Objective: The aim of this study was to evaluate resuscitation skills, defined as recognition of resuscitation situations and performance of Basic Life Support (BLS) in students at the Brandenburg Model Medical School (BMM). Methods: Participating students (n=102) were randomized to different simulation scenarios: unconscious person with physiological breathing (15/min), gasping (<10/min) and apnea (resuscitation dummy AmbuMan® Wireless with electronic recording). Primary endpoint was the proportion of students with correct decision for or against resuscitation. Secondary endpoint was resuscitation quality, self-assessment, and prior resuscitation experience. The latter two were assessed by questionnaire prior to the simulated situation. Results: Overall, there was a high risk for incorrectly omitted or incorrectly performed resuscitation (OR 3.4 [95% CI 1.4-8.1] p=0.005. The highest probability of error occurred in the unconsciousness and gasping groups. 22.3% of all performed resuscitations where at the same time indicated and reached the European Resuscitation Council recommendations for compression frequency, pressure depth and where as well = 90% relieved. A particularly large discrepancy emerged between participants' self-assessment of being prepared for a resuscitation situation by medical school and their actual documented resuscitation competence. Conclusion: The present data indicate significant uncertainty among students in recognizing a resuscitation situation. Even in curricula with a high proportion of practice and a high degree of students with completed vocational training in health care, resuscitation competence is poor.