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SYNOPSIS FOR REGISTRATION

OF SUBJECT FOR DISSERTATION

SUBMITTED BY:

Mr. SHYAMRAJ V.
I M.Sc. NURSING

MEDICAL SURGICAL NURSING


(2011-2013 BATCH)

FORTIS INSTITUTE OF NURSING


#20/5, YELACHENAHALLI, KANAKAPURA ROAD
BANGALORE-560078
SYNOPSIS FOR REGISTRATION OF SUBJECT FOR
DISSERTATION

1. NAME OF THE Mr. SHYAMRAJ V.


CANDIDATE AND M.Sc. NURSING 1ST YEAR,
ADDRESS FORTIS INSTITUTE OF
NURSING,
#20/5, YELACHENAHALLI,
KANAKAPURA MAIN ROAD,
BANGALORE – 560 078.
2. NAME OF THE FORTIS INSTITUTE OF
INSTITUTION NURSING
3. COURSE OF THE MASTERS DEGREE IN
STUDY AND THE NURSING,
SUBJECT MEDICAL SURGICAL
NURSING
4. DATE OF ADMISSION 31ST MAY 2011.
TO COURSE

5. TITLE OF THE TOPIC “A STUDY TO ASSESS


THE EFFECTIVENESS OF
STRUCTURED TEACHING
PROGRAMME ON
KNOWLEDGE REGARDING
SELECTED FIRST AID
MEASURES AMONG SCHOOL
TEACHERS OF SELECTED
URBAN SCHOOLS IN
BANGALORE”.

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6.0 BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION
“Not using a skill regularly increases the likelihood of forgetting
and of losing confidence with ability.”

- Unknown Author
Injuries are very common now a day and can occur at any point of
time in our day to day life. Among them, injuries in school children rank
a major part. The most frequent causes of school related injuries requiring
hospitalization are falls and sports activities. Play ground equipment
related injuries occur on school play ground during school hours and
these require adequate supervision.1

First aid is the immediate care given to a person who has been
injured or suddenly fallen ill. It includes self-help and home care if
medical assistance is not available or is delayed. It also includes well-
selected words of encouragement, evidence of willingness to help, and
promotion of confidence by demonstration of competence.2

First aid is the immediate care given to victims of accidents before


trained medical workers arrive. Its goal is to stop and, if possible, reverse
harm. It involves rapid and simple measures such as clearing the air
passageway, applying pressure to bleeding wounds or dousing chemical
burns to eyes or skin. First aid personnel are persons on the spot,
generally workers who are familiar with the specific conditions of work,
and who might not be medically qualified but must be trained and
prepared to perform very specific tasks. Not every worker is suitable to
be trained for providing first aid. First aid personnel should be selected
carefully, taking into account attributes such as reliability, motivation and
the ability to cope with people in a crisis situation.3

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First aid training not only provides with knowledge and skill to
give life support and other emergency care but also helps you to develop
safety awareness and habits that promote safety at home, at work, during
recreation, and on the streets and highways. In the promotion of safety
awareness, it is important to closely relate three terms: cause, effect, and
prevention.2

The purpose of first aid is twofold: In cases where a person will


need help from a medical practitioner or nurse, to give treatment for the
purpose of preserving life and minimising the consequences of injury and
illness until such help is obtained and to treat minor injuries which would
otherwise receive no treatment or which do not need treatment by a
medical practitioner or nurse. It is on this basis that facilities and
arrangements for first aid should be provided in educational
establishments.4

Every school establishment shall have as a minimum one member


of staff who is a trained first aider and two emergency first aiders in the
work place. Head teachers and managers must ensure that a qualified first
aider is in attendance at all times, including foreseeable absences.
Additional trained staff may therefore be required to ensure that suitable
arrangements are in place to ensure that first aid of a sufficient standard
can be administered.4

The provision of first aid should always have a direct relationship


to general health and safety organization, because first aid itself will not
handle more than a small part of workers’ total care. First aid is a part of
the total health care for workers. In practice, its application will depend to
a large extent on persons present at the time of an accident, whether co-
workers or formally trained medical personnel. This immediate

