Enhancing Team Dynamics and Leadership Skills for Residents Leading Multidisciplinary In-Patient Cardiac Arrest Teams

Cardiac arrest is a prevalent event with low survival rates, both in out-of-hospital and in-hospital settings. There is a lack of specific training programs addressing team dynamics and leadership skills during resuscitation events, creating a clinical gap. This project aimed to enhance team dynamics and improve leadership skills during IHCA resuscitation events.

We implemented the Mock Code Project for resident physicians from our Internal Medicine Residency Programs in the simulation center (i.e., in a controlled environment) to address this gap. Multidisciplinary team mock code scenarios were created for residents, allowing them to lead resuscitation simulations. The scenarios were based upon common conditions encountered during codes (Cardiac arrest). Trained evaluators provided real-time feedback, and pre-and post-surveys were conducted to assess team perception and gather feedback.

Baseline data revealed that 98.6% (143 of 145 residents total) felt uncertain or lacked confidence in leading effective codes in our hospital prior to the intervention. Post-test survey outcome data revealed that 95.1% of participants (136 residents of 143) reported that the sessions challenged their skills at leading codes and improved their skills at managing resuscitation teams.

Organized codes with clear roles, responsibilities, bed positioning, and clear leadership significantly improve closed-loop communication, effective team interaction, and patient outcomes. The Mock Code Project fills the gap in training programs by focusing on team dynamics and leadership skills during IHCA resuscitation. Ongoing evaluations and feedback ensure continual improvement in resident confidence and skills. Implementing organized codes benefits residents and healthcare teams, ultimately improving patient care during IHCA. Well-designed mock code scenarios with real-time feedback from senior physicians are an effective way for trainees to develop these skills and this awareness without compromising patient safety.