of the most commonly used options for managers and administrators alike (Burke, 2018). It is notable that the chosen theory of organizational change is known to impart specific benefits such as simplicity (three steps to be taken), context (interactions and performance), and the absence of time limits (authors are responsible for meeting a deadline).
According to Lewin’s theory of change, three steps are significant and merit attention: unfreezing, moving, and refreezing. During the first stage, dissatisfaction with current conditions is expressed, and internal performance is evaluated to reinforce the urgency of change as well as its direction (Batras, Duff, & Smith, 2016). Burke (2018) posited that this period is characterized by a variety of steps and ideas, including imparting education for teachers, student activities, or participation in discussions. Unfreezing is particularly crucial for the teachers’ training process. Before first-aid instruction is implemented in schools, knowledge, and skills must be imparted to teachers that they will then pass down to the students.
Subsequently, the step of moving occurs to implement necessary practices, define new responsibilities, and approve training courses. However, this stage cannot commence until the completion of the previous steps, and the attainment of all the goals. As soon as a movement is successfully applied in a facility, a new task needs to be performed. Finally, a refreezing phase signals the establishment of new organizational norms, practices, and policies to support the appropriateness of change (Batras et al., 2016). A unique and changed condition occurs with specific processes and reinforces being explained and approved. Opinions should be gathered and analyzed to ascertain that the chosen direction is correct.
In general, perspectives of high school teachers on first aid education in Saudi Arabian schools have not been fully explored with regard to the implementation of first-aid training in schools. These perceptions are important for the purpose of improving students’ knowledge and readiness in order to prevent and control illnesses associated with menstruation, asthma, or epilepsy, teachers enhance their self-awareness. The Saudi Arabian system of education, in conjunction with health care and medicine, continue developing, and this project marks one of these attempts to contribute to the chosen fields and their national success.
Illnesses Among Students
The promotion of a safe environment at schools is one of the significant priorities of teachers, administrative workers, as well as principals. However, despite sincere intentions to protect children and offer them the best conditions for education, unintentional health-related issues cannot be ruled out as, paving the way for unpredictable emergencies (Elewa & Saad, 2017). According to Mohammed (2018), childhood is a period when students are extremely vulnerable to various illnesses, and thus, they need to be prepared to offer or accept first aid care. Furthermore, the researcher notes that many of the health-related issues occur during childhood, especially during their schooling years (Mohammed, 2018).
Whereas academic studies have illuminated these facts, no sufficient resolutions of the problem are in sight due to the lack of systematic support from the learning institutions (Mohammed, 2018). Hence, knowing about the potential risks to student health is a decisive factor, but it needs to be further promoted by instructing teachers on the ways of mitigating such issues.
Correspondingly, the investigation of Foran et al. (2019) elucidated the worth of teachers’ participation in and reflection on various practices. For example, imparting training or educating the students not only helps prepare them for health-related issues but also provides them with an opportunity to avoid them. Inexorably, the lack of knowledge about the basic principles of primary care frequently makes students vulnerable to health-related risks. Therefore, a brief examination of such health conditions along with menses, asthma, and stomachaches, dental health issues should help identify the importance of student well-being and the promotion of a healthy learning environment.
Asthma
Asthma is one of the common illnesses plaguing the lives of millions of people around the globe (Marks, Pearce, Strachan, Asher, & Ellwood, 2018). It refers to a respiratory illness that causes the swelling and inflammation of an individual’s airways, leading to difficulties in breathing (Jayaram et al., 2006). Research undertaken by Alotaibi (2015) has introduced a sufficient opportunity to understand the role of asthma education, control, and self-management from an international perspective. Asthma is a common phenomenon among students (Alotaibi, 2015). Most schools or learning institutions lack proper mechanisms to help students manage this respiratory illness.
In Saudi Arabia, the government supports the development of new initiatives for asthma control in order to ensure that schools as well as other public facilities have access to helpful guidelines and can manage asthmatic cases in either adults or female adolescents (Alotaibi, 2015). However, the duration and quality of first aid for asthmatic patients assume significance, and it is imperative for schools to provide students with the basic knowledge of necessary procedures. In this regard, understanding how teachers perceive the incorporation of first-aid education in schools will help advance the understanding of the effectiveness of its implementation in schools to help students with asthma.
