DETERMINANTS OF RELUCTANCE TO PERFORM CPR AMONG RESIDENTS AND APPLICANTS - THE IMPACT OF EXPERIENCE ON HELPING-BEHAVIOR

Background: Though mouth-to-mouth resuscitation (MMR) is widely endors ed as a useful lifesaving technique, studies have shown that health ca re professionals are reluctant to perform it. To characterize the circ umstances which facilitate this reluctance among physicians, we have s urveyed current and future residency trainees regarding attitudes towa rd providing ventilation by this method to strangers experiencing arre st in the community. Methods: A total of 280 categorical emergency med icine (EM) and internal medicine (IM) house officers and respective pr ogram applicants at a 655 bed Brooklyn, New York teaching hospital wer e anonymously surveyed regarding their willingness to attempt resuscit ation in five hypothetical scenarios of cardiopulmonary arrest. Result s: A direct relationship was observed between residency training level and reluctance to perform MMR in each scenario. Applicants expressed greater overall willingness to perform MMR than all residents (56 vers us 34%, P < 0.00001). Willingness among experienced residents was lowe r than for junior-level residents (29 versus 40%, P = 0.01). EM and IM physicians were statistically indifferent in their responses. There w ere no differences in willingness to perform MMR by age in MD applican t or resident groups. Conclusions: Many physicians and future doctors are reluctant to perform MMR on arrest victims in the community, a tre nd that increases in prevalence among those with more residency traini ng. These data support the hypothesis that diminished helping behavior occurs gradually over the training period and may occur as a direct c onsequence of the training experience. A model for characterizing the elements that make up a rescuer's decision process is proposed. (C) 19 97 Elsevier Science Ireland Ltd.