Abstract：
BACKGROUND:Several studies have assessed the effects of training using patient simulation systems on medical skills. However, endocrine and psychological stress responses in a patient simulation situation and the relationship between stress reactivity and medical performance have been studied rarely, so far. METHODS:Medical students (18 males and 16 females) who had completed at least two months anaesthesiology training participated in the study. In a counterbalanced cross-over design they were subjected to three conditions: rest, laboratory stress (LS; public speaking), and simulated emergency situation (SIM; myocardial ischemia and ventricular fibrillation). Salivary cortisol and psychological responses (visual analogue scales, VAS) were assessed every 15 min from 15 min prior to until 60 min after intervention. Differences between stress and rest conditions were analysed. Medical performance was assessed according to the European Resuscitation Council's Guidelines for Resuscitation. RESULTS:As compared to rest, cortisol increased significantly in both stress conditions with different time courses in LS and SIM. Psychological responses in SIM exceeded those in LS. Cortisol increase in LS (r(s)=.486; p=.019) but not in SIM (r(s)=.106; p=.631) correlated significantly with medical performance. DISCUSSION:A simulated emergency situation is a profound stressor. The positive relationship between endocrine stress responsiveness in a standard laboratory situation and medical performance in a simulated emergency situation indicates that high stress responsiveness might be a predictor of good performance. At the same time the high stress response might counteract educational efforts associated with training using high-fidelity patient simulation.
journal_name
Psychoneuroendocrinologyjournal_title
Psychoneuroendocrinologyauthors
Keitel A,Ringleb M,Schwartges I,Weik U,Picker O,Stockhorst U,Deinzer Rdoi
10.1016/j.psyneuen.2010.06.011subject
Has Abstractpub_date
2011-01-01 00:00:00pages
98-108issue
1eissn
0306-4530issn
1873-3360pii
S0306-4530(10)00153-8journal_volume
36pub_type
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