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intervention must be followed by specialized medical care whenever
needed.3

First aid cannot be planned in isolation. It requires an organized


approach and co-operative effort. The training of first aid personnel is the
single most important factor determining the effectiveness of organized
first aid. Training programme will depend on the circumstances within
the enterprise, especially the type of work and the risks involved. First aid
boxes should always be easily accessible near areas where accidents
could occur. They should be able to be reached within one to two
minutes.3

6.1 NEED FOR THE STUDY


Our environment is full of accidents, emergency illnesses and other
health problems that have different level of severity and magnitude. The
problems can be generally classified into two. These are accidents
(deliberate and incidental) and emergency illnesses. The consequences of
these health problems could end up in physical disability and death.
However, the physical disability or death can be significantly reduced
and/or prevented by first-aid treatment using locally available materials.5

According to the National safety council’s report (1952), on the


location at which injuries occur, it was reported that 57% was school
related injuries occurred in the school building, school play ground or
while going or coming back from the school and only 43% were non-
school injuries and occurred either at home or in public places. Immediate
medical attention and early medical help is essential to reduce morbidity
and mortality associated with such trauma.6

Teachers in five primary schools were surveyed for their


knowledge and attitudes about epilepsy. An analysis of 113 teacher

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responses revealed knowledge deficits. Misconceptions regarding first aid
were also common. Few teachers had not attended any educational
programme on epilepsy. Only about one-fifth of the teachers were
confident in dealing with an epileptic child.7

Most of the accidents requiring first aid in a school situation are


minor and subsequently are not brought to the attention of a medical
professional. Even the most incidental injury should command the
teachers attention and first aid care. The procedures involved in the first
aid cannot be acquired completely from a text book alone and it must be
practised over a period of time until the first aider can perform the
procedure correctly. First aid courses provide opportunities to practice,
acquire proper skills in procedures and to complete first aid for
emergencies. Hence each teacher should be trained to render first aid
care, so that when any emergencies arrive he or she will be competent in
their ability to deal with the situation.6

WHO technical report series (1999) showed that schools had the
potential to provide an excellent base for large scale programming and
there is a need to strengthen the school as a setting for health intervention.
Schools can provide many services to young people, in addition to formal
education, such as health education, skill development in the areas such
as life saving skills. A school is an appropriate setting for the introduction
of teaching and training on life saving first aid skills and is often
economically efficient and there are possibilities for short term and long
term evaluation.8

In response to the Health and Safety (First Aid) Regulations 1981,


guidance from the Health and Safety Executive in the Approved Code of
Practice 'First Aid at Work', amended 1997 and advice from the

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Department for Education and Skills, the Department has issued a
detailed policy and guidance to all establishments. It is recognised that
there is a need in educational establishments to provide facilities and
arrangements for first aid when an accident occurs. First aid is a vital
part of every establishment’s provision for health and safety. The aim is
to clarify the Department’s policy on the standard and level of first aid
provision in schools and to provide guidance for managers to assist them
when assessing their needs. It is not possible in most cases to determine
precise requirements for first aid provision due to the wide nature of
establishment types and activity. Head teachers and managers should
assess their own requirements for first aid provision based on local needs
and the minimum guidelines.4

In America, to ensure the safety and well being of students while


they are in school, the students and school personnel are trained to
provide first aid and this is the first critical link in the management of
trauma (American School Health Association, 2000), each school should
have a well equipped first aid room, a trained first aider available in the
first aid room or on call, at least one student from each class trained in
first aid. They have also pointed out that their pupils will be an asset to
children/school at the time of emergency and there is no substitute for
proper training.6

WHO (1999) through its expert committee as comprehensive


school health education and promotion pointed out that some of the
components of school health programmes, have proved to be effective but
there is no practical guidance on their implementation and they have
recommended that every school should enable children and adolescent at
all levels to learn critical health and life saving skills.8

