Cognitive appraisals and team performance under stress: A simulation study.


OBJECTIVES:The present study explored how challenge and threat responses to stress relate to performance, anxiety, confidence, team identity and team characteristics (time spent in training and postgraduate experience) in a medical simulation-based team competition. METHODS:The study was conducted during a national simulation-based training event for residents, the SIMCUP Italia 2018. The SIMCUP is a simulation competition in which teams of four compete in simulated medical emergency scenarios. Cross-sectional data were collected prior to the 3 days of the competition. Subjects included 95 participants on 24 teams. Before the competition on each day, participants completed brief self-report measures that assessed demands and resources (which underpin challenge and threat responses to stress), cognitive and somatic anxiety, self-confidence and team identification. Participants also reported time (hours) spent practising as a team and years of postgraduate experience. A team of referees judged each scenario for performance and assigned a score. A linear mixed model using demands and resources was built to model performance. RESULTS:The data showed that both demands and resources have positive effects on performance (31 [11-50.3] [P < .01] and 54 [25-83.3] [P < .01] percentage points increase for unitary increases in demands and resources, respectively); however, this is balanced by a negative interaction between the two (demands * resources interaction coefficient = -10 [-16 to -4.2]). A high level of resources is associated with better performance until demands become very high. Cognitive and somatic anxieties were found to be correlated with demands (Pearson's r = .51 [P < .01] and Pearson's r = .48 [P < .01], respectively). Time spent training was associated with greater perceptions of resources (Pearson's r = .36 [P < .01]). CONCLUSIONS:We describe a model of challenge and threat that allows for the estimation of performance according to perceived demands and resources, and the interaction between the two. Higher levels of resources and lower demands were associated with better performance.


Med Educ


Medical education


Carenzo L,Braithwaite EC,Carfagna F,Franc J,Ingrassia PL,Turner MJ,Slater MJ,Jones MV




Has Abstract


2020-03-01 00:00:00












  • A healing curriculum.

    abstract:CONTEXT:The banner of patient-centredness flies over many academic institutions; however, the practice and teaching of medicine remain oriented to disease. This incongruence is the result of an original Flexnerian dichotomy between the basic and clinical sciences and is maintained by a more recent distinction between d...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Boudreau JD,Cassell EJ,Fuks A

    更新日期:2007-12-01 00:00:00

  • Medical student attitudes to psychiatry: lack of effect of psychiatric hospital experience.

    abstract::Medical students' attitudes toward psychiatry before and after their final (sixth) year psychiatric clerkship at a large psychiatric hospital were measured. We anticipated that exposure to severe, chronic psychiatric illness would affect student attitudes, and we undertook this study to investigate the direction and p...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Galletly CA,Schrader GD,Chesterman HM,Tsourtos G

    更新日期:1995-11-01 00:00:00

  • Well-being in an academic environment.

    abstract:PURPOSE:Due to the high volume and acuity of mental health issues presented by graduate and professional students nationwide, this study explored specific mental health needs in students in order to identify credible areas for intervention. METHODS:An assessment tool was created for this project, which identified sati...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Stecker T

    更新日期:2004-05-01 00:00:00

  • Current status of curriculum mapping in Canada and the UK.

    abstract:CONTEXT:As part of curriculum evaluation, management and quality assurance strategies, many undergraduate medical schools are in the process of constructing computer-based curriculum maps. METHODS:A survey was distributed to Canadian and UK medical schools to determine the current status, characteristics, and challeng...

    journal_title:Medical education

    pub_type: 杂志文章,多中心研究


    authors: Willett TG

    更新日期:2008-08-01 00:00:00

  • A communication skills course for preclinical students: evaluation of general practice based teaching using group methods.

    abstract::Teaching preclinical medical students about doctor-patient communication gives them an opportunity to develop their interviewing skills prior to their having to elicit lists of symptoms in their clinical years. General practitioners should be among the more efficient interviewers in clinical medicine and therefore abl...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Kendrick T,Freeling P

    更新日期:1993-05-01 00:00:00

  • A trial of multiple choice examination in pharmacology.

    abstract::An account is given of the introduction of MCQ in an Indian Medical institution in 1974/75. Preliminary results suggest that the reliability coefficient of MCQs rises with their difficulty, and that Pearson-type coefficient indicates a higher degree of correlation with essay marks than do Spearman coefficients. A 'stu...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Gandhi IS,Ghosh MN

    更新日期:1978-07-01 00:00:00

  • Pre-registration house officers' views on studying under a reformed medical curriculum in the UK.

    abstract::In 1996 the University of Liverpool introduced a new curriculum based on the recommendations published in Tomorrow's Doctors. This work examines how graduates of that course view their undergraduate curriculum and whether they consider it prepared them well for the pre-registration year. Five focus groups were arrange...

    journal_title:Medical education

    pub_type: 杂志文章,多中心研究


    authors: Watmough S,Garden A,Taylor D

    更新日期:2006-09-01 00:00:00

  • Premedical training, personal characteristics and performance in medical school.

