Comparison of dyad versus individual simulation-based training on stress, anxiety, cognitive load, and performance: a randomized controlled trial

Abstract

Background Dyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner. In this pilot study, we investigate the relationship between dyad training on stress, anxiety, cognitive load, and performance in a simulated bradycardia scenario. Methods Forty-one fourth-year medical school trainees were randomized as dyads (n = 24) or individuals (n = 17) for an education session on day 1. Reassessment occurred on day 4 and was completed as individuals for all trainees. Primary outcomes were cognitive load (Paas scale), stress (Cognitive Appraisal Ratio), and anxiety levels (abbreviated State-Trait Anxiety Inventory). Secondary outcomes were time-based performance metrics. Results On day 1 we observed significant differences for change in anxiety and stress measured before and after the training scenario between groups. Individuals compared to dyads had larger mean increases in anxiety, (19.6 versus 7.6 on 80-point scale, p = 0.02) and stress ratio (1.8 versus 0.9, p = 0.045). On the day 4 post-intervention assessment, no significant differences were observed between groups. Secondary outcomes were significant for shorter time to diagnosis of bradycardia (p = 0.01) and time to initiation of pacing (p = 0.04) in the dyad group on day 1. On day 4, only time to recognizing the indication for pacing was significantly shorter for individual training (hazard ratio [HR] = 2.26, p = 0.02). Conclusions Dyad training results in lower stress and anxiety levels with similar performance compared to individual training.

Dyad pedagogy in practical anatomy: A description of the implementation and student perceptions of an adaptive approach to cadaveric teaching

“…Working in pairs in this setting has been shown to permit more efficient use of simulators, is more cost‐effective than individual practice, and in the case of laparoscopic cholecystectomy, reduces surgical operating time (Kowalewski et al, 2019 ). Notably, dyad training for procedural skills has also been shown to significantly reduce stress and anxiety among students while learning (Abbott et al, 2021 ).…”

Dyadic practice for the acquisition of laparoscopic skills (DALS)—A randomized controlled trial

“…Many valued the ability to independently problem solve, aligning with the findings of Abbott et al, who found that although DP participants reported lower stress and anxiety, a majority still preferred IP. 28 The remaining major themes describe disadvantages of IP: limitations of a lack of peer-to-peer support and teamwork, learning being restricted due to the lack of peer feedback, and limitations of continuous repetitive practice. Whilst some participants valued independence, others recognized the inefficiency of continuous repetitive practice, as they were limited to their own abilities which are less than the shared abilities of a collaborative pair.…”

Impact of dyadic practice on the clinical self-efficacy and empathy of nursing students

“…Abbott et al (2021) compared dyad versus individual simulation-based training on performance. Dyad practicing caused similar performance versus solo training [ 34 ].…”

“…The results of their phenomenological research indicated that the student’s level of self-efficacy increased as a result of interactions with their peers [ 32 ]. In addition, some studies indicated a decrease in the student dyads’ level of anxiety and stress and increased confidence in their abilities [ 33 , 34 ].…”