Elsevier

Resuscitation

Volume 49, Issue 1, April 2001, Pages 33-38
Resuscitation

Developing leaders for advanced life support: evaluation of a training programme

https://doi.org/10.1016/S0300-9572(00)00345-2Get rights and content

Abstract

Aim: To evaluate the effectiveness of a leadership development seminar introduced into the Resuscitation Council (UK) Advanced Life Support (ALS) Provider course. Methods: Observational assessments of leadership performance during cardiac arrest scenarios before and after a leadership seminar. Results: The leadership training programme significantly improved candidates leadership performance in the training situation. Conclusion: A formal leadership development programme should be introduced into advanced life support courses.

Resumen

Objectivo: Avaliar a eficiência de um seminário sobre competências de liderança a incluir no programa do curso de Suporte Avançado de Vida (SAV) promovido pelo Resuscitation Council (UK). Métodos: Avaliações observacionais de desempenho de liderança em casos de simulação de paragem cardı́aca, antes e depois do seminário. Resultados: O treino de liderança melhorou significativamente o desempenho em contexto de treino. Conclusão: Deveria ser formalmente introduzido nos cursos de SAV um módulo especı́fico para treino da capacidade de lidereança.

Introduction

This investigation was designed to develop the earlier findings of Mann and Heyworth [1] and Cooper and Wakelam [2] in their observational assessments of team performance. Cooper and Wakelam concentrated on leadership issues and identified that the current programmes of Advanced Life Support (ALS) training in the UK were not enhancing leadership performance in the practice situation. Experience did make a difference to performance but only if this had been extensive; feedback on performance was rare and therefore without accurate feedback a change in behaviour was unlikely. As a result effective leaders tended to be those with a predisposition to the form of behaviour required to manage an emergency. The conclusion was that without training and performance feedback, leaders will not have a model to positively influence their behaviour and performance will be dependent on personality.

To develop and support these findings it was decided to introduce a leadership development programme into the Resuscitation Council (UK) 3-day ALS course and to measure its effectiveness through observation and appraisal. If such a scheme proved effective this would indicate that it was possible to develop leadership skills through training.

The study was based at an ALS course centre, Derriford Hospital in Plymouth and ran for a year April 1999–April 2000. During this period three ALS courses were run in the hospital medical centre. There were 22 candidates on two of the courses and 24 on one, a total sample of 68. Approval for the study was gained from the Resuscitation Council (UK).

Section snippets

Research methods

In each course the candidates were randomly assigned to either a control or an experimental group (either 11 or 12 in each group depending on the total number of candidates). Candidates and instructors were blinded to these allocations until the end of each course, when full explanations were given. Candidate grades and professions (doctors, nurses and technicians) were equally mixed in each group. As required in the standard ALS programme candidates learned to manage a cardiac arrest in what

Results

As expected, general experience through the course, for both the experimental and control groups, showed that LBDQ 2 increased significantly over LBDQ 1 (Z=−4.261, N=68, P=0.000**). However, looking more closely at this data it was the experimental groups improvement that added most to this result. They achieved a mean increase in the total LBDQ score of 4.53 (Z=−3.533, N=34, P=<0.000**) compared to the control groups increase of 2.23 (Z=−2.435, N=34, P=0.008**). Independent sample analysis

Discussion

Results from this study indicate that there was a generalised improvement in leadership performance for both the control and experimental groups. However Cooper and Wakelam's work [2] indicate that this improvement is not carried over into practice or that such training was not sufficient to substantially change leadership behaviour. In this latest study it has been demonstrated that, in the training situation, a leadership development programme significantly changes behaviour and increases

Acknowledgements

Many thanks to the observation team: Jackie Scobie, Amanda Wirgman, Karen Sharland, Ian Wren and Chris Evans.

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