The impact of CPR coach presence and position on team leader and team performance during asystole simulation scenario: a randomized simulation-based trial

BACKGROUND: High-quality cardiopulmonary resuscitation is critical for patient survival, and its effectiveness depends on compression quality, team coordination, and leadership. The CPR coach provides real-time feedback aimed at optimizing chest compressions and enhancing the overall resuscitation process. The primary aim is to evaluate whether the presence and the position of a CPR coach are equivalent compared to the absence of a CPR coach regarding the team leader's performance. As a secondary objective, it was investigated whether the presence and the position of the CPR coach influence the teams' performance. METHODS: This is single-center, randomized, controlled, three-arm, simulation-based equivalence trial. Teams of residents participated in standardized asystole scenarios, randomized to one of three groups: Group A (CPR coach positioned near the defibrillator), Group B (CPR coach allowed to move freely), and Group C (no CPR coach). The primary outcome was assessed using the Resuscitation Team Leader Evaluation Scale. The secondary outcome was measured by the Clinical Performance Tool and a CPR execution quality score derived from simulation manikin feedback. RESULTS: A total of 42 teams were included in the analysis. With respect to the primary outcome, team leader performance was statistically equivalent across Groups A, B, and C. As for the secondary outcome, no significant differences were observed in overall team performance. CONCLUSION: The presence and position of a CPR coach did not significantly influence team leader or team performance. Further research is needed to explore the role of CPR coaches in real-life settings and among more experienced teams. TRIAL REGISTRATION: Trial registration: NCT05309434. Registered 15/04/2022.