Endocrine and psychological stress responses in a simulated emergency situation

Keitel, Ariane; Ringleb, Matthias; Schwartges, Ingo; Weik, Ulrike; Picker, O.; Stockhorst, Ursula; Deinzer, Renate

doi:10.1016/j.psyneuen.2010.06.011

Cited by 91 publications

(53 citation statements)

References 34 publications

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“…The findings supported that the teachers' abilities in facilitating are crucial [20,45] . The educator's role is to clarify what kind of communities the students should learn for and to recognize that the perception of risk and tolerance for anxiety is individual [40] .…”

Section: Discussionsupporting

confidence: 66%

“…For achieving simulation competency, it is vital that the students are familiar with and accustomed to the principles and strategies used [17] , which is also essential for a positive learning outcome [18][19][20][21] . This also includes in debriefing the need to know the principles of the method, being able to problem-solve the topic, and a willingness to be involved and actively participate.…”

Section: Introductionmentioning

confidence: 99%

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Debriefing in simulation conducted in small and large groups - nursing students’ experiences

Tosterud

Hall‐Lord

Petzäll

et al. 2014

JNEP

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The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students' experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Debriefing in simulation conducted in small and large groups - nursing students’ experiences

Tosterud

Hall‐Lord

Petzäll

et al. 2014

JNEP

View full text Add to dashboard Cite

show abstract

“…Thus, despite the presence of an older group (IDE, AD) in the present study, analysis of biological stress was possible as well as comparisons among MDTs. SC and its relative variation increased after simulation scenario has been acted as suggested in high-fidelity simulation [7][8][9][10] and decreased after debriefing [35]. Debriefing using the good-judgment debriefing technique [36] could induce a lowering level of SC.…”

Section: Discussion About the Primary Objectivementioning

confidence: 99%

“…Simulation-based education is commonly used to train multidisciplinary teams (MDTs) in the management of lifethreatening situations [4][5][6]. Stress has been reported during simulation and assessed by various means [7][8][9][10]. HPA activity can be apprehended by the non-invasive measurement of salivary cortisol (SC) [11].…”

Section: Introductionmentioning

confidence: 99%

Salivary Cortisol Increases after One Immersive Simulation but the Repetition of Sessions does not Blunt it

Ghazali¹

2016

Ann Clin Lab Res

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Objective: Simulated life-threatening medical emergencies generate stress that can be apprehended by measurement of salivary cortisol (SC). The aim of this study was to analyze SC level in multidisciplinary teams (MDTs) members during immersive simulation and to study its evolution over time with repetition of simulation sessions in all team members.Methods: 48 participants constituted 12 Emergency Medical Service MDTs made up of 4 members each. Six MDTs underwent 9 simulations (experimental group) and 6 underwent 3 simulations over one year (control group). SC was assessed the day prior to simulation (T0), before simulation (T1), after simulation (T2) and after debriefing (T3). 1152 samples were analyzed by ELISA. Variation over time was analyzed using ANOVA for repeated measures. Mann-Whitney test was used for comparison between groups at two times and Kruskal-Wallis test was used to study stress response in the different status of teams. A p value <0.05 was considered significant.Results: SC increased from 0.16 ± 0.12 (T0) to 0.26 ± 0.14 (T1). SC level continued to rise up to 0.39 ± 0.27 at T2 before decreasing to 0.21 ± 0.12 at T3, p<0.0001. SC increase was found in all team members with no status effect. SC level was not blunt after repetition of sessions regardless of the frequency of sessions.Conclusion: SC raised during immersive simulation and this variation was not blunt after repetition of simulation sessions. No status effect was found among the MDTs' members. Future study should investigate on other markers of stress response and correlate them to team performance.Trial registration: ClinicalTrials.gov registration number NCT02424890

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“…The second one will have a long term effect (at least several hours), mainly related to the production of corticotropes and cortisol which have a moderating effect as opposed to adrenaline. The short term stress is thus mainly concerned by the sympathetic nervous system and its effects (see for example Davezies, 2008;Montano et al, 2009;Keitel et al, 2011).…”

Section: Heart Parameters Measurementsmentioning

confidence: 99%

Characterization of Anesthetists’ Behavior during Simulation Training: Performance Versus Stress Achieving Medical Tasks with or without Physical Effort

Alekhine¹,

Geeraerts²

2014

PSBR

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-Decades of research about stress have shown that it could be source of performance but also of cognitive deficit. The studies have led to highlight occupational stress variables that researchers have characterized by physiological measurements, data treatments and protocols becoming more and more complex with time. If these devices are gaining in precision, they are now too complex to allow non-specialist users to produce a quick interpretation of results. Yet for vocational training, specifically on simulators, trainers need to know in real time whether or not what they implement allows the trainees to learn in good conditions, i.e. by favoring the behavior produced by the positive effect of stress on performance. The present paper addresses the performance versus occupational stress during training sessions of anesthetists on simulator. We studied the performance and stress with or without physical effort using a simple protocol based on the use of basic heart parameters in order to obtain a quasi-instantaneous interpretation of the data. We identified cognitive deficit zone during training according to the Yerkes & Dodson (1908) relationship between performance and stress. We showed that performance versus stress during simulation training with or without physical efforts could be successfully analyzed for immediate assessment of stress influencing performance. Suggestions have been made for improving training sessions and avoid trainees' behavior induced by cognitive deficit. Limits of the protocol are exposed.

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Endocrine and psychological stress responses in a simulated emergency situation

Cited by 91 publications

References 34 publications

Debriefing in simulation conducted in small and large groups - nursing students’ experiences

Debriefing in simulation conducted in small and large groups - nursing students’ experiences

Salivary Cortisol Increases after One Immersive Simulation but the Repetition of Sessions does not Blunt it

Characterization of Anesthetists’ Behavior during Simulation Training: Performance Versus Stress Achieving Medical Tasks with or without Physical Effort

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