Epilepsy
The World Health Organization (WHO) has been tackling the challenge posed by epilepsy for a long time. According to Reilly et al. (2014), epilepsy is prevalent among school children. Although the prevalence of this condition in Saudi Arabia is not as high as compared to other countries, Al-Harbi, Alsaid, and Parameaswari (2018) made suggestions to improve current practices toward students with epilepsy, thereby supporting the idea of introducing first aid education for this disorder to schools’ curriculums. Epilepsy not only influences the work of the brain and heart but may also adversely impact the quality of life in a short period. For this reason, first aid education in schools must be prioritized so that students, as well as teachers, can be prepared for related health issues and prevent complications.
Menstrual health
Many girls remain unaware of the signs of menstruation and the steps that need to be undertaken and only learn about menstruation when they reach puberty (United Nations Population Fund, 2019). In this regard, Karout (2016) recommended increasing awareness and offering accurate information about the changes taking place in the female reproductive system at both schools and colleges in terms of physiology, psychological changes, and other aspects of reproductive health. Studies reveal that, as soon as young women get access to data about menstrual health, they are likely to be able to predict psychological traumas, inconvenience, and fears (Mohamed et al., 2018).
Menstruation education can lead to such positive outcomes, as wrong beliefs and the lack of awareness regarding menstrual health can lead to psychological burdens individuals may experience. The reason for it is that, without appropriate education, female adolescents may not understand the causes of menstruation and the ways of managing it, as well as be highly affected by stigma (Mohamed et al., 2018).
Summary
Most learning institutions have not developed mechanisms to deal with the above-mentioned health issues impacting adolescents effectively. They affect students psychologically by hindering their learning process. However, educating them on the myriad health issues that may potentially occur may help in managing them better. Therefore, it is essential to understand how teachers feel about incorporating first-aid education in schools to ascertain whether its implementation will be sufficient.
Importance of Student Physical Well-Being
Essentially, students’ well-being remains a priority for many schools, regardless of their specifications and populations. Health care education is paramount for athletes, people with disabilities, and even ordinary people. However, particular prominence is given to this aspect concerning schools and the two major participants of the educational process: students and teachers. In this regard, Schneider, Meeteer, Nolan, and Campbell (2017) underlined the importance of the implementation of emergency and administrative procedures to prepare students and teachers for sudden health problems, complications, and deaths. It is relevant to consider these authors’ views because of their credentials as clinical education coordinators, and assistant professors, and professors with Ph.D. Scholars in the past have explained the value of better/increased legislation and qualified medical personnel (Schneider et al., 2017).
However, they have been unable to predict the outcomes in case the information about emergency or administrative procedures is missing in the program. Therefore, new methods and policies are required to promote positive health outcomes, along with a high level of knowledge.
First aid is critical in any public organization, and people would do well to understand what they can do to help a person and pinpoint the activities that must be avoided so as to avoid causing new problems. Louw and de Villiers (2015) refer to first aid courses as a period when learners gain knowledge about the most common conditions that require emergency, develop necessary medical skills, and then share their experiences with other people.
It is essential to consider the findings of this study since both authors hold a Ph.D. degree and have acquired much experience in the field of research. It is noteworthy that the health-related problems incurred during the childhood period may cause severe lifelong problems or even lead to death, thereby necessitating great attention (Mohammed, 2018). In this context, first aid represents an opportunity for children to avoid such adverse outcomes and allows teachers to make significant contributions toward the improvement of students’ well-being.
It is also notable that the well-being of students is vital, which means that health education measures should be implemented in all schools. Al-The study by Hashem (2016) supports the significance of health education and notes that it should be an obligatory part of modern curriculums in terms of which learners and teachers discuss objectives, skills, and available resources. The author works as an assistant professor of health education at the College of Health and Rehabilitation Sciences at Princess Nora Bint Abdulrahman University. Thus, her contribution to the topic of research should be considered highly relevant and useful.
However, first-aid education may not be a primary goal of health education. The physical wellness of students is contingent upon the quality of knowledge related to preventive measures to support health, the safety of the environment, as well as the awareness of teachers of first-aid techniques (Foran et al., 2019). Health-related knowledge is vital, as it can help individuals to avoid unhealthy practices, such as tobacco use, and engage in healthy ones, such as physical activities.
Mere identification of illnesses does not suffice, and the identification of the environment and participants’ roles can no longer be ignored. In this regard, incorporating first-aid education as part of health education in schools will help students understand how to manage their health issues to prevent any possible health-related issues within the school environment. To achieve this, health education must focus on the safety of the learning environment, with an emphasis on first aid education.
