title: Factors relating to the perceived management of emergency situations: a survey of former Advanced Life Support course participants' clinical experiences.
abstract: BACKGROUND
  This study explored individual, team, and setting factors associated with the quality of management of in-hospital emergency situations experienced by former Advanced Life Support (ALS) course participants.
  
  
  METHODS
  This study was a survey of former ALS course participants' long-term experience of management of in-hospital, emergency situations. The survey was carried out in 2012 in Denmark and Norway.
  
  
  RESULTS
  A questionnaire was send to 526 potential responders and (281/479 × 100) 58.7% responded. The results demonstrated that 75% of the emergency situations were perceived as "managed well". In general, the responders' confidence in being ALS providers was high, mean 4.3 (SD 0.8), scale 1-5. Significant differences between the perceived "well" and "not well" managed situations were found for all questions, p<0.001. The largest differences related to perception of co-workers' ability to apply ALS principles, the team atmosphere and communication. Responders' ratings of quality of management of emergency situations increased with intensity of setting. However, the 'clinical setting' was rated significantly lower as attributor to ability to apply ALS principles compared to 'co-workers familiarity with ALS principles', 'own confidence as ALS-provider' and 'own social/inter-personal skills'.
  
  
  CONCLUSIONS
  The results of this survey emphasise that ALS providers' perceived ability to apply ALS skills were substantially affected by teamwork skills and co-workers' skills. Team related factors associated with successful outcome were related to clear role distribution, clear inter-personal communication and attentive listening, as well as respectful behaviour and positive team atmosphere. Although intensity of setting was attributed to ability to apply ALS principles, this did not affect management of emergency situations to the same extent as individual and team factors.
authors.affiliation: Centre for Clinical Education (CEKU), Centre for Human Resources and Rigshospitalet, Capital Region of Denmark and University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. Electronic address: mariabirkvad@gmail.com.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Rasmussen
authors.affiliation: Centre for Clinical Education (CEKU), Centre for Human Resources and Rigshospitalet, Capital Region of Denmark and University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Juliane Marie Centre, Rigshospitalet, Capital Region of Denmark, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Tolsgaard
authors.affiliation: Danish Institute for Medical Simulation (DIMS) and Herlev Hospital, Capital Region of Denmark, and University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Dieckmann
authors.affiliation: Gordon Centre for Research in Medical Education, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Miami, FL 33136, USA.
authors.forename: S Barry
authors.initials: SB
authors.lastname: Issenberg
authors.affiliation: Danish Institute for Medical Simulation (DIMS) and Herlev Hospital, Capital Region of Denmark, and University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark.
authors.forename: Doris
authors.initials: D
authors.lastname: Ostergaard
authors.affiliation: Stavanger Acute Medicine Foundation for Education and Research (Safer), Stavanger University Hospital, 4068 Stavanger, Norway.
authors.forename: Eldar
authors.initials: E
authors.lastname: Søreide
authors.affiliation: Department of Internal Medicine, Capital Region of Denmark, Glostrup University Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Rosenberg
authors.affiliation: Department of Anesthesia and The Wilson Centre, University of Toronto and University Health Network, Toronto, ON, Canada.
authors.forename: Charlotte V
authors.initials: CV
authors.lastname: Ringsted
mesh_terms: D002983:Clinical Competence; D003718:Denmark; D019468:Disease Management; D004501:Education, Medical / Q000379:methods; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008020:Life Support Care; D008297:Male; D009664:Norway; D010348:Patient Care Team; D012151:Resuscitation / Q000193:education*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: ALS; Cardiac arrest; Clinical emergency situations; Simulation based training; Team factors; Transfer