Der Einfluss von Crisis-Resource-Management-Training als Teil des medizinischen Curriculums auf die Qualität und Leitlinienadhärenz des Advanced Life Supports

Abstract

Objectives: To evaluate the impact of video-based and Laerdal PC-Skillreporting-based interactive crisis resource management (CRM) training on no-flow time (NFT) and on guidelineadherence during simulated cardiopulmonary resuscitation (CPR). Methods: The randomised controlled study was embedded in the obligatory advanced life support (ALS) course for final-year medical students. Students (156; 25.35 ± 1.03 years, 63% female) were alphabetically assigned to 39 four-person teams that were then randomly (computer-generated) assigned to either CRM intervention (n = 23), receiving interactive video-based CRM-training, or to control intervention (n = 16), receiving an additional ALS-training. Primary outcomes were NFT and guidelineadherence. Measurements were made of all groups administering simulated adult CPR. Results: NFT rates were significantly lower in the CRM-training group (24.9 ± 4.7% vs. 29.6 ± 4.6%, p = 0.007). Regarding the guidelineadherence the CRM-training group scored higher (37 points min/max 24/57 vs. 29 points min/max 15/42 points) especially in the categories medication and intubation. Conclusions: The inclusion of CRM training in undergraduate medical education reduces NFT in simulated CPR and improves guidelineadherence during simulated CPR. Further research will test how these results translate into clinical performance and patient outcome.