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The Health and Safety Executive has issued the following
guidance: “Research has shown that following training, the practical
skills of first aiders can deteriorate. The Health and Safety Executive
strongly recommends that it is good practice for first aiders to undergo
annual ‘refresher’ courses. It is important that employers make sure
qualified first aiders attend these courses to help maintain their basic
skills and keep up to date with any changes to first aid procedures.” Head
teachers must ensure that all first aiders holding the First Aid at Work
certificate, the Schools First Aid certificate completes annual basic skills
update. First Aiders in designated services and settings who hold either
the First Aid at Work or Emergency First Aider in the Workplace
certificates may also need to complete the annual skills updated if this has
been identified via the Children’s Services first aid risk assessment.4

Providing first aid in the emergency situations can be


overwhelming and traumatic. Encouraging more people to learn basic
first aid and to intervene will rely to some extent on the development of
improved strategies to provide support to those who have given first aid
care in an emergency.9 so the investigator feel that it is necessary to
impart knowledge to the school teachers regarding selected first aid
measures with the help of structured teaching programme which help
them to take appropriate first aid measures in emergencies.

6.2 REVIEW OF LITERATURE

A review of literature on the research topic makes the researcher


familiar with the existing studies and provides information which helps to
focus on a particular problem, lays a foundation upon which to base new
knowledge. It creates accurate picture of the information found on the
subjects.10

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Reviews include,

6.2.1 Reviews related to first aid measures in school children.


6.2.2 Reviews related to knowledge of teachers regarding first aid
measures.
6.2.3 Reviews related to effectiveness of structured teaching programme.

6.2.1 Reviews related to first aid measures in school children.


A retrospective study of the hospital files of patients younger than
12 years admitted to the institute of ophthalmology of Verona University
for eye injuries suggests that eighty-eight cases of eye injuries [69 (78%)
boys, 19(22%) girls] were identified; mean age of children admitted was
7.2 years. The most frequent causes of eye injuries were domestic
accidents in patients younger than 6 years (25%) and accidents at play in
those older than 6 years (35%). Scissors were the most frequent causative
agents in children under 6 and toys, stones, and ball injuries in those over
6. It was concluded that the major cause of eye injuries in childhood are
preventable; thus more adequate adult supervision and educational and
legislative measures are necessary and useful in order to reduce
prevalence and morbidity of these accidents.11

A descriptive study was conducted to estimate the incidence of


minor injuries and to study the wound care practices of school children. A
fortnightly follow up of urban and rural high school children was done in
Chandigarh and rural Haryana. Initial point prevalence survey was
followed by fortnightly follow up survey involving interview for
assessing incidence and wound care practices among students. The setting
was government high schools of Chandigarh and rural Ambala. It was
found that in average episodes of minor injuries per year, point
prevalence was higher in urban area. First aid training of teachers or the

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students were lacking in both the areas. Many of the injuries occurred
during the school time. Rural students were more tolerant to minor
injuries. It was concluded that incidence of minor injuries was higher in
rural area as compared to urban area. Training on wound care is
recommended.12

A descriptive study was conducted in New Zealand to determine


the incidence, nature and circumstances of unintentional injuries to
students at school which resulted in death or hospitalization. Fatalities
were identified from national mortality data for inclusive. Hospitalization
cases were identified from the national hospital discharge summary. The
circumstances of deaths were diverse with the most frequent event being
a fall. Injury rates declined with increasing age, and males had higher
rates than females for all ages. Fractures of the upper and lower limbs and
intracranial injury represented more than three-quarters of all injury. The
results suggest that prevention policy should place emphasis on those in
their first two years of schooling, provision of protective equipment for
sporting activities, establishment of standardized injury referral
procedures, first-aid training, and a standardized injury reporting
system.13

