a Department of Critical Care Medicine , University of Toronto , Toronto , Ontario , Canada.
Teach Learn Med. 2014;26(1):9-16. doi: 10.1080/10401334.2014.859932.
Medical trainees have identified stress as an important contributor to their medical errors in acute care environments.
The objective of this study was to determine if the addition of acute stressors to simulated resuscitation scenarios would impact on residents' simulated clinical performance.
Fifty-four residents completed a control and a high-stress simulated scenario on separate visits. Stress measures were collected before and after scenarios. Two assessors independently evaluated residents' videotaped performance.
Both control and high-stress scenarios triggered significant stress responses among participants; however, stress responses were not significantly different between control and high-stress conditions. No difference in performance was found between control and high-stress conditions (F value = 2.84, p = .098).
Residents exposed to simulated resuscitation scenarios experienced significant stress responses irrespective of the presence of acute stressors during these scenarios. This anticipatory stressful response could impact on resident learning and performance and should be further explored.
医学实习生已经确定压力是导致他们在急性护理环境中犯错的一个重要因素。
本研究的目的是确定在模拟复苏场景中增加急性压力源是否会影响住院医师的模拟临床表现。
54 名住院医师在两次单独访问中完成了控制和高压力模拟场景。在场景前后收集压力测量值。两名评估员独立评估了住院医师的录像表现。
控制和高压力场景都引发了参与者的显著压力反应；然而，控制和高压力条件下的压力反应没有显著差异。在控制和高压力条件下，表现没有差异（F 值=2.84，p=.098）。
无论在这些场景中是否存在急性压力源，接受模拟复苏场景的住院医师都会经历显著的压力反应。这种预期的应激反应可能会影响住院医师的学习和表现，应进一步探讨。