    abstract::Despite concern over the concentration on science in pre-medical education and the selection of medical students in the United States, no major changes have been made. The present study compares attrition rates and clinical competence levels of medical students who vary in pre-medical training, age, and sex, in order ...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Herman MW,Veloski JJ

    更新日期:1981-11-01 00:00:00

  • Using standardised students in faculty development workshops to improve clinical teaching skills.

    abstract:PURPOSE:We describe the use of standardised students (SSs) in interdisciplinary faculty development programmes to improve clinical teaching skills. Standardised students are actual health professions students who are trained to portray a prototypical teaching challenge consistently across many encounters with different...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Gelula MH,Yudkowsky R

    更新日期:2003-07-01 00:00:00

  • Career preferences of graduate and non-graduate entrants to medical schools in the UK.

    abstract:OBJECTIVE:Recent UK policy has been to increase substantially the number of graduate entrants to medical schools. Our aim was to study whether graduate and non-graduate entrants have different long-term career preferences. METHODS:We conducted postal questionnaire surveys of medical qualifiers from all UK medical scho...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Goldacre MJ,Davidson JM,Lambert TW

    更新日期:2007-04-01 00:00:00

  • An electronic study guide for problem-based learning.

    abstract::This paper describes the development and structure of an Electronic Study Guide for Oncology (LETSGO) for undergraduate medical students. LETSGO is aimed at clinical students learning about cancer. The subject of the guide is breast cancer and learning objectives cover structure and function, behavioural science, publ...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Mooney GA,Bligh JG,Leinster SF,Warenius HM

    更新日期:1995-11-01 00:00:00

  • Teaching medical students about family planning: experiences from a primary health care course in Lagos, Nigeria.

    abstract::In 1979, the College of Medicine, Lagos, Nigeria embarked on a new curriculum, which places more emphasis on primary health care in line with the needs of the country. This paper discusses one aspect of the primary health care course, family planning, which involves teaching a practical subject to a large number of st...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Olukoya AA,Oyediran MA

    更新日期:1986-01-01 00:00:00

  • Management of somatic presentations of psychiatric illness in general medical settings: evaluation of a new training course for general practitioners.

    abstract::An improved teaching package is described which aims to help general practice trainees manage somatized presentations of psychological distress. The package comprises a training videotape in which a reattribution model is demonstrated, with material for role-play of new skills and small-group video feedback of consult...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Kaaya S,Goldberg D,Gask L

    更新日期:1992-03-01 00:00:00

  • Comparison of medical and non-medical student attitudes to social issues in medicine.

    abstract::A 63-item questionnaire on attitudes to psychosocial issues in medicine was administered to final-year students in the Faculties of Medicine (n = 104), Pharmacy (n = 57) and Arts and Social Sciences (n = 75) of the University of Benin. The responses given were analysed by the summation and Cornell scalogram techniques...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Nnodim JO,Osuji CU

    更新日期:1995-07-01 00:00:00

  • General practitioners, revalidation and appraisal: a cross sectional survey of attitudes, beliefs and concerns in Lincolnshire.

    abstract:BACKGROUND:All general practitioners (GPs) are expected to have an appraisal from 2002 and the first cohort will experience revalidation in 2005. Although there is a link between appraisal and revalidation, this has yet to be clarified. OBJECTIVE:To investigate the knowledge, attitudes and beliefs of GPs towards reval...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Middlemass J,Siriwardena AN

    更新日期:2003-09-01 00:00:00

  • The sleep habits, personality and academic performance of medical students.

    abstract::The academic performance of 104 fourth-year medical students was assessed in relation to their sleep habits reported in a questionary and their scores on the Minnesota Multiphasic Personality Inventory. Poorer academic performance was related significantly to later times of waking up in the morning, particularly at we...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Johns MW,Dudley HA,Masterton JP

    更新日期:1976-05-01 00:00:00

  • A method of teaching epidemiology in the clinical setting.

    abstract::It is important to provide an epidemiological presence when teaching clinical medicine to undergraduate medical students in order to supply the underlying facts about disease. A series of pictorial or tabular presentations which together make up a 'master set' of Data Boards has been designed to give the medical stude...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Garraway WM,French EB,Scrimgeour JB,Pizer JE,Petrie H

    更新日期:1976-11-01 00:00:00

  • Medical education accreditation in Mexico and the Philippines: impact on student outcomes.

    abstract:CONTEXT:Accreditation of medical education programmes is becoming increasingly prevalent worldwide, but beyond the face validity of these quality assurance methods, data linking accreditation to improved student outcomes are limited. Mexico and the Philippines both have voluntary systems of medical education accreditat...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: van Zanten M,McKinley D,Durante Montiel I,Pijano CV

    更新日期:2012-06-01 00:00:00

  • Short answer questions in an undergraduate qualifying examination: a study of examiner variability.

    abstract::Scripts of a short answer Final MB examination paper were re-marked by the original examiner and three colleagues. While individual question marks varied considerably, most examiners agreed quite well as to the overall rank order of candidates--although not about absolute total marks--but a few disagreed considerably....

