Literature DB >> 17507825

Residents feel unprepared and unsupervised as leaders of cardiac arrest teams in teaching hospitals: a survey of internal medicine residents.

Chris W Hayes1, Augustine Rhee, Michael E Detsky, Vicki R Leblanc, Randy S Wax.   

Abstract

OBJECTIVE: We aimed to determine internal medicine residents' perceptions of the adequacy of their training to serve as in-hospital cardiac arrest team leaders, given the responsibility of managing acutely critically ill patients and with recent evidence suggesting that the quality of cardiopulmonary resuscitation provided in teaching hospitals is suboptimal.
DESIGN: Cross-sectional postal survey.
SETTING: Canadian internal medicine training programs. PARTICIPANTS: Internal medicine residents attending Canadian English-speaking medical schools.
INTERVENTIONS: A survey was mailed to internal medicine residents asking questions relating to four domains: adequacy of training, perception of preparedness, adequacy of supervision and feedback, and effectiveness of additional training tools.
MEASUREMENTS AND MAIN RESULTS: Of the 654 residents who were sent the survey, 289 residents (44.2%) responded. Almost half of the respondents (49.3%) felt inadequately trained to lead cardiac arrest teams. Many (50.9%) felt that the advanced cardiac life support course did not provide the necessary training for team leadership. A substantial number of respondents (40%) reported receiving no additional cardiac arrest training beyond the advanced cardiac life support course. Only 52.1% of respondents felt prepared to lead a cardiac arrest team, with 55.3% worrying that they made errors. Few respondents reported receiving supervision during weekdays (14.2%) or evenings and weekends (1.4%). Very few respondents reported receiving postevent debriefing (5.9%) or any performance feedback (1.3%). Level of training and receiving performance feedback were associated with perception of adequacy of training (r(2) = .085, p < .001). Respondents felt that additional training involving full-scale simulation, leadership skills training, and postevent debriefing would be most effective in increasing their skills and confidence.
CONCLUSIONS: The results suggest that residents perceive deficits in their training and supervision to care for critically ill patients as cardiac arrest team leaders. This raises sufficient concern to prompt teaching hospitals and medical schools to consider including more appropriate supervision, feedback, and further education for residents in their role as cardiac arrest team leaders.

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Mesh:

Year:  2007        PMID: 17507825     DOI: 10.1097/01.CCM.0000268059.42429.39

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  46 in total

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4.  Using Simulation Education With Deliberate Practice to Teach Leadership and Resource Management Skills to Senior Resident Code Leaders.

Authors:  Amanda R Burden; Erin W Pukenas; Edward R Deal; Douglas B Coursin; Gregory M Dodson; Gregory W Staman; Irwin Gratz; Marc C Torjman
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5.  A simulation-based program to train medical residents to lead and perform advanced cardiovascular life support.

Authors:  Mihaela S Stefan; Raquel K Belforti; Gerard Langlois; Michael B Rothberg
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6.  A mixed methods evaluation of paediatric trainee preparedness to manage cardiopulmonary arrests.

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Review 7.  "Putting it all together" to improve resuscitation quality.

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8.  Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.

Authors:  Jasmeet Soar; Mary E Mancini; Farhan Bhanji; John E Billi; Jennifer Dennett; Judith Finn; Matthew Huei-Ming Ma; Gavin D Perkins; David L Rodgers; Mary Fran Hazinski; Ian Jacobs; Peter T Morley
Journal:  Resuscitation       Date:  2010-10       Impact factor: 5.262

9.  Afraid of being "witchy with a 'b'": a qualitative study of how gender influences residents' experiences leading cardiopulmonary resuscitation.

Authors:  Christine Kolehmainen; Meghan Brennan; Amarette Filut; Carol Isaac; Molly Carnes
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10.  Leadership is the essential non-technical skill in the trauma team--results of a qualitative study.

Authors:  Magnus Hjortdahl; Amund H Ringen; Anne-Cathrine Naess; Torben Wisborg
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2009-09-26       Impact factor: 2.953

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