Cavaleri Rocco, Withington Alexia, Chalmers K Jane, Blackstock Felicity
School of Health Sciences and.
Brain Stimulation and Rehabilitation (BrainStAR) Lab, Western Sydney University