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Wakeford RE,Roberts S

    更新日期:1984-05-01 00:00:00

  • The role of empathy in establishing rapport in the consultation: a new model.

    abstract:CONTEXT:Considerable research has been conducted recently into the notion of patient-centred consulting. The primary goal of this approach is to establish a clear understanding of the patient's perspective on his or her problem, and to allow this understanding to inform both the explanation and planning stages of the c...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Norfolk T,Birdi K,Walsh D

    更新日期:2007-07-01 00:00:00

  • Towards an understanding of resilience and its relevance to medical training.

    abstract:OBJECTIVES:This article explores the concept of resilience and its potential relevance to medicine. It also looks at the dimensions of resilience and its ethical importance for effective professional practice, and considers whether a focus on resilience might be useful in medical training. METHODS:An applied literatur...

    journal_title:Medical education

    pub_type: 杂志文章,评审


    authors: Howe A,Smajdor A,Stöckl A

    更新日期:2012-04-01 00:00:00

  • Population-based longitudinal analyses of offer likelihood in UK medical schools: 1996-2012.

    abstract:CONTEXT:The challenge of ensuring 'fair' selection processes confronts all medical schools around the globe. In the UK, historical analyses suggest applicants who are male, non-White, and from less advantaged socio-economic and school backgrounds have been less likely to be offered a place at medical school. We provide...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Mathers J,Sitch A,Parry J

    更新日期:2016-06-01 00:00:00

  • Reasoning versus knowledge retention and ascertainment throughout a problem-based learning curriculum.

    abstract:CONTEXT:Since 2000, problem-based learning (PBL) seminars have been introduced into the curriculum of medical studies at the University of Liège. We aimed to carry out a cross-sectional investigation of the maturational increase in biomedical reasoning capacity in comparison with factual knowledge retention throughout ...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Collard A,Gelaes S,Vanbelle S,Bredart S,Defraigne JO,Boniver J,Bourguignon JP

    更新日期:2009-09-01 00:00:00

  • Motivations for studying dentistry among first-year dental students.

    abstract::Reasons for choosing dentistry as a profession were analysed among first-year dental students at the University of Toronto. The motivations of various sub-groups were also examined. It was found that an extrinsic motivation, financial rewards, was the most widespread, although the other widely chosen motivations refer...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Cohen R,Coburn D

    更新日期:1977-03-01 00:00:00

  • Teaching of medical ethics.

    abstract::Teaching medical ethics in Manchester within the introductory course of obstetrics and gynaecology is a joint activity with the Centre for Social Ethics and Policy. This interdisciplinary teaching has evolved through lecture sessions with small-group discussions dealing with topics of interest in human reproduction. T...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Elstein M,Harris J

    更新日期:1990-11-01 00:00:00

  • Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan.

    abstract:OBJECTIVES:This study analyses and discusses recent changes in young Japanese doctors' career paths, in terms of their distribution in different types of facilities and specialties, following changes to the postgraduate clinical training system in 2004. METHODS:Data from the National Survey of Physicians, Dentists and...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Koike S,Ide H,Yasunaga H,Kodama T,Matsumoto S,Imamura T

    更新日期:2010-03-01 00:00:00

  • Smoking history-taking skills: a simple guide to teach medical students.

    abstract::Many doctors rate themselves as ineffective smoking cessation counsellors. It is logical to initiate training efforts with medical students. We incorporated smoking history-taking in the physical diagnosis course at the University of North Carolina at Chapel Hill using a simple method to teach smoking history-taking s...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Boehlecke B,Sperber AD,Kowlowitz V,Becker M,Contreras A,McGaghie WC

    更新日期:1996-07-01 00:00:00

  • Computer analysis of the student log diary: an aid in the teaching of general practice and family medicine.

    abstract::At the University of Queensland all medical students in their fifth year rotate through a 2-week attachment to a general practitioner tutor as part of the course in community practice. As a means of learning from this experience each student records information in a log diary on seventy-five consecutive patients seen,...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Munro JG

    更新日期:1984-03-01 00:00:00

  • Service increment for teaching (SIFT): a review of its origins, development and current role in supporting undergraduate medical education in England and Wales.

    abstract:OBJECTIVES:To describe the ways in which total resources available for the Service Increment for Teaching (SIFT) have been determined and related to numbers of undergraduate medical students; and the development and current arrangements for allocating SIFT to the providers of service support for teaching. DESIGN:The d...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Clack GB,Bevan G,Eddleston AL

    更新日期:1999-05-01 00:00:00

  • New consultants mastering the role of on-call supervisor: a longitudinal qualitative study.

    abstract:CONTEXT:The supervision of specialty registrars during on-call shifts is essential to ensure the quality of both health care and medical education, but has been identified as a major novelty and stressor for new consultants in the transition from specialty training. There is a paucity of research on how consultants dea...

    journal_title:Medical education

    pub_type: 杂志文章


    authors: Westerman M,Teunissen PW,Fokkema JP,Siegert CE,van der Vleuten CP,Scherpbier AJ,Scheele F

    更新日期:2013-04-01 00:00:00