6.2.2 Reviews related to knowledge of teachers regarding first aid


measures.
A descriptive study was conducted to determine the extent of
training and emergency care knowledge of public school teachers in
Midwestern states. A secondary purpose was to assess the frequency of
injury and illness in the school setting requiring the teacher to first
respond. A questionnaire was developed and pretested. A discrimination
index was used for validation of the instrument and a reliability
coefficient was computed using the Kuder-Richardson Formula. A

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randomly recruited group of public school nurses from Arkansas, Kansas
and Missouri administered the instrument to 334 teachers who had no
prior knowledge of the test. One third of the teachers had no specific
training in first aid. Most of the respondents strongly agreed that
emergency care training should be required in teacher preparation
programs. The average score for all respondents on the emergency care
test was 58%. Significant deficiencies were noted for recognition and
appropriate treatment of student emergencies. It was concluded that most
of the public school teachers in this study were deficient in both training
and knowledge of emergency care and basic life support modalities.14

A descriptive study was conducted to determine the knowledge and


attitudes of a sample of Turkish teachers regarding the administration of
first aid. Three hundred and twelve teachers took part in this study and
data were obtained using a questionnaire. It included 30 questions that
help identify the teachers and determine their knowledge and attitudes
about first aid. Data were analyzed by chi-square test. In this study it was
determined that most of the teachers do not have correct knowledge and
attitudes about first aid. It was found that as the age of the teachers
increases, appropriate first aid practice becomes more and more unlikely.
The results of this study showed that teachers did not have enough
knowledge about first aid.15

A descriptive study was conducted to assess the level of knowledge


of primary school teachers in Ajman with regards to the immediate
emergency management of dental trauma. It was done by means of self-
administered structured questionnaire which was sent to teachers in
randomly selected primary schools in Ajman. A total of 161 teachers
responded. Among 138 respondents gave the appropriate management for
fractured tooth. Most teachers were unsatisfied with their level of

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knowledge for dental trauma and the majority were interested in having
further education on the topic. The findings revealed that the level of
knowledge of management of dental trauma among school teachers in
Ajman is inadequate, and education campaigns are necessary to improve
their emergency management of dental injuries.16

6.2.3 Reviews related to effectiveness of structured teaching


programme.
An experimental study was conducted to find out the effectiveness
of a structured teaching programme on knowledge about cancer
prevention and early detection among 99 teacher trainees in a selected
college of education in Udupi taluk. The findings of the study revealed a
significant increase in mean post-test knowledge scores on cancer
prevention. This indicates that the structured teaching programme was an
effective method to improve knowledge of the people.17

6.3 STATEMENT OF THE PROBLEM


A STUDY TO ASSESS THE EFFECTIVENESS OF
STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE
REGARDING SELECTED FIRST AID MEASURES AMONG
SCHOOL TEACHERS OF SELECTED URBAN SCHOOLS IN
BANGALORE.

6.4 OBJECTIVES
1. To assess the demographic profile of the school teachers.
2. To assess the knowledge of the school teachers regarding selected
first aid measures.
3. To find out the effectiveness of structured teaching programme on
knowledge of school teachers regarding selected first aid measures
by conducting post-test.

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4. To find out the association between the post-test knowledge scores
of school teachers regarding selected first aid measures and
selected demographic variables.

6.5 OPERATIONAL DEFINITIONS


6.5.1 ASSESS: In the present study assess refers to, ‘statistical
measurement of the knowledge scores of the school teachers regarding
selected first aid measures as observed by using structured questionnaire’.

6.5.2 EFFECTIVENESS: In the present study effectiveness refers to,


‘the gain in knowledge among school teachers as evidenced by
improvement in post-test knowledge scores when compared with pre-
test’.

6.5.3 STRUCTURED TEACHING PROGRAMME: In the present


study structured teaching programme refers to, ‘systematically developed
structured teaching programme designed for a group of school teachers
to provide information regarding selected first aid measures such as
injuries, fracture, heat stroke, heat exhaustion, nose bleeding, foreign
bodies, poisoning, snake bite, electric shock, and drowning’.

6.5.4 KNOWLEDGE: In the present study Knowledge refers to, ‘the


correct responses of the school teachers related to the selected first aid
measures’.

