Perceived strain of undergraduate medical students during a simulated first day of residency

Fürstenberg, Sophie; Prediger, Sarah; Kadmon, Martina; Berberat, Pascal O.; Harendza, Sigrid

doi:10.1186/s12909-018-1435-4

Cited by 7 publications

(3 citation statements)

References 34 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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.…”

mentioning

confidence: 99%

Stress responses in high-fidelity simulation among anesthesiology students

Stecz

Makara‐Studzińska

Białka

et al. 2021

Sci Rep

View full text Add to dashboard Cite

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.

show abstract

mentioning

confidence: 99%

Stress responses in high-fidelity simulation among anesthesiology students

Stecz

Makara‐Studzińska

Białka

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The FOC ‘Structure, work planning and priorities’ includes management skills and multitasking, which are required in physicians’ daily work and caused strain in medical students when they participated in the physician’s role in a simulated first day of residency [ 36 ]. Therefore, management skills are recommended to be incorporated as learning objectives in undergraduate medical curricula [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Final-year medical students’ self-assessment of facets of competence for beginning residents

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Final-year undergraduate medical students often do not feel well prepared for their start of residency training. Self-assessment of competences is important so that medical trainees can take responsibility for their learning. In this study, we investigated how final-year medical students self-assessed their competences as they neared their transition to postgraduate training. The aim was to identify areas for improvement in undergraduate training. Methods In the academic year 2019/2020, a national online survey was sent to final-year undergraduate medical students via their respective medical schools. The survey included ten facets of competence (FOC) most relevant for beginning residents. The participants were asked to self-assess their competence for each FOC on a 5-point Likert scale (1: strongly disagree to 5: strongly agree). We established an order of self-assessed FOC performance by means and calculated paired t-tests. Gender differences were assessed with independent t-tests. Results A total of 1083 students from 35 medical schools completed the questionnaire. Mean age was 27.2 ± 3.1 years and 65.8% were female. Students rated their performance highest in the FOCs ‘Teamwork and collegiality’ and ‘Empathy and openness’ (97.1 and 95.0% ‘strongly agree’ or ‘agree’, respectively) and lowest in ‘Verbal communication with colleagues and supervisors’ and ‘Scientifically and empirically grounded method of working’ (22.8 and 40.2% ‘strongly disagree’, ‘disagree’, or ‘neither agree nor disagree’, respectively). Women rated their performance of ‘Teamwork and collegiality’, ‘Empathy and openness’, and ‘Knowing and maintaining own personal bounds and possibilities’ significantly higher than men did (Cohen’s d > .2), while men showed higher self-assessed performance in ‘Scientifically and empirically grounded method of working’ than women (Cohen’s d = .38). The FOCs ‘Responsibility’, ‘Knowing and maintaining own personal bounds and possibilities’, ‘Structure, work planning, and priorities’, ‘Coping with mistakes’, and ‘Scientifically and empirically grounded method of working’ revealed lower self-assessed performance than the order of FOC relevance established by physicians for beginning residents. Conclusions The differences between the level of students’ self-assessed FOC performance and physicians’ ranking of FOC relevance revealed areas for improvement in undergraduate medical education related to health system sciences. Final-year students might benefit from additional or better training in management skills, professionalism, and evidence-based medicine. Surveys of self-assessed competences may be useful to monitor competence development during undergraduate training.

show abstract

“…Several such deficits were exemplary identified in the BMBF-funded project ÄKHOM [Ärztliche Kompetenzen: Hamburg – Oldenburg – München; https://www.kompetenzen-im-hochschulsektor.de/aekhom/, retrieved 22.6.19], where advanced medical students participated in the resident’s role at a simulated first day of work with a 360° assessment of their medical competences. The participants received the lowest scores for the facet of competence “Structure, work planning and priorities” [6], while at the same time they felt the highest strain during the management phase of the assessment with interprofessional interactions where this competence is especially important [7]. Of particular importance for medical practice are the mastery of clinical reasoning and problem solving [8], coping with uncertainty, which is already a criterion used in the selection of medical students [9], and the development of a blame-free medical culture [10].…”

Section: Editorialmentioning

confidence: 99%