***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Pre-training evaluation and feedback have been shown to improve medical students ' skills acquisition of basic life support ( BLS ) immediately following training . The impact of such training on BLS skills retention is unknown . This study was conducted to investigate effects of pre-training evaluation and feedback on BLS skills retention in medical students . METHODS Three hundred and thirty 3rd year medical students were r and omized to two groups , the control group ( C group ) and pre-training evaluation and feedback group ( EF group ) . Each group was subdivided into four subgroups according to the time of retention-test ( at 1- , 3- , 6- , 12-month following the initial training ) . After a 45-min BLS lecture ,  BLS skills  were assessed ( pre-training evaluation ) in both groups before training . Following this , the C group received 45 min training . 15 min of group feedback corresponding to students ' performance in pre-training evaluation was given only in the EF group that was followed by 30 min of BLS training . BLS skills were assessed immediately after training ( post-test ) and at follow up ( retention-test ) . RESULTS No skills difference was observed between the two groups in pre-training evaluation . Better skills acquisition was observed in the EF group ( 85.3 ± 7.3 vs. 68.1 ± 12.2 in C group ) at post-test ( p<0.001 ) . In all retention-test , better skills retention was observed in each EF subgroup , compared with its paired C subgroup . CONCLUSIONS Pre-training evaluation and feedback improved skills retention in the EF group for 12 months after the initial training , compared with the control group Objectives : To determine the impact of a low-re source -dem and , easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams . Design : A r and omized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011 . Setting : This study was conducted at the simulation suite within the Kado Family Clinical Skills Center , Wayne State University School of Medicine . Participants : Participants ( n = 231 ) were fourth-year medical students and first- , second- , and third-year emergency medicine residents at Wayne State University . Each participant was assigned to a team of four to six members ( nteams = 45 ) . Interventions : Teams were r and omly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module . Measurements : Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses . Teamwork behavior items ( e.g. , “ chest radiograph findings communicated to team ” and “ team member assists with intubation preparation ” ) were st and ardized before combining to create overall teamwork scores . Similarly , patient care items ( “ chest radiograph correctly interpreted ” ; “ time to start of compressions ” ) were st and ardized before combining to create overall patient care scores . Subject matter expert review s and pilot testing of scenario content , teamwork items , and patient care items provided evidence of content validity . Main Results : When controlling for team members ’ medically relevant experience , teams in the training condition demonstrated better teamwork ( F [ 1 , 42 ] = 4.81 , p < 0.05 ; & eegr;2p = 10 % ) and patient care ( F [ 1 , 42 ] = 4.66 , p < 0.05 ; & eegr;2p = 10 % ) than did teams in the placebo condition . Conclusions : Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations . This low-re source team training intervention may help to address the dissemination and sustainability issues associated with larger , more costly team training programs Background Cardiac arrests are h and led by teams rather than by individual health-care workers . Recent investigations demonstrate that adherence to CPR guidelines can be less than optimal , that deviations from treatment algorithms are associated with lower survival rates , and that deficits in performance are associated with shortcomings in the process of team-building . The aim of this study was to explore and quantify the effects of ad-hoc team-building on the adherence to the algorithms of CPR among two types of physicians that play an important role as first responders during CPR : general practitioners and hospital physicians . Methods To unmask team-building this prospect i ve r and omised study compared the performance of preformed teams , i.e. teams that had undergone their process of team-building prior to the onset of a cardiac arrest , with that of teams that had to form ad-hoc during the cardiac arrest . 