Cognitive appraisals and team performance under stress: A simulation study

Abstract

Objectives The present study explored how challenge and threat responses to stress relate to performance, anxiety, confidence, team identity and team characteristics (time spent in training and postgraduate experience) in a medical simulation‐based team competition. Methods The study was conducted during a national simulation‐based training event for residents, the SIMCUP Italia 2018. The SIMCUP is a simulation competition in which teams of four compete in simulated medical emergency scenarios. Cross‐sectional data were collected prior to the 3 days of the competition. Subjects included 95 participants on 24 teams. Before the competition on each day, participants completed brief self‐report measures that assessed demands and resources (which underpin challenge and threat responses to stress), cognitive and somatic anxiety, self‐confidence and team identification. Participants also reported time (hours) spent practising as a team and years of postgraduate experience. A team of referees judged each scenario for performance and assigned a score. A linear mixed model using demands and resources was built to model performance. Results The data showed that both demands and resources have positive effects on performance (31 [11‐50.3] [P < .01] and 54 [25‐83.3] [P < .01] percentage points increase for unitary increases in demands and resources, respectively); however, this is balanced by a negative interaction between the two (demands * resources interaction coefficient = −10 [−16 to −4.2]). A high level of resources is associated with better performance until demands become very high. Cognitive and somatic anxieties were found to be correlated with demands (Pearson's r = .51 [P < .01] and Pearson's r = .48 [P < .01], respectively). Time spent training was associated with greater perceptions of resources (Pearson's r = .36 [P < .01]). Conclusions We describe a model of challenge and threat that allows for the estimation of performance according to perceived demands and resources, and the interaction between the two. Higher levels of resources and lower demands were associated with better performance.

Health Care Professional Students’ Perceptions of Teamwork and Roles After an Interprofessional Critical Care Simulation

“…Similarly, a literature review examining knowledge of Sim-IPE among practicing nurses indicated a need for Sim-IPE to better understand the roles of other practitioners with whom nurses collaborate. 25 Four studies of a mixed methods design 12,16,26,27 used questionnaires and interviews to study nursing staff perceptions of care transfers of older people. By using Sim-IPE, these studies validated that care transitions were improved, and integrated care skills were developed among hospital staff.…”

“…Four studies of a mixed methods design 12,16,26,27 used questionnaires and interviews to study nursing staff perceptions of care transfers of older people. By using Sim-IPE, these studies validated that care transitions were improved, and integrated care skills were developed among hospital staff.…”

“…Results revealed Simulation Effectiveness Tool-Modified scores did not vary between the experimental and control groups ( P = .658). Carenzo et al 26 used simulation to identify how 95 participants and 24 teams responded to a medical emergency scenario. They found that a high level of resources is associated with better performance until demands become very high.…”

Predictors of end-of-life care stress, calling, and resilience on end-of-life care performance: a descriptive correlational study

“…Providing EOLC is a highly stressful event for nurses, and they experience high levels of stress due to role conflicts, psychological burdens, and time-pressing work as their expertise and clinical competencies increase. Although past findings on stress and performance are somewhat inconsistent, an experimental study reported that stress caused by challenges in task-solving actually improves performance [ 42 ]. This reflects the Yerkes-Dodson law [ 43 ], which explains that an appropriate level of stress is conducive to creative activities and enables problem-solving.…”

“…This reflects the Yerkes-Dodson law [ 43 ], which explains that an appropriate level of stress is conducive to creative activities and enables problem-solving. Conversely, increased anxiety due to stress responses can diminish one’s performance [ 42 ]. As repetitive simulation training reduces anxiety [ 44 ], practical education programs may be developed to boost EOLC performance.…”