Medical Intensive Care Unit, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2013 Apr 18;143:w13774. doi: 10.4414/smw.2013.13774. eCollection 2013.
The 2010 American Heart Association guidelines now recommend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions because of the high heterogeneity of the situations, difficulties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fidelity video-assisted simulator studies from different research groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team performance. In addition, randomised controlled studies have provided evidence that medical students receiving leadership training subsequently showed improved CPR performance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.
2010 年美国心脏协会指南现在建议在高级心脏生命支持课程中进行领导力培训。在这篇综述中，我们综合总结了从临床研究中得出的数据，这些研究调查了领导力在心搏骤停（CPR）中的重要性。由于情况的高度异质性、CPR 初始阶段的捕获困难以及伦理问题，只有少数（主要是观察性）研究是在现实生活条件下进行的。人类模拟器中的精心控制研究可以填补现有空白并提供重要的见解。来自不同研究小组的高保真视频辅助模拟器研究表明，团队建设的延长过程与 CPR 中的显著缺陷有关，而有效的领导可以提高团队绩效。此外，随机对照研究提供了证据表明，接受领导力培训的医学生随后表现出改善的 CPR 性能，在 4 个月的随访后仍保持不变。此外，领导力受到性别和其他因素的影响，如情绪压力。需要进一步的研究来调查文化差异以及模拟器的研究结果如何转化为现实情况。