Safety of the Learning Environment
Teachers often do not have the expertise to provide their students with effective primary care. This means that they may not possess the knowledge and skills to be able to offer first-aid. Moreover, a poorly developed environment is one reason for the teachers’ inability to provide first aid to students. According to research performed by the Ph.D. and associate professor Hırça (2012), the lack of safety in schools and classrooms does not allow teachers to address the first aid needs of students.
There are several possible reasons for such an insufficient level of safety. Firstly, the increased number of technological and human-made hazards is likely to affect present-day schoolchildren. Secondly, there is no systematic support for schools to focus on health education, particularly first-aid training, thereby making it difficult for teachers to impart these skills to students effectively. Thus, safety in schools has become a significant concern in Saudi Arabia.
Thirdly, the quality of knowledge possessed by teachers is not always as high as it should be. To that end, Hırça (2012) opined that even if teachers can obtain some theoretical knowledge and learn about different case studies, they do not demonstrate high-quality, practical skills. Therefore, it is necessary to explicitly discuss the duties of teachers and expectations of students while simultaneously identifying the signs of a safe learning environment.
Meanwhile, sustainable training, which is focused on deliverables and solutions recognized to be up-to-date, is known to impart positive outcomes for students because they are taught how to cooperate and regularly apply their knowledge on a practical level (Zinckernagel et al., 2016).
According to Schneider et al. (2017), funding is another vital contribution made to the safe learning environment because it represents a reasonable possibility of hiring professional staff, identifying additional resources, and discovering new ways of teaching. Finally, health problems may vary in children and adult students alike, and the awareness of students does not always suffice. The environment needs to be safe not only in terms of health and control of illnesses, but also with regard to the available materials, teachers’ skills, and knowledge, as well as students’ abilities and intentions.
First-Aid Knowledge and Skills
There are many reasons why it is essential to develop the necessary skills of first aid knowledge in both teachers and students. Currently, many teachers acknowledge the complexity of first-aid education (Berden et al., as cited in Foran et al., 2019). In this regard, Schneider et al. (2017) described the in-depth knowledge of coaches and teachers about first-aid practice. Finally, the research undertaken by Lown and de Villiers (2015) proved that students are eager to develop their practice skills concerning the management of health-related issues.
The existing statistical data explain the choice of such geographical location that 6 out of every 1000 people of Saudi Arabian schools have epilepsy and need additional first aid knowledge (Al-Harbi et al., 2018; Alotaibi, 2015). Girls at the age of puberty also need extra help and elucidations on how to cope with changes related to menstruation; for that purpose, specialized courses within their curriculums are viewed as a helpful idea (Karout, 2016). Therefore, it is essential to understand how teachers feel about incorporating first-aid education in schools to facilitate its implementation process.
Perspectives of high school teachers on adding first-aid education to classroom activities have not been extensively explored. Firstly, several benefits are imparted for children equipped with new knowledge related to the prevention of further health problems (Elewa & Saad, 2017). Secondly, several successful attempts have been made to implement first aid practices and improve the level of knowledge among students in Saudi Arabia (Mohammed, 2018).
Finally, first-aid knowledge varies, including the social aspects of medicine and psychological reactions, whereas teachers help students define their priorities and succeed in dealing with health-related issues (Louw & de Villiers, 2015). The development of such knowledge and skills is paramount for students and teachers as critical members of society as well as potential contributors to the fields of medicine and health care.
First-Aid Curriculum Guidelines
After underlining the importance of first aid education and explaining the required skills and knowledge to be developed, it is necessary to explore curriculum guidelines. In many modern schools, there are no clear guidelines for common health-related issues in students as well as adults (Zinckernagel et al., 2016). Instructions are necessary as they introduce a definite plan of action and hints for users. As a result, people can learn how to recognize a health problem, discover the most effective decisions, share information with healthcare experts, and support a person in need till the time professional help is offered.
The example of Danish secondary schools revealed that principals prefer to address external experts for help rather than training local teachers (Zinckernagel et al., 2016). The reason for it was that schools’ authorities believed that extraordinary skills were crucial to conduct effective healthcare training because first-aid-related measures were considered substantially different from other teaching subjects. Zinckernagel et al. (2016) added that the problem was potentially associated with the lack of schools’ authorities’ confidence in their own first-aid skills.