50 teams consisting of three general practitioners each and 50 teams consisting of three hospital physicians each , were r and omised to two different versions of a simulated witnessed cardiac arrest : the arrest occurred either in the presence of only one physician while the remaining two physicians were summoned to help ( " ad-hoc " ) , or it occurred in the presence of all three physicians ( " preformed " ) . All scenarios were videotaped and performance was analysed post-hoc by two independent observers . Results Compared to preformed teams , ad-hoc forming teams had less h and s-on time during the first 180 seconds of the arrest ( 93 ± 37 vs. 124 ± 33 sec , P < 0.0001 ) , delayed their first defibrillation ( 67 ± 42 vs. 107 ± 46 sec , P < 0.0001 ) , and made less leadership statements ( 15 ± 5 vs. 21 ± 6 , P < 0.0001 ) . Conclusion H and s-on time and time to defibrillation , two performance markers of CPR with a proven relevance for medical outcome , are negatively affected by shortcomings in the process of ad-hoc team-building and particularly deficits in leadership . Team-building has thus to be regarded as an additional task imposed on teams forming ad-hoc during CPR . All physicians should be aware that early structuring of the own team is a prerequisite for timely and effective execution of CPR OBJECTIVE Data on the efficacy of the simulation and multimedia teaching modalities is limited , particularly in developing nations . This study evaluates the effectiveness of simulator and multimedia educational tools in India . METHODS Advanced Cardiac Life Support ( ACLS ) certified paramedic students in India were r and omized to either Simulation , Multimedia , or Reading for a 3-h ACLS refresher course .  Simulation students  received a lecture and 10 simulator cases . The Multimedia group viewed the American Heart Association ( AHA ) ACLS video and played a computer game . The Reading group independently read with an instructor present . Students were tested prior to ( pre-test ) , immediately after ( post-test ) , and 3 weeks after ( short-term retention test ) , their intervention . During each testing stage subjects completed a cognitive , multiple-choice test and two cardiac arrest scenarios . Changes in exam performance were analyzed for significance . A survey was conducted asking students ' perceptions of their assigned modality . RESULTS One hundred and seventeen students were r and omized to Simulation  ( n=39 ) , Multimedia ( n=38 ) , and Reading ( n=40 ) . Simulation demonstrated greater improvement managing cardiac arrest scenarios compared to both Multimedia and Reading on the post-test ( 9 % versus 5 % and 2 % , respectively , p<0.05 ) and Reading on the short-term retention test ( 6 % versus -1 % , p<0.05 ) . Multimedia showed significant improvement on cognitive , short-term retention testing compared to Simulation and Reading ( 5 % versus 0 % and 0 % , respectively , p<0.05 ) . On the survey , 95 % of Simulation and 84 % of Multimedia indicated they enjoyed their modality . CONCLUSION Simulation and multimedia educational tools were effective and may provide significant additive benefit compared to reading alone . Indian students enjoyed learning via these modalities Purpose Barriers to optimal performance of cardiopulmonary resuscitation may partly relate to human factors , such as stress and specific emotions . The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers . Methods This prospect i ve , observational study was conducted at the Simulator Center of the University Hospital Basel , Switzerl and . A total of 120 medical students ( 70 % female ) participated in teams of three . They reported levels of perceived stress , feeling overwhelmed , motivation and specific emotions before , during , and after a simulated resuscitation . The association of stress/overload ( index of stress and feeling overwhelmed ) , motivation , and specific emotions with resuscitation performance defined as h and s-on time during the first 180 s after cardiac arrest was investigated . Results During resuscitation , levels of stress/overload , motivation , and negative emotions were significantly higher as compared to the periods before and after resuscitation . In contrast , positive emotions were highest before and after resuscitation and significantly lower during resuscitation . In general , females reported higher stress/overload and negative emotions , whereas males reported more positive emotions . A multivariate linear regression model showed negative associations of stress/overload ( regression coefficient −18.12 , 95 % CI −30.73 , −5.51 , p = 0.006 ) and positive associations of motivation ( regression coefficient 13.45 , 95 % CI 0.95 , 25.95 , p = 0.036 ) with resuscitation performance . Conclusion A simulated cardiac arrest caused substantial perceived stress/overload and negative emotions , particularly in female students , which adversely impacted resuscitation performance . Further studies are required to exp and our findings to more experienced medical professionals and investigate whether stress coping strategies improve resuscitation performance Introduction : In this study design ed with adequate statistical power to detect relevant training effects , investigators evaluated Crisis Re source Management ( CRM ) training during a simulated patient crisis . This study is guided by the Team Effectiveness Conceptual Model by Kozlowski and Ilgen . Methods : An experimental pretest/posttest design was used . Four-member , interdisciplinary teams , each composed of nursing and medical students , were r and omly assigned to experimental or control conditions : Basic Life Support plus CRM training or Basic Life Support only , respectively . Team process ( task management , teamworking , situation awareness , and interprofessional attitude ) and team effectiveness ( team error rate and response times ) were the outcomes of interest . Results : Experimental teams demonstrated significant improvement in team process measures compared with control teams . CRM training predicted 13 % of the variance in task management ( P = 0.05 ) , 15 % of the variance in teamworking ( P = 0.04 ) , and 18 % of the variance in situation awareness ( P = 0.03 ) . CRM training and task management predicted 22 % of the variance ( P = 0.04 ) in team error rate ; CRM training and teamworking predicted 35 % of the variance ( P = 0.01 ) , while CRM training and situation awareness predicted 20 % of the variance ( P = 0.04 ) in response time to chest compressions . Both experimental and control teams demonstrated significant improvement in team effectiveness measures . Conclusions : CRM team training and team practice in an environment of high-fidelity simulation and facilitated debriefing have significant effects on team process and team effectiveness . The conceptual framework is potentially adaptable to additional setting s and population s for team-related research and education Objective : To determine the impact of simulation-based instruction on  student performance in the role of emergency department resuscitation team leader . Methods : A r and omized , single-blinded , controlled study using an intention to treat analysis . Eighty-three fourth-year medical students enrolled in an emergency medicine clerkship were r and omly allocated to two groups differing only by instructional format . Each student individually completed an initial simulation case , followed by a st and ardized curriculum of eight cases in either group simulation or case-based group discussion format before a second individual simulation case . A remote coinvestigator measured eight objective performance end points using digital recordings of all individual simulation cases . McNemar & khgr;2 , Pearson correlation , repeated measures multivariate analysis of variance , and follow-up analysis of variance were used for statistical evaluation . Results : Sixty-eight students ( 82 % ) completed both initial and follow-up individual simulations . Eight students were lost from the simulation group and seven from the discussion group . The mean postintervention case performance was significantly better for the students allocated to simulation instruction compared with the group discussion students for four outcomes including a decrease in mean time to ( 1 ) order an intravenous line ; ( 2 ) initiate cardiac monitoring ; ( 3 ) order initial laboratory tests ; and ( 4 ) initiate blood pressure monitoring . Paired comparisons of each student ’s initial and follow-up simulations demonstrated significant improvement in the same four areas , in mean time to order an abdominal radiograph and in obtaining an allergy history . Conclusions : A single simulation-based teaching session significantly improved student performance as a team leader . Additional simulation sessions provided further improvement compared with instruction provided in case-based group discussion format Objective . To determine whether a high-fidelity simulation technique compared with lecture would produce greater improvement in  advanced cardiac life support ( ACLS ) knowledge , confidence , and overall satisfaction with the training method . Design . This sequential , parallel-group , crossover trial r and omized students into 2 groups distinguished by the sequence of teaching technique  delivered for  ACLS instruction ( ie , classroom lecture vs high-fidelity simulation exercise ) . Assessment . Test scores on a written examination administered at baseline and after each teaching technique improved significantly from baseline in all groups but were highest when lecture was followed by simulation . Simulation was associated with a greater degree of overall student satisfaction compared with lecture . Participation in a simulation exercise did not improve pharmacy students ’  knowledge of ACLS more than attending a lecture , but it was associated with improved student confidence in skills and satisfaction with learning and application . Conclusions . College curricula should incorporate simulation to complement but not replace lecture for ACLS education Objective : The influence of teaching leadership on the performance of rescuers remains unknown . The aim of this study was to compare leadership instruction with a general technical instruction in a high-fidelity simulated cardiopulmonary resuscitation scenario . Design : Prospect i ve , r and omized , controlled 
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In conclusion ,  student attitudes toward interprofessional learning and simulation experiences were more positive .
Research reports emphasized the importance of adherence to established guidelines , adopting a holistic approach to training , and that preliminary training , briefing , deliberate practice s , and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training