Effect of CRM team leader training on team performance and leadership behavior in simulated cardiac arrest scenarios: a prospective, randomized, controlled study
Effect of CRM team leader training on team performance and leadership behavior in simulated cardiac arrest scenarios: a prospective, randomized, controlled study
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DOI：
10.1186/s12909-015-0389-z
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发表时间：
2015-07-24
影响因子：
3.6
通讯作者：
Russo, Sebastian G.
中科院分区：
文献类型：
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作者：
Castelao, Ezequiel Fernandez;Boos, Margarete;Russo, Sebastian G.
背景：在心肺复苏(CPR)中，有效的团队领导被公认为是影响绩效的关键因素。一般来说，领导力培训侧重于领导和非领导团队成员的任务要求。我们只为高级生命支持(ALS)培训团队的指定团队负责人提供危机资源管理(CRM)培训。本研究评估了CRM团队领导培训对CPR绩效和团队领导言语的影响。方法：将45个团队，每组4人，随机分为两组：CRM团队领导培训(CRM-TL)和附加ALS培训(ALS Add-on)。在最初的讲座和三个为期90分钟的ALS技能培训教程(基本生命支持、呼吸道管理和节律识别/除颤)之后，每个小组的一名成员被随机分配为即将到来的CPR模拟的小组组长。CRM-TL组的团队负责人参加了90分钟的CRM-TL培训。所有其他参与者都接受了额外的90分钟的ALS技能培训。结果：CRM-TL组较ALS-ADD组无血流时间(NFT)发生率低(平均1.34(95%CI-2.5，5.2)，P=0.48)。治疗组ADH评分显著高于对照组(P=0.002)。直接订购(差值-1.82(95%CI-2.4p<；0.001)；非定向订购(差值-1.82(95%CI-2.8，-0.9)，p<；0.001)；计划(差异性-0.27(95%CI-0.5，-0.05)，p=0.018)和任务分配(差异性-0.09(95%CI-0.2，-0.01)，p=0.023)。结论：只对指定的团队领导进行客户关系管理培训可以提高整个团队的绩效，特别是指导方针的遵守和团队领导的行为。强调团队领导行为的培训似乎有利于复苏和急救医学课程的表现。
Background: Effective team leadership in cardiopulmonary resuscitation (CPR) is well recognized as a crucial factor influencing performance. Generally, leadership training focuses on task requirements for leading as well as non-leading team members. We provided crisis resource management (CRM) training only for designated team leaders of advanced life support (ALS) trained teams. This study assessed the impact of the CRM team leader training on CPR performance and team leader verbalization.Methods: Forty-five teams of four members each were randomly assigned to one of two study groups: CRM team leader training (CRM-TL) and additional ALS-training (ALS add-on). After an initial lecture and three ALS skill training tutorials (basic life support, airway management and rhythm recognition/defibrillation) of 90-min each, one member of each team was randomly assigned to act as the team leader in the upcoming CPR simulation. Team leaders of the CRM-TL groups attended a 90-min CRM-TL training. All other participants received an additional 90-min ALS skill training. A simulated CPR scenario was videotaped and analyzed regarding no-flow time (NFT) percentage, adherence to the European Resuscitation Council 2010 ALS algorithm (ADH), and type and rate of team leader verbalizations (TLV).Results: CRM-TL teams showed shorter, albeit statistically insignificant, NFT rates compared to ALS-Add teams (mean difference 1.34 (95 % CI -2.5, 5.2), p = 0.48). ADH scores in the CRM-TL group were significantly higher (difference -6.4 (95 % CI - 10.3, -2.4), p = 0.002). Significantly higher TLV proportions were found for the CRM-TL group: direct orders (difference -1.82 (95 % CI -2.4, -1.2), p < 0.001); undirected orders (difference -1.82 (95 % CI -2.8, -0.9), p < 0.001); planning (difference -0.27 (95 % CI -0.5, -0.05) p = 0.018) and task assignments (difference - 0.09 (95 % CI -0.2, -0.01), p = 0.023).Conclusion: Training only the designated team leaders in CRM improves performance of the entire team, in particular guideline adherence and team leader behavior. Emphasis on training of team leader behavior appears to be beneficial in resuscitation and emergency medical course performance.