ABSTRACT
We report four studies with participants being confronted with a cardiac arrest of a "patient" in a high-fidelity simulation. Based on video-tapes, performance was assessed in terms of the time until meaningful treatment was started and "hands-on" time; leadership behavior was coded on the basis of video-tapes. We could show (1) that directive leadership of first responding nurses and later aniving residents was associated with higher performance, (2) that there was more directive leadership and better performance if groups of three physicians were all present when a cardiac arrest occurred, as compared to a condition where they entered sequentially, indicating that deficiencies in leadership behavior are not simply due to a lack of
skills, (3) that medical students who received a leadership-oriented debriefing after a cardiac arrest scenario showed more leadership, and better perfonnance during a second visit four months later, and (4) that a brief instruction to first responding physicians encouraging them to lead improved leadership and performance. Teambuilding is important for the perfonnancc of medical emergency teams should receive more attention in guidelines and training.
