Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study

Evain, Jean-Noël; Zoric, Lana; Mattatia, Laurent; Picard, Olivier; Ripart, Jacques; Cuvillon, Philippe

doi:10.1016/j.accpm.2016.09.008

Cited by 13 publications

(14 citation statements)

References 20 publications

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“…Assuming that stress reaction is rather complex in its manifestation, few studies addressed stress response changes related to HFS, emphasizing the equal importance of psychological, physiological and humoral components for stress assessment [19][20][21][22] . Hence, many questions regarding the dynamics and mechanisms of stress reaction to HFS remain to be addressed.…”

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confidence: 99%

Stress responses in high-fidelity simulation among anesthesiology students

Stecz

Makara‐Studzińska

Białka

et al. 2021

Sci Rep

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Simulation sessions can produce high-fidelity emergency situations that facilitate the learning process. These sessions may also generate a complex stress response in the learners. This prospective observational study assessed psychological, physiological, immunological, and humoral levels of stress during high-fidelity simulation training. Fifty-six undergraduate medicine students who took part in a medical simulation session were assigned team roles (physician, nurse or assistant). Subsequently, each participant was assessed before the scenario (T0), after the procedure (T1), and two hours later (T2). Psychological stress and anxiety were measured at T0 and T1, using the State-Trait Anxiety Inventory (STAI) and Dundee Stress State Questionnaire (DSSQ). Cortisol, testosterone, secretory immunoglobulin class A (sIgA), alpha-amylase, and oxygen saturation level were measured at T0, T1, and T2, as was the physiological response indicated by heart rate (HR) and blood pressure (BP). It was found that the onset of task performance was related to increased anticipatory worry and higher oxygen saturation. The participants reported decreased worry, followed by increased emotional distress after the simulation training (T1). Participants trait anxiety predicted the intensity of worry, distress and task engagement. In contrast, no clear relationships were found between trait anxiety and biological stress markers. Testosterone levels were growing significantly in each phase of measurement, while physiological responses (BP, HR) increased at T1 and declined at T2. The levels of stress markers varied depending on the assigned roles; however, the trajectories of responses were similar among all team members. No evidence for prolonged cortisol response (T1, T2) was found based on psychological stress at the onset of simulation (T0). Regression analysis followed by receiver operating characteristics analyses showed uncertain evidence that initial state anxiety and worry predicted the levels of sIgA. Medical students are relatively resilient in terms of stress responses to medical simulation. The observed stress patterns and interrelationships between its psychological, physiological, hormonal, and immunological markers are discussed in accordance with theoretical concepts, previous research work, and further recommendations.

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confidence: 99%

Stress responses in high-fidelity simulation among anesthesiology students

Stecz

Makara‐Studzińska

Białka

et al. 2021

Sci Rep

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“…In addition, it was suggested that strong emotional involvement could have a negative effect on the performance of professionals in simulated crisis situations. This negative impact on the ability to perform technical procedures was highlighted with cricothyrotomy or laparoscopy in a study by Evain et al [ 18 ]. In turn, a combination of intense emotional events could improve the mechanisms of memory consolidation.…”

Section: Discussionmentioning

confidence: 99%

Effect of high-fidelity simulation on alpha-amylase activity and concentrations of secretory immunoglobulin class A, cortisol, and testosterone among medical students

et al. 2021

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Purpose High-fidelity simulation calls heavily upon cognitive capacities and generates stress and anxiety. The objective of this prospective, observational study was to evaluate the degree of stress in medical students by measuring hormone levels during critical care classes. Methods Overall, 55 students (senior years of medical faculty) of both sexes were divided into 5-person teams. Demographic data and information on diagnosed diseases, stimulants used, and previous experience in the field of medical simulation were collected with a personal questionnaire. Before starting the scenario (T0), after the end of the scenario (T1), and 120 min thereafter (T2), stress level was measured. For this purpose, systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate and blood oxygen saturation were evaluated. In addition, saliva was collected to determine alpha-amylase activity and the concentrations of secretory immunoglobulin class A, cortisol, and testosterone. Results Among hemodynamic parameters, systolic and mean blood pressure and heart rate were significantly higher in T1 than in T0 and T2 time points (p < 0.05). Cortisol concentration was higher at T2 compared with T0 and T1. Alpha-amylase activity was highest at T1. Secretory immunoglobulin class A concentration was highest at T0, followed by T1 and then T2. These differences were not statistically significant. Testosterone concentration showed significantly higher values at T2 compared with T0 and T1 (p < 0.05). The analysis of team leaders vs. other members revealed significantly lower cortisol and alpha-amylase values in leaders (p < 0.05). Conclusions High-fidelity simulation is a useful education method in medical subjects, especially in cases where a mistake could produce serious or irreversible consequences. It can increase stress hormone concentrations and thus can be assumed effective as a learning aid even in senior-year students of medical faculty.

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“…We would hypothesize, based on previous literature, that more exposure to simulations would result in less perceived stress, and therefore, less movement around the simulation environment. 15 16 34–36 We also suggest it would be important to consider student performance in future studies and evaluate the relationship between perceived stress, movement and performance.…”

Section: Discussionmentioning

confidence: 99%

“…25 26 Additional practice in a simulated, low-stakes environment may be used to reduce stress and optimize movement for participants through exposure to high-stakes medical scenarios, training and targeted feedback. 15 16 34–36…”

Section: Discussionmentioning

confidence: 99%

Job role and stress influence student movement during postpartum haemorrhage simulation: an exploratory study

Bican

Heathcock

Jedryszek

et al. 2020

BMJ Simul Technol Enhanc Learn

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IntroductionPostpartum haemorrhage is the leading cause of maternal death. Healthcare simulations are an educational tool to prepare students for infrequent high-risk emergencies without risking patient safety. Efficiency of movement in the simulation environment is important to minimize the risk of medical error. The purpose of this study was to quantify the movement behaviours of the participants in the simulation and evaluate the relationship between perceived stress and movement.MethodsN=30 students participated in 10 high-fidelity medical simulations using an adult patient simulator experiencing a postpartum haemorrhage. The participants completed the State-Trait Anxiety Inventory prior to the simulation to measure perceived stress. Physical movement behaviours included walking around the simulation, time spent at bedside, arm movements, movements without purpose, looking at charts/vitals and total movement.ResultsMidwife (MW) students spent significantly more time walking (p=0.004) and looking at charts/vitals (p=<0.001) and significantly less time at bedside (p=<0.001) compared to obstetric (OB) students. The MW students demonstrated significantly more total movements compared to the OB students (p=<0.001). There was a significant, moderate, positive relationship between perceived stress and total movement during the simulation for the MW group (r=0.50, p=0.05). There was a trend for a moderate, positive relationship between perceived stress and total movement during the simulation for the OB group (r=0.46, p=0.10).ConclusionsPhysical movement during a simulation varies by job role and is influenced by perceived stress. Improved understanding of physical movement in the simulation environment can improve feedback, training and environmental set-up.

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Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study

Cited by 13 publications

References 20 publications

Stress responses in high-fidelity simulation among anesthesiology students

Stress responses in high-fidelity simulation among anesthesiology students

Effect of high-fidelity simulation on alpha-amylase activity and concentrations of secretory immunoglobulin class A, cortisol, and testosterone among medical students

Job role and stress influence student movement during postpartum haemorrhage simulation: an exploratory study

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