Abstract
BackgroundGender composition, stress and leadership of a resuscitation team influence CPR performance. Whether psychological variables such as self-esteem, motivation and personality traits are associated with resuscitation performance, stress levels and gender of rescuers during a cardiac arrest scenario remains uncertain.MethodsWe included 108 medical students in this prospective, observational simulator study. We videotaped the resuscitation performance and assessed self-esteem, perceived stress-overload and personality traits using validated questionnaires. In addition, we analysed leadership utterances and ECG data of all participants during the simulation. The primary endpoint was cardiopulmonary resuscitation performance, defined as hands-on time within the first 180 sec. Secondary outcomes included first meaningful measure of resuscitation, leadership statements of group leaders and physiological stress parameters of rescuers.ResultsAdjusted for group size and leadership designation, mean self-esteem of students was significantly associated with hands-on time (adjusted regression coefficient 7.94 (95%CI 2.61 to 13.27), p<0.01). The personality trait conscientiousness was positively associated with hands-on time (adjusted regression coefficient 38.4, [95%CI 7.41 to 69.38, p = 0.02]). However, after additional adjustment for self-esteem, this association was no longer significant. Further, agreeableness of team leaders was significantly associated with longer hands-on time (adjusted regression coefficient 20.87 [95%CI 3.81 to 37.94], p = 0.02). Openness to experience was negatively associated with heart rate reactivity (-5.92 (95%CI -10 to -1.85), p<0.01). Male students showed significantly higher (mean, [±SD]) self-esteem levels (24.6 [±3.8] vs. 22.0 [±4.4], p<0.01), expressed significantly more leadership statements (7.9 [±7.8] vs. 4.6 [±3.8], p<0.01) and initiated first resuscitation measures more often (n, [%]) compared to female students (16, [23] vs. 7, [12], p = 0.01).ConclusionThis simulator study found that self-esteem of resuscitation teams and agreeableness of team leaders of inexperienced students was associated with cardiopulmonary resuscitation performance. Whether enhancing these factors during resuscitation trainings serve for better performance remains to be studied.
Highlights
Witnessing a cardiac arrest causes serious mental stress among rescuers [1]
Stress and leadership of a resuscitation team influence cardiopulmonary resuscitation (CPR) performance. Whether psychological variables such as self-esteem, motivation and personality traits are associated with resuscitation performance, stress levels and gender of rescuers during a cardiac arrest scenario remains uncertain
The personality trait conscientiousness was positively associated with hands-on time
Summary
Witnessing a cardiac arrest causes serious mental stress among rescuers [1]. Psychological stress may be defined as a physical as well as an emotional response to the feeling of strain and pressure caused by an external stimulus[2]. Coping with mental stress might reflect the individual’s personality and its adaptation to perceived external pressure. Previous studies found associations between personality traits and self-esteem with stress response.[7,8,9,10]. The personality traits openness to experience, extraversion and conscientiousness are thought to be associated with active coping mechanisms leading to reduced stress levels of individuals[10,11,12]. Stress and leadership of a resuscitation team influence CPR performance. Whether psychological variables such as self-esteem, motivation and personality traits are associated with resuscitation performance, stress levels and gender of rescuers during a cardiac arrest scenario remains uncertain
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