Learning to provide emergency care alone and with others in the clinical environment imposes unexplored stresses on novice caregivers. It is unclear whether this stress inhibits or promotes performance and learning. Many academic health professions programs incorporate simulation as a method for teaching patient care emergencies. This study employed a modified switching replications design to explore the relationships and differences between psychological, physiological, and performance measures in health professions students who participated in acutely stressful health care simulation scenarios. Twenty-seven volunteer participants recruited from nursing, medicine, pharmacy, physical therapy, occupational therapy and speech therapy were assigned to teams in either a simulation treatment or a control group. Teams participated in two simulations scenarios where a fallen patient required assistance. Subjects in the simulation treatment groups received a standardized training module called the First Five Minutes® between simulation experiences. Mean heart rate, maximal mean heart rate, salivary alpha amylase levels, and salivary cortisol levels were compared at intervals before, during, and after each simulation scenario. Psychological stress was evaluated using the Stressor Appraisal Scale (SAS). Team performance during scenarios was scored by independent evaluators using an skills checklist adapted from a standardized commercially available training module, The First Five Minutes™. Performance scores improved in both groups during the second simulation. Mean performance scores of the simulation intervention teams (M = 14.1, SD = 1.43) were significantly higher (t = 4.54, p < .01) than the performance scores of the control teams ( M = 10.6, SD = .96). Psychological and physiological measures did not significantly predict performance. Psychological and physiological indicators were reactive to the simulations across time, but did not differ significantly between the control and simulation intervention groups. This investigation explored the multi-dimensional nature of stress (psychological and physiological) that health professions students experience while learning. Simulation intervention did significantly improve group performance, but did not mitigate individual participant stress. Future research should include study with teams of working professionals to determine whether performance and stress measures differ with experience and expertise.
|Commitee:||Barbosa-Leiker, Cestina, Hoeksel, Renee|
|School:||Washington State University|
|School Location:||United States -- Washington|
|Source:||DAI-B 74/11(E), Dissertation Abstracts International|
|Subjects:||Pedagogy, Health sciences, Developmental psychology, Physiology|
|Keywords:||Interprofessional students, Patient emergency, Performance, Simulation, Stress|
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