Stress responses in high-fidelity simulation among anesthesiology students

Abstract 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...

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Autores principales:	Patryk Stecz, Marta Makara-Studzińska, Szymon Białka, Hanna Misiołek
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/08b0f01a78b9460687111b5c5f7002df
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spelling	oai:doaj.org-article:08b0f01a78b9460687111b5c5f7002df2021-12-02T16:34:53ZStress responses in high-fidelity simulation among anesthesiology students10.1038/s41598-021-96279-72045-2322https://doaj.org/article/08b0f01a78b9460687111b5c5f7002df2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96279-7https://doaj.org/toc/2045-2322Abstract 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.Patryk SteczMarta Makara-StudzińskaSzymon BiałkaHanna MisiołekNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Patryk Stecz Marta Makara-Studzińska Szymon Białka Hanna Misiołek Stress responses in high-fidelity simulation among anesthesiology students
description	Abstract 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.
format	article
author	Patryk Stecz Marta Makara-Studzińska Szymon Białka Hanna Misiołek
author_facet	Patryk Stecz Marta Makara-Studzińska Szymon Białka Hanna Misiołek
author_sort	Patryk Stecz
title	Stress responses in high-fidelity simulation among anesthesiology students
title_short	Stress responses in high-fidelity simulation among anesthesiology students
title_full	Stress responses in high-fidelity simulation among anesthesiology students
title_fullStr	Stress responses in high-fidelity simulation among anesthesiology students
title_full_unstemmed	Stress responses in high-fidelity simulation among anesthesiology students
title_sort	stress responses in high-fidelity simulation among anesthesiology students
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/08b0f01a78b9460687111b5c5f7002df
work_keys_str_mv	AT patrykstecz stressresponsesinhighfidelitysimulationamonganesthesiologystudents AT martamakarastudzinska stressresponsesinhighfidelitysimulationamonganesthesiologystudents AT szymonbiałka stressresponsesinhighfidelitysimulationamonganesthesiologystudents AT hannamisiołek stressresponsesinhighfidelitysimulationamonganesthesiologystudents
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Stress responses in high-fidelity simulation among anesthesiology students

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