Practice, not just training

Skills decay on a timescale much shorter than certification.

Retention of first aid skills falls substantially within months, and the certification interval is measured in years. That gap is a known feature of the field and organisations manage it by assuming the certificate represents the capability.

Short, frequent practice addresses it cheaply. A ten-minute refresher on compressions every few months, using whatever equipment is available, maintains far more than an annual event, and it costs almost nothing in time.

Scenario walkthroughs address the organisational half. Walking through what would happen if somebody collapsed in a specific location, with the people who would be there, finds the locked door and the missing key rather than the clinical gap.

These do not have to be formal exercises. A five-minute conversation at a team meeting, working through one location, is enough and is far more likely to actually happen.

Where a genuine incident occurs, the practice value of a debrief is very high and it should be conducted with care for the people involved, since the same conversation can be either useful or damaging depending on how it is framed.

It is worth adding that practice reduces the hesitation more than it improves the technique. Most trained people can perform compressions adequately; what stops them is the moment of deciding to start, and repetition is what shortens it.