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

Ghazali, Daniel Aiham

doi:10.21767/2386-5180.100083

Cited by 3 publications

(2 citation statements)

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“…We also found that HR and HRV in the frequency domain (LF/HF ratio) increased during all repeated sessions in both groups. In another study pertaining to the same randomized control trial, results suggested that salivary cortisol similarly increased during all repeated simulations and decreased during debriefing in both experimental and control groups [19]. On this subject, the Yerkes-Dodson law on tendency for optimal performance models the relationship between performance and stress as an inverted-U curve: stress improves performance up to a peak, and subsequently drives it down [36].…”

Section: Discussionmentioning

confidence: 99%

“…We previously found that stress increased during simulation and decreased during and after debriefing [14,18]. Repeated simulations using salivary cortisol did not blunt it during the simulation phase [19]. However, to our knowledge, up until now no study has analyzed level of stress in participants during the whole day of planned simulation training and its evolution when simulations are repeated.…”

Section: Introductionmentioning

confidence: 99%

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Stress response in the daily lives of simulation repeaters. A randomized controlled trial assessing stress evolution over one year of repetitive immersive simulations

et al. 2019

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Background Simulations in healthcare reproduce clinical situations in stressful conditions. Repeated stress exposure might influence the learning process in simulation as well as real-life. Objectives 1) To record heart rate and heart rate variability evolution during one-day simulation over one year; 2) To analyze the effect of repetitive high-fidelity simulations on the risk of post-traumatic stress disorder. Study design Single-center, investigator-initiated RCT. 48 participants were randomized in 12 multidisciplinary teams of French Emergency Medical Services to manage infant shock in high-fidelity simulations. In the experimental group, 6 multidisciplinary teams were exposed to 9 different simulation sessions over 1 year. In the control group, 6 multidisciplinary teams participated in only 3 simulation sessions, in common with those of the experimental group (initial, intermediate after 6 months, and finally after 1 year). Heart rate (HR) and heart rate variability (HRV) were analyzed on a 24-hour Holter from the day prior to simulation until the end of simulation. Questionnaires of Impact of Event Scale-Revised at 7 days and Post-traumatic Check-List Scale at 1 month were used to detect possible post-traumatic stress disorder in participants. p<0.05 was considered significant. Results Stress increased during each simulation in the two groups. After analysis on the 24-hour period, there was no significant difference between the two groups during the initial simulation session in terms of heart rate and heart rate variability. In the 24-hour period of the intermediate and final simulation sessions, the level of stress was higher in the control group during the diurnal (p = 0.04) and nocturnal periods (p = 0.01). No participant developed post-traumatic stress disorder after the 72 simulation sessions. Conclusions Despite the stress generated by simulation, the more the sessions were repeated, the less were their repercussions on the daily lives of participants, reflected by a lower sympathetic activity. Moreover, repetition of simulations did not lead to post-traumatic stress disorder. Trial registration ClinicalTrials.gov NCT02424890 .

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Section: Discussionmentioning

confidence: 99%