Proficiency in cardiopulmonary resuscitation of medical students at graduation: a simulator-based comparison with general practitioners

Question understudy: There are no data on the preparedness of medical students at the time of their graduation to handle a cardiac arrest. The aim of the present study was to compare the performance in cardiopulmonary resuscitation of medical students at the time of their graduation with that of experienced general practitioners. Methods: 24 teams consisting of three medical students and 24 teams consisting of three general practitioners were confronted with a scenario of a simulated witnessed cardiac arrest. Analysis was performed post-hoc using video recordings obtained during the simulation. Results: Medical students diagnosed the cardiac arrest as quickly as general practitioners. Medical students were less likely to call for help in the initial phase of the cardiac arrest (14/24 vs 21/24; P = 0.002); had less hands-on time during the first 180 seconds of the arrest (52 +/- 33 sec vs 105 +/- 39 sec; P <0.0001); delayed the first defibrillation (168 +/- 78 vs 116 +/- 46 sec, P <0.007); and showed less directive leadership (4/24 vs; 14/24 teams, P <0.007). The technical quality of cardiopulmonary resuscitation provided by medical students was partly better, but for no parameter worse, than that provided by general practitioners. Conclusions: When confronted with a cardiac arrest, medical students at the time of their graduation substantially delayed evidence-based life-saving measures like defibrillation and provided only half of the resuscitation support provided by experienced general practitioners. Future research should focus on how to best prepare medical students to handle medical emergencies.