Evaluation of stress induced by high-fidelity simulation among anesthesiology and emergency residents: impact of oral debriefing versus video assisted Section Pedagogy

##plugins.themes.academic_pro.article.sidebar##

Published Oct 14, 2023
Download
pdf
Vol. 101 No. 6 (2023): Tunis med jun 2023

##plugins.themes.academic_pro.article.main##

Saida Zelfani
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Safia Othmani
Emergency Department -Charles Nicolle Hospital/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Islem Ouanes
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Rafika Ben Chihaoui
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Afef Chakroun
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Héla Manai
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia
Teycir Kharraz
SAMU 01 North East/Faculty of Medicine of Tunis- University of Tunis el Manar- Tunis- Tunisia

Abstract

Aim: To describe the level of stress in emergency medicine and anesthesia residents during high fidelity simulation sessions and to evaluate the effect of video-assisted debriefing versus no-video assisted debriefing on stress level.


Methods: Prospective randomized study. Inclusion: emergency medicine and anesthesia residents consenting. Stress was assessed, before and after the training session, by: Blood Pressure (BP), Heart Rate (HR), Simple Numerical Scale (SNS), Scale trait anxiety inventory-YA (STAI-YA). Heart Rate and SNS were measured after debriefing. Residents were randomized into two groups according to the debriefing modality. The design of the simulation session was evaluated by the Simulation design scale (SDS). 


Results: Thirty-six residents were included. We observed significant increase in the mean HR and mean Systolic BP before briefing and after the scenario respectively from 83.8±9.97   cpm to 101.3±17.84   cpm (p <0.001) and from 112.2±8.3 mmHg to 149.6±16.8 (p <0.001). Mean SNS and mean STAY-YA increased before the briefing and after the scenario respectively from 5±2.11 to 6±1.52 (p=0.004) and from 40±6.6 to 57.8±12.3 (p=0.01). HR and SNS decreased significantly after debriefing regardless of modality. The mean SDS was 84.53±5.8. After scenario, we found significant negative correlation between HR and time needed to initiate symptomatic treatment (r = - 0.449, p = 0.019).


Conclusion: Learning by simulation of critical situations is associated with significant stress which decreased after debriefing.

Keywords:

Simulation, Stress, Pedagogy, Evaluation study, Emergencies

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Keitel A, Ringleb M, Schwartges I, Weik U, Picker O, Stockhorst U, et al. Endocrine and psychological stress responses in a simulated emergency situation. Psychoneuroendocrinology 2011;36:98–108.
  2. Salehi B, Cordero MI, Sandi C. Learning under stress: the inverted-U-shape function revisited. Learn Mem 2010;17:522–30.
  3. Vytal K, Cornwell B, Arkin N, Grillon C. Describing the interplay between anxiety and cognition: from impaired performance under low cognitive load to reduced anxiety under high load. Psychophysiology 2012;49: 842–52.
  4. Marteau TM, Bekker H. The development of a six-item shortform of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol 1992;31:301-6.
  5. Franklin AE, Burns P, Lee CS. Psychometric testing on the NLN Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale, and Educational Practices Questionnaire using a sample of pre-licensure novice nurses. Nurse Educ Today. 2014;34(10):1298‑304.
  6. Bakhshialiabad H, Bakhshi M, Hassanshahi G. Students perceptions of the academic learning environment in seven medical sciences courses based on DREEM. Adv Med Educ Pract. 2015;6:195-203.
  7. Chung LY, Chang RC. The Effect of Gender on Motivation and Student Achievement in Digital Game-based Learning: A Case Study of a Contented-Based Classroom. Eurasia J Math Sci Technol Educ. 2017;13(6):2309‑27.
  8. Price JW, Price JR, Pratt DD, Collins JB, McDonald J. High-fidelity simulation in anesthesiology training: a survey of Canadian anesthesiology and critical care residents’ simulator experience. Can J Anaesth 2010;57:134–42.
  9. Linda TK, Janet MC, Molla SD. To Err Is Human: Building a Safer Health System. Washington: National Academies Press; 2000. Disponible sur : https://hcupdate.files.wordpress.com/2016/03/to-err-is-human-building-a-safer-health-system.pdf
  10. Nunes F, Pene M, Coffin P, Queva C, Wiel E, Lebuffe G. Impact de la simulation sur le stress lors de prise en charge de situation critiques. Ann Fr Anesth Réanimation. 2014;33:A369-441.
  11. Sandroni C, Fenici P, Cavallaro F, Bocci MG, Scapigliati A, Antonelli M. Haemodynamic effects of mental stress during cardiac arrest simulation testing on advanced life support courses. Resuscitation. 2005;66(1):39‑44.
  12. Ghazali DA, Rogot S, Oriot D. Salivary-cortisol-increases-after-one-immersive-simulation-but-the-repetition-of-sessions-does-not-blunt-it. Ann Clin Lab Res. 2016;4(2):83
  13. Geeraerts T. Evaluation du stress induit par la simulation des situations critiques en AnesthésieRéanimation chez les internes d’Ile de France [Mémoire]. Diplôme Inter Universitaire de Pédagogie Médicale: France; 2009. 28p
  14. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med 2006;81:354–73.
  15. Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ 2014;48:963–79.
  16. Ben Ahmed H, Ouanes I, Allouche E, Chetoui A, Ouechtati W, Bazdeh L. Évaluation du stress généré par un exercice de simulation haute-fidélité chez des étudiants en médecine. Tun Med 2020;98 (05) : 363-69.
  17. Bauer C, Rimmelé T, Duclos A, Prieto N, Cejka JC, Carry PY, et al. Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions. Anaesth Crit Care Pain Med. 2016;35(6):407-16.
  18. Sandi C, Pinelo-Nava MT. Stress and memory: behavioral effects and neurobiological mechanisms. Neural Plast 2007;20(7):78-97
  19. Yerkes RM, Dodson JD. The relation of strength of stimulus to rapidity of habitformation. J Comp Neurol Psychol 1908;18:459–82.
  20. Horlait G, Niemants J, Gerard Y,Hanchard B, Bihin B, Sauvage R. Comparing effectiveness of video assisted oral debriefing alone during human resuscitation simulation: a randomized trial. Transl Biomed. 2018;9(3):153-8.
  21. Sheehan KH, Sheehan DV, White K, Leibowitz A, Baldwin DC Jr. A pilot study of medical student “abuse”. Student perceptions of mistreatment and misconduct in medical school. JAMA [Internet]. 1990;263(4):533–37. Available from: https://jamanetwork.com/journals/jama/article-abstract/380398
  22. Zhang H, Morelius E, Goh SHL, Wang W. Effectiveness of video assisted debriefing in simulation based health professions education: a systemic review of quantitative evidence. Nurse Educ. 2019;44(3):E1-E6.