Meanwhile, Norwegian public schools develop their curriculums and hire trained teachers who explain how to perform simple first aid, water rescue, life-saving procedures, and assistance for sports injuries (Bakke, Bakke, & Schwebs, 2017). As a result, 90% of teachers Bakke et al. (2017) polled had taken a first-aid course at some point in their lives; more than 45% of them have undergone courses as a part of their teacher training. It means that, generally, Norwegian educators have a high level of first-aid skills.
Another example is the guidelines in Canada that are created to prevent injuries, control outdoor pursuits, and stipulate first aid training about students’ needs (Foran et al., 2019). Notably, the guidelines are designed to address remote first aid needs for school grounds that are located 30 or more minutes away from emergency medical services. The primary domains that guide Canadian regulations regarding first aid are prevention and preparation; thus, all of the measures are focused on analyzing potential emergency cases and risk assessment (Foran et al., 2019). The international illustrations presented in this section reveal a diverse range of guidelines to be implemented in curriculums for first aid.
Many approaches to introduce first aid techniques exist in schools at an international level. However, there are no clear examples of how to implement these guidelines in the Saudi Arabian context without disrupting the already-existing curriculums. Such access to materials may help tackle one of the major problems in modern schools where teachers have an understanding of theoretical basics but fail to implement them in practice (Hırça, 2012; Qureshi et al., 2018). For instance, available background, excellent examples, and credible resources are all known to contribute to the development of new courses in the Saudi Arabian context. Thus, incorporating first-aid education in schools may improve with the availability of resources and information.
The Rationale
The justification of the project’s implementation is associated with the fact that first aid knowledge and skills among school teachers/students are too low to be deemed satisfactory. According to extant research, the majority of school teachers lack awareness on how to give first aid when confronted with the need for it (Al Gharsan & Alarfaj, 2019). Meanwhile, Saudi Arabian schools are also jeopardized by natural and human-made disasters on a daily basis (Youssef et al., 2016).
They include earthquakes, river floods, water scarcity, and terrorist attacks. When a student suffers from an injury or natural cataclysms, it is imperative for the teacher or peers to offer first aid immediately in order to control the situation until the ambulance arrives. However, currently, the studies analyzed above show that the level of first aid knowledge among the target population is rather low (Al Gharsan & Alarfaj, 2019). Thus, it is crucial to address students’ needs in this regard by adopting the following approaches. A mandatory first aid course will be useful for students because they will learn how to give first aid and behave in emergency situations.
Gaps in Literature
The first focal aspect of the research is the ways of implementing necessary changes in the curriculum. The existing literature does not cover this aspect in detail, as incorporating first aid classes as a mandatory component of the school curriculum has not been explored by many researchers. While some investigations have been conducted on the problem of altering curriculum, including the works by Mbarushimana and Allida (2017) and Alsubaie (2016), no studies have analyzed the addition of this particular subject. For the researchers, it is important to ascertain the experience of several schools as an example to make viable conclusions about changes taking place at the national level. Therefore, it is essential to focus on how teachers perceive the program to understand whether it will be effectively implemented in schools.
Another possible gap in the existing literature is that there is a lack of evidence on first-aid curriculum guidelines in Saudi Arabia. The amount of information available on the issue in other countries, such as Canada, Denmark, and Norway, seems significantly larger than the data that can be found for Saudi Arabian schools. This problem reveals that, in Saudi Arabia, first aid education and regulations may remain a secondary concern, which is an acute issue considering the country’s exposure to potential hazards (Youssef et al., 2016).
Conclusion
The above literature review adequately reinforces the fact that the problem of insufficient knowledge of students about first aid techniques exists in Saudi Arabia as well as worldwide. In some countries, the government and specific organizations have already developed curriculums and courses to support the idea of new knowledge for students (Bakke et al., 2017; Zinckernagel et al., 2016). Evidence of inadequate education and practical skills among teachers has been provided by Hırça (2012). Different topics about the importance of first aid for populations, including menstruation health, asthma support, or epilepsy cases, have been raised by Saudi Arabian and other researchers (Al-Harbi et al., 2018; Alotaibi, 2015; Karout, 2016).
However, no specific attention was paid to unite Saudi Arabian schools, first aid education, and teachers’ perspectives within one study, which denotes a significant gap. However, the kingdom can take inspiration from Canada, which has witnessed the promotion of first aid education for outdoor athletes due to the increased interest of existing teachers on this issue (Foran et al., 2019). Saudi Arabian teachers demonstrate other priorities and social aspects to determine the content of education. The defined gap raises a new question that needs to be answered in order to successfully implement first aid training courses into current Saudi Arabia curriculums.
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