6.5.5 SCHOOL TEACHER: In the present study, school teacher refers


to ‘a person who is qualified and provides education for the students’.

6.5.6 FIRST AID: In the present study First aid refers to, ‘First aid is the
immediate care given to a person who has been injured or suddenly fallen
ill, before taking him to hospital’.

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6.5.7 SELECTED FIRST AID MEASURES: In the present study
selected first aid measures refers to, ‘providing first aid in school for
injuries, fracture, heat stroke, heat exhaustion, nose bleeding, foreign
bodies, poisoning, snake bite, electric shock, and drowning ’.

6.6 HYPOTHESIS
H0: There is no significant difference between the pre and post-test
knowledge scores of the school teachers regarding selected first
aid measures.

H0.1: There is no significant association between the post-test knowledge


scores of school teachers regarding selected first aid measures
with their demographic variables.

H1.1: There is a significant difference between pre and post-test


knowledge scores of school teachers regarding selected first aid
measures.

H1.2: There is a significant association between post test knowledge


scores of school teachers with selected demographic variables

6.7 VARIABLES
INDEPENDENT VARIABLE:
Structured teaching programme regarding selected first aid measures
among school teachers of selected urban schools, Bangalore.

DEPENDENT VARIABLE:
Knowledge of school teachers regarding selected first aid measures.

DEMOGRAPHIC VARIABLES:
It includes age, sex, religion, educational status, income, years of
teaching experience, place of residence, and previous exposure to the
information.

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7.0 MATERIALS AND METHODS
7.1.1 Source of data : School teachers of selected urban
schools, Bangalore.
7.1.2 Research approach : Experimental approach.
7.1.3 Research design : Quasi-experimental design with one
group pre-test Post-test.
7.1.4 Population : School teachers of selected urban
schools in Bangalore.

7.1.5 Sample : School teachers working in selected


urban schools, Bangalore.

7.1.6 Research setting : Selected urban schools of Bangalore.

7.1.7 Sampling technique : Non probability purposive sampling


technique
7.1.8 Sample size : 60
7.1.9 SAMPLE CRITERIA

INCLUSION CRITERIA: School teachers who are,


1. willing to participate in the study.
2. present during the period of data
collection.
EXCLUSION CRITERIA: School teachers who had,
1. already undergone first aid
training.

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7.2.1 TOOL FOR DATA COLLECTION

SECTION 1: Includes age, sex, religion, educational status, income,


years of teaching experience, place of residence, and previous exposure to
the information.

SECTION 2: Structured questionnaire to assess the knowledge of school


teachers regarding selected first aid measures.

7.2.2 METHOD OF DATA COLLECTION

Pre-test knowledge will be assessed by using structured


questionnaire, followed by administration of a structured teaching
programme, and post-test knowledge will be assessed by administering
the same structured questionnaire.

DESCRIPTIVE STATISTICS

Mean, mean %, median and standard deviation will be used for assessing
the demographic characteristics.

INFERENTIAL STATISTICS

Student’s paired t-test will be used to find out the significant mean
difference between mean pre and post-test knowledge scores of the
School teachers. Chi-square (χ2) test for measuring association between
the knowledge levels of school teachers with selected demographic
variables.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR


INTERVENTIONS TO BE CONDUCTED ON OTHER
HUMANS OR ANIMALS? IF SO, PLEASE DESCRIBE
BRIEFLY.

YES.
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7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM
INSTITUTION?

1. The ethical clearance is obtained from the research committee of


Fortis Institute of Nursing.
2. Written permission will be obtained from the concerned authorities
of selected urban schools in Bangalore.
3. Written consent will be obtained from each of the participants.

