• Candice Wang, Chin-Chou Huang, Shing-Jong Lin, and Jaw-Wen Chen.
• Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, California, USA.
• BMJ Open. 2016 Sep 26; 6 (9): e012195.

ObjectivesThe goal of our study was to shed light on educational methods to strengthen medical students' cardiopulmonary resuscitation (CPR) leadership and team skills in order to optimise CPR understanding and success using didactic videos and high-fidelity simulations.DesignAn observational study.SettingA tertiary medical centre in Northern Taiwan.ParticipantsA total of 104 5-7th year medical students, including 72 men and 32 women.InterventionsWe provided the medical students with a 2-hour training session on advanced CPR. During each class, we divided the students into 1-2 groups; each group consisted of 4-6 team members. Medical student teams were trained by using either method A or B. Method A started with an instructional CPR video followed by a first CPR simulation. Method B started with a first CPR simulation followed by an instructional CPR video. All students then participated in a second CPR simulation.Outcome MeasuresStudent teams were assessed with checklist rating scores in leadership, teamwork and team member skills, global rating scores by an attending physician and video-recording evaluation by 2 independent individuals.ResultsThe 104 medical students were divided into 22 teams. We trained 11 teams using method A and 11 using method B. Total second CPR simulation scores were significantly higher than first CPR simulation scores in leadership (p<0.001), teamwork (p<0.001) and team member skills (p<0.001). For methods A and B students' first CPR simulation scores were similar, but method A students' second CPR simulation scores were significantly higher than those of method B in leadership skills (p=0.034), specifically in the support subcategory (p=0.049).ConclusionsAlthough both teaching strategies improved leadership, teamwork and team member performance, video exposure followed by CPR simulation further increased students' leadership skills compared with CPR simulation followed by video exposure.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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