Leadership Instructions Improve Cardiopulmonary Resuscitation in a High Fidelity Simulation

• Hands-on time in the first 180 seconds after the onset of the cardiac arrest and the time elapsed until cardiopulmonary resuscitation is started. [ Time Frame: 180 sec after start of CPR ] [ Designated as safety issue: No ]
  

• The effectiveness of the technical and leadership instructions [ Time Frame: 180 sec after starting CPR ] [ Designated as safety issue: No ]
  

Context:

Whether the performance of cardiopulmonary resuscitation can be positively influenced by teaching leadership with a short debriefing remains largely unknown

Objective:

To test the hypothesis that (1) leadership instruction are effective and (2) improved leadership results in better performance in a high fidelity simulated cardiopulmonary resuscitation.

Design:

Prospective, randomized-controlled superiority trial

Setting:

Simulator Center of the University Hospital Basel in Switzerland

Patients or Other Participants:

237 volunteer medical students in teams of 3

Intervention:

During a baseline visit, the medical students participate in a video-taped simulated witnessed cardiac arrest. Participants are randomized to receive thereafter a short video-assisted debriefing focusing either on correct positions of arms and shoulders (technical debriefing) or on leadership and communication to enhance team coordination (leadership debriefing). A follow-up simulation is conducted after 4 months. Leadership utterances, technical skills and the resuscitation performance of the teams are compared based on videotapes coded by two independent researchers.

Main Outcome Measures:

The primary outcomes for this study are the amount of hands-on time in the first 180 seconds after the onset of the cardiac arrest and the time elapsed until cardiopulmonary resuscitation was started. Secondary endpoints are the effectiveness of the technical and leadership instructions, respectively.