Background: Resuscitation of critically ill pediatric patients is complex and difficult, even for experienced clinicians. Fortunately, pediatric cardiopulmonary arrests in hospital remain rare events, occurring in only 0.1 to 0.3% of children admitted to hospital, with the majority occurring in intensive care settings.1 Early recognition of respiratory compromise or shock in hospitalized pediatric patients with rapid intervention,2 and the involvement of the intensive care team for serious or refractory cases, remain fundamental measures to minimize the progression of the patient towards a pulmonary or cardiac arrest. Unfortunately, response times for formal resuscitation teams in hospitals often exceed 3 minutes;3-5, hence the current low performance6. of hospital service teams must be addressed as an important hospital quality assurance issue. Illustrating the importance of the initial response, one study demonstrated that all adult patients who survived to discharge from hospital following cardiac arrest on wards were resuscitated by 'first responders' (including medical personnel) restoring circulation before the arrival of the cardiac arrest team. 7Medical students (clinical clerks) care for hospitalized pediatric patients under the supervision of residents and staff physicians. They are not primarily responsible for the care of acutely deteriorating pediatric patients, but they may, incidentally, be the first "medical" professionals to evaluate these patients and can assist in resuscitation efforts until personnel arrive. more experienced. Assessing patients, calling for help appropriately, and initiating treatment for patients whose condition deteriorates or those with sudden decompensation, such as seizures, syncope, or arrhythmias, should arguably be part of this. ..... middle of document ...... value of written-knowledge tests and a multiple-station exam to assess actual medical performance in daily practice. Med Éduc 1999;33: 197-203.27. Remmen R, Scherpbier A, Denekens J et al. Correlation of a written skills test and a performance-based test: A study in two traditional medical schools. MedTeach 2001; 23:29-32.28. Van der Vleuten CP, Van Luyk SJ, Beckers HJ. A written test as an alternative to performance tests. Med Educ 1989;23:97-107.29. Verhoeven BH, Hamers JG, Scherpbier AJ, Hoogenboom RJ, van der Vleuten CP. The effect on reliability of adding a separate written assessment component to an objective structured clinical examination. Med Educ 2000;34:525-9.30. Jansen JJ, Tan LH, van der Vleuten CP, van Luijk SJ, Rethans JJ, Grol RP. Assessment of clinical technical skills skills of general practitioners. Educational Medicine 1995;29:247-53.