The optimal approach for teaching and maintaining competency in cardiopulmonary resuscitation (CPR) remains unclear. Basic CPR competency is a foudational skill in both basic and advanced life support training and ample data supports the need to improve ongoing maintenance of competency. Many out-of-hospital cardiac arrest victims do not receive CPR before the arrival of professional rescuers. Video-based instruction effectively trains students more quickly than traditional classroom based courses and evidence suggests ongoing refresher training benefits skill retention. Real time feedback devices improve CPR quality in both training and actual resuscitation events. High fidelity simulation may improve competency in advanced life support training scenarios.