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8.0 LIST OF REFERENCES

1. Facts about injuries to children at school. Available at: URL:


http://ukhealthcare.uky.edu/uploadedFiles/school.facts.pdf .
2. Parker G Thomas. Introduction to first aid. Available at: URL:
http://www.healthguidance.org/entry/8941/1/introduction_to_First_
Aid.html.
3. Dajer J Antonio. First aid. Available at: URL:
www.ilo.org/safework_bookshelf/english?content&nd=857170142
4. Health and safety team. Guidance for Head teachers and managers on
first aid. East Sussex county council, Flinder University. 2011.
Available at: URL:
https://czone.eastsussex.gov.uk/schoolmanagement/healthsaftey/main/
Documents/First%20Aid%20guidance.
5. Ababa Addis. First Aid extension package. Federal Democratic
Republic of Ethopia, Ministry of health. 2003 Sep. Available at:
URL: http://cnhde.ei.columbia.edu/training/documents/First_Aid.pdf
6. Baby Elizabeth. Effectiveness of planned teaching programme on
First Aid for students in a selected high school in Mangalore.
Published Dissertation. 2002 May.
7. Pala I, Vankar GK. Epilepsy and teachers: a survey. Indian J Pediatr.
1997 Mar-Apr;64(2):211-4.
8. WHO Technical Report Series. World Health Organization, Geneva.
1999.
9. Arbon Paul, Hayes Jo. First Aid and harm minimisation for victims of
road trauma. A population study. 2007 Jun. Available at URL:
http://www.ambulance.net.av/clicktosave/www/docs/Australian_po
pulation_study_on_victims_of_Road_Trauma.pdf

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10. Polit Denise F, Beck Cheryl Tatano. Nursing research generating and
assessing evidence for nursing practice. 8th ed. New Delhi: Wolters
Kluwar (India) Pvt Ltd; 2008. P.105.
11. Tomazzoli L, Renzi G, Mansoldo C. Eye injuries in childhood. Eur J
opthalmol. 2003 Oct;13(8):710-3.
12. Singh AJ, Kaur A. Minor injuries in ninth class school children of
Chandigarh and rural Haryana. Indian Pediatr. 1996 Jan;33(1):25-
30.
13. Boyce SH, Quigley MA. An audit of sports injuries in children
attending an accident and emergency department. Scott Med J. 2003
Aug;48(3):88-90.
14. Gagliardi M, Neighbors M, Spears C, Byrd S, Snarr J. Emergencies
in the school setting: are public school teachers adequately trained
to respond. Prehospital Disaster Med. 1994 Oct-Dec;9(4):222-5.
15. Baser M, Coban S, Tasci S, Sungur G, Bayat M. Evaluating first aid
knowledge and attitudes of a sample of Turkish primary school
teachers. J Emerg Nurs. 2007 Oct;33(5):428-32.
16. Hashim R. Dental trauma management awareness among primary
school teachers in the Emirate of Ajman. Eur J Pediatr Dent. 2011
Jun;12(2):99-102.
17. Prathibha S. The effectiveness of structured teaching programme on
knowledge about cancer prevention and early detection among
teacher trainees in a selected college of education Udupi taluk.
Unpublished Master in Nsg Dissertation, University of MAHE
Manipal. 1997.

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9 SIGNATURE OF THE
CANDIDATE SHYAMRAJ V

10 REMARKS OF THE GUIDE Study is feasible. Adds to the


knowledge base of nursing.
Tests the effectiveness of
structured teaching programme
on knowledge of school
teachers regarding first aid
measures.
11 NAME AND DESIGNATION MR. PRABHUSWAMY A.C
OF ASSOCIATE PROFESSOR
11.1 THE GUIDE
11.2 SIGNATURE
PRABHUSWAMY A.C
11.3 CO-GUIDE PROF. SHRIDHAR K.V

11.4 SIGNATURE
SHRIDHAR K.V
11.5 HEAD OF THE PROF. SHRIDHAR K.V
DEPARTMENT

11.6 SIGNATURE
SHRIDHAR K.V
12 REMARKS OF THE Study is feasible. The designed
PRINCIPAL structured teaching programme
helps to improve the
knowledge of school teachers
regarding first aid measures.

12.1 SIGNATURE SHRIDHAR K.V

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