Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Dec;98(49):e18201.
doi: 10.1097/MD.0000000000018201.

Improving the position of resuscitation team leader with simulation (IMPORTS); a pilot cross-sectional randomized intervention study

Ismail M Saiboon  1 , Farah N Apoo  1 , Shamsuriani M Jamal  1 , Afliza A Bakar  1 , Fadzlon M Yatim  1 , Johar M Jaafar  1 , Benjamin W Berg  2
Affiliations
Randomized Controlled Trial

Improving the position of resuscitation team leader with simulation (IMPORTS); a pilot cross-sectional randomized intervention study

Ismail M Saiboon et al. Medicine (Baltimore). 2019 Dec.

Abstract

Background: Leadership and teamwork are important contributory factors in determining cardiac resuscitation performance and clinical outcome. We aimed to determine whether fixed positioning of the resuscitation team leader (RTL) relative to the patient influences leadership qualities during cardiac resuscitation using simulation.

Methods: A cross-sectional randomized intervention study over 12 months' duration was conducted in university hospital simulation lab. ACLS-certified medical doctors were assigned to run 2 standardized simulated resuscitation code as RTL from a head-end position (HEP) and leg-end position (LEP). They were evaluated on leadership qualities including situational attentiveness (SA), errors detection (ED), and decision making (DM) using a standardized validated resuscitation-code-checklist (RCC). Performance was assessed live by 2 independent raters and was simultaneously recorded. RTL self-perceived performance was compared to measured performance.

Results: Thirty-four participants completed the study. Mean marks for SA were 3.74 (SD ± 0.96) at HEP and 3.54 (SD ± 0.92) at LEP, P = .48. Mean marks for ED were 2.43 (SD ± 1.24) at HEP and 2.21 (SD ± 1.14) at LEP, P = .40. Mean marks for DM were 4.53 (SD ± 0.98) at HEP and 4.47 (SD ± 0.73) at LEP, P = .70. The mean total marks were 10.69 (SD ± 1.82) versus 10.22 (SD ± 1.93) at HEP and LEP respectively, P = .29 which shows no significance difference in all parameters. Twenty-four participants (71%) preferred LEP for the following reasons, better visualization (75% of participants); more room for movement (12.5% of participants); and better communication (12.5% of participants). RTL's perceived performance did not correlate with actual performance CONCLUSION:: The physical position either HEP or LEP appears to have no influence on performance of RTL in simulated cardiac resuscitation. RTL should be aware of the advantages and limitations of each position.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Resuscitation room configuration. Showing the area of RTL in HEP and in LEP, ‘patient’ location, confederates, defibrillator, airway trolley, and patient monitor.
Figure 2
Figure 2
Participants’ distribution according to study flow.
Figure 3
Figure 3
Box plots and P values (using Wilcoxon signed rank test) for situational attentiveness, error detection and decision making according to position.
Figure 4
Figure 4
Histogram for mean total marks at head-end-position and leg-end position.
See this image and copyright information in PMC

References

    1. Marsch SC, Muller C, Marquardt K, et al. Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests. Resuscitation 2004;60:51–6. - PubMed
    1. Hunziker S, Tschan F, Semmer NK, et al. Importance of leadership in cardiac arrest situations: from simulation to real-life and back. Swiss Med Wkly 2013;143:w13774. - PubMed
    1. Schenarts PJ. Incorporating leadership training, a horizontal approach to resuscitation and performance feedback, into advanced life support. Crit Care Med 2007;35:1781–2. - PubMed
    1. Shetty P, Cohen T, Patel B, et al. The cognitive basis of effective team performance: features of failure and success in simulated cardiac resuscitation. AMIA Annu Symp Proc 2009;2009:599–603. - PMC - PubMed
    1. Schenarts PJ, Cohen KC. The leadership vacuum in resuscitative medicine. Crit Care Med 2010;38:1216–7. - PubMed

Publication types