| Brief leadership instructions improve cardiopulmonary resuscitation in a high-fidelity simulation: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20124886 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The influence of teaching leadership on the performance of rescuers remains unknown. The aim of this study was to compare leadership instruction with a general technical instruction in a high-fidelity simulated cardiopulmonary resuscitation scenario. DESIGN: Prospective, randomized, controlled superiority trial. SETTING: Simulator Center of the University Hospital Basel in Switzerland. SUBJECTS: Two-hundred thirty-seven volunteer medical students in teams of three. INTERVENTION: During a baseline visit, the medical students participated in a video-taped simulated witnessed cardiac arrest. Participants were thereafter randomized to receive instructions focusing either on correct positions of arms and shoulders (technical instruction group) or on leadership and communication to enhance team coordination (leadership instruction group). A follow-up simulation was conducted after 4 mos. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the amount of hands-on time, defined as duration of uninterrupted cardiopulmonary resuscitation in the first 180 secs after the onset of the cardiac arrest (hands-on time) [corrected]. Secondary outcomes were time to start cardiopulmonary resuscitation, total leadership utterances, and technical skills. Outcomes were compared based on videotapes coded by two independent researchers. After a balanced performance at baseline, the leadership instruction group demonstrated a longer hands-on time (120 secs; interquartile range, 98-135 vs. 87 secs; interquartile range, 61-108; p < .001), a shorter median time to start cardiopulmonary resuscitation (44 secs; interquartile range, 32-62; vs. 67 secs; interquartile range, 43-79; p = .018), and had more leadership utterances (7; interquartile range, 4-10; vs. 5; interquartile range, 2-8; p = .02) in the follow-up visit. The rate of correct arm and shoulder positions was higher in teams with technical instruction (59%; 19 out of 32; vs. 23%; 7 out of 31; p = .003). CONCLUSIONS: Video-assisted leadership and technical instructions after a simulated cardiopulmonary resuscitation scenario showed sustained efficacy after a 4-mo duration. Leadership instructions were superior to technical instructions, with more leadership utterances and better overall cardiopulmonary resuscitation performance. |
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Authors:
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Sabina Hunziker; Cyrill B?hlmann; Franziska Tschan; Gianmarco Balestra; Corinne Legeret; Cleo Schumacher; Norbert Karl Semmer; Patrick Hunziker; Stephan Marsch |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-25 Completed Date: 2010-04-09 Revised Date: 2010-06-01 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1086-91 Citation Subset: AIM; IM |
Affiliation:
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Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland. HunzikerS@uhbs.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiopulmonary Resuscitation
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education*,
methods,
standards Female Humans Leadership* Male Manikins* Outcome Assessment (Health Care) Patient Care Team Prospective Studies Students, Medical Teaching / methods Time Factors Video Recording Young Adult |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2010 Apr;38(4):1216-7
[PMID:
20335703
]
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Erratum In:
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Crit Care Med. 2010 Jun;38(6):1510 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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