Context: Swimming is taught to help protect people from drowning. The causes of drowning should thus dictate what children should learn. Yet historically, both method and content have varied dramatically. The purposes of this study were to
a) identify physical causes of drowning and
b)derive a definition of the ability to swim.

Methods: Causal elements in drowning were identified by examining accident reports, by in-depth interview with survivors and by observation of subjects who simulated drowning episodes. Each element implied a weak or missing skill. Lastly, the content of beginner courses in leading organizations, was analyzed. The sum of this information allowed a conceptual model of “the ability to swim”.

Results: Causes identified were: loss of breath, awkward fall, deep submersion, and inability to; level off, turn toward safety, roll over, swim on back, rest in deep water, swim clothed and lack of specific knowledge or understanding of danger. The eight point conceptual definition of the ability to swim included; entry, level off, swim on front and back, roll over, turn, swim under water, stop and rest in deep water.

Discussion/Implications: As shown in the figure, causes of drowning lead to “what children should learn”. Water safety education is more than correct movement of arms and legs. Attitudes, knowledge and relevant skills must be included.

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