Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions

Bauer, Christian; Rimmelé, Thomas; Duclos, Antoine; Prieto, Nathalie; Cejka, Jean-Christophe; Carry, Pierre-Yves; Grousson, S.; Friggeri, Arnaud; Secco, Julien; Bui‐Xuan, Bernard; Lilot, Marc; Lehot, Jean‐Jacques

doi:10.1016/j.accpm.2016.01.004

Cited by 26 publications

(33 citation statements)

References 25 publications

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“…Even though the experience was determined by the students as a source of stress, and this was similar even for subjects with previous experience with HFS, the variation in haemodynamic parameters and difference in concentration of analyzed variables was not statistically significant and it shows rather a trend, that could may be be proven to be significant on a larger group of participants. Cortisol concentration and alpha-amylase activity measured in saliva was higher after the simulation and the concentration of sIgA was reduced at both T1 and T2 time points, which could suggest that the stress level was highest after the simulation, but the size of the effect is small and although this finding is in line with other studies it cannot be stated that in our population this reaction to stress was visible [15]. The hypothalamicpituitary-adrenal axis and the autonomic nervous system play vital roles in mediating the response to acute stress.…”

Section: Discussionsupporting

confidence: 73%

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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Section: Discussionsupporting

confidence: 73%

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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“…However, almost no relationships were found between trait anxiety and other (physiological, cardiovascular system, humoral and immunological) stress markers. It suggests that personality related vulnerability to stress could have affected psychological responses rather than biological 3 . This inconsistency should be interpreted with caution, as our sample was non-clinical with almost 90% of participants displaying low to average vulnerability to stress and anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, high-fidelity simulation (HFS) may effectively contribute to identifying and reducing the causes of human error in medical settings 2 . Although medical simulations are recognized as a highly cost-effective educational method, there is growing evidence showing that its participants are exposed to stress, which manifests in a complex way, including physiological response, humoral reactions, or psychological state of distress 3 – 5 .…”

Section: Introductionmentioning

confidence: 99%

Stress responses in high-fidelity simulation among anesthesiology students

Stecz

Makara‐Studzińska

Białka

et al. 2021

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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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“…Thresholds used in the French literature are as follows: low, less than 46; moderate, between 46 and 55; and high, greater than 55. 18 Outcomes were the presence of severe self-reported symptoms, ie, the presence of suicidal thoughts or a high score on at least 1 scale (ie, IES-R >36; PSS-10 >26; BDI-13 >15; or STAI-Y2 >55). 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 …”

Section: Methodsmentioning

confidence: 99%

Factors Associated With Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic

et al. 2020

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Key Points Question What is the mental health state of university students in France who were confined during the coronavirus disease 2019 (COVID-19) pandemic, and what factors are associated with the development of mental health symptoms? Findings This survey study of 69 054 students who experienced quarantine found high prevalence rates of severe self-reported mental health symptoms. Among risk factors identified, female or nonbinary gender, problems with income or housing, history of psychiatric follow-up, symptoms compatible with COVID-19, social isolation, and low quality of information received were associated with altered mental health. Meaning The findings of this study suggest that students’ mental health is a public health issue that has become even more critical in the context of a pandemic, underlining the need to reinforce prevention, surveillance, and access to care.

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Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions

Cited by 26 publications

References 25 publications

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

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

Stress responses in high-fidelity simulation among anesthesiology students

Factors Associated With Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic

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