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Influence of Gender on the Performance of Cardiopulmonary Rescue Teams: A Randomized, Prospective Simulator Study

Amacher, Simon Adrian MMed1; Schumacher, Cleo MMed1; Legeret, Corinne MD1; Tschan, Franziska PhD3; Semmer, Norbert Karl PhD4; Marsch, Stephan MD, PhD1,5; Hunziker, Sabina MD, MPH1,2,5

doi: 10.1097/CCM.0000000000002375
Clinical Investigations

Objectives: Little is known about the influence of gender on resuscitation performance which may improve future education in resuscitation. The aim of this study was to compare female and male rescuers in regard to cardiopulmonary resuscitation and leadership performance.

Design: Prospective, randomized simulator study.

Setting: High-fidelity patient simulator center of the medical ICU, University Hospitals Basel (Switzerland).

Subjects: Two hundred sixteen volunteer medical students (108 females and 108 males) of two Swiss universities in teams of three.

Interventions: None.

Measurements and Main Results: We analyzed data on the group and the individual level separately. The primary outcome on the group level was the hands-on time within the first 180 seconds after the onset of the cardiac arrest. Compared with male-only teams, female-only teams showed less hands-on time (mean ± SD) (87 ± 41 vs 109 ± 33 s; p = 0.037) and a longer delay before the start of chest compressions (109 ± 77 vs 70 ± 56 s; p = 0.038). Additionally, female-only teams showed a lower leadership performance in different domains and fewer unsolicited cardiopulmonary resuscitation measures compared with male-only teams. On the individual level, which was assessed in mixed teams only, female gender was associated with a lower number of secure leadership statements (3 ± 2 vs 5 ± 3; p = 0.027). Results were confirmed in regression analysis adjusted for team composition.

Conclusions: We found important gender differences, with female rescuers showing inferior cardiopulmonary resuscitation performance, which can partially be explained by fewer unsolicited cardiopulmonary resuscitation measures and inferior female leadership. Future education of rescuers should take gender differences into account.

1Department of Intensive Care Medicine, Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland.

2Medical Communication, Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland.

3Department of Psychology, University of Neuchatel, Neuchatel, Switzerland.

4Department of Psychology, University of Bern, Bern, Switzerland.

5Medical Faculty, University of Basel, Basel, Switzerland.

Drs. Marsch and Hunziker contributed equally to this article and are considered equally last authors. Study concept, study planning, and simulations organized and performed by Drs. Marsch and Hunziker. Data collection, data analysis, data interpretation and writing of the article performed by Drs. Amacher, Schumacher, Legeret, Tschan, Semmer, Marsch, and Hunziker.

Dr. Tschan’s institution received grant funding from Swiss National Science Foundation, and she received support for article research from the Swiss National Science Foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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