From Able to Help to Taking Action: Mechanisms and Educational Pathways Through Which First Aid Education Fosters Social Responsibility Among University Students

Abstract

First aid education in universities is both an important component of public-health capacity building and a preparation for the basic social responsibilities that students may assume in public life. Existing research has focused primarily on knowledge and skill training in cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and trauma care. Yet learning first aid does not necessarily mean that students will feel confident, be willing, or be able to take appropriate action in real emergencies. Drawing on a conceptual analysis and integrative narrative review, this article synthesizes evidence on first aid training outcomes, university students’ willingness to perform bystander CPR, self-efficacy, the theory of planned behavior, the bystander effect, and norm activation. It proposes a four-stage model: Able to Help–Confident to Help–Willing to Help–Taking Action. In this model, first aid knowledge and procedural skills provide the capability base for being able to help; repeated practice, mastery experiences, and scenario simulation strengthen first aid self-efficacy and create confidence to help; behavioral attitudes, subjective norms, legal and risk perceptions, empathy, and personal responsibility shape willingness to help; and actual socially responsible action requires students to recognize an emergency, accept a role, select an appropriate response, and coordinate with others in real or high-fidelity scenarios. Based on this model, a six-stage educational pathway is proposed: knowledge learning, skills training, scenario simulation, responsibility and ethics discussion, reflective learning, and public practice. A four-dimensional evaluation framework covering knowledge, skills, psychological readiness, and socially responsible behavior is also developed. The article argues that university first aid education should neither end with a one-time skill examination nor reduce social responsibility to an abstract moral slogan. Instead, students should be supported through continuous, contextualized, and observable learning processes that enable them to transform first aid capability into appropriate public action while respecting personal safety, competence boundaries, and professional standards. Conceptually, the article contributes by integrating social cognitive theory, the theory of planned behavior, bystander-intervention research, and norm activation into a stage-specific framework that distinguishes capability, self-efficacy, intention, and observable action rather than treating first aid training as a single direct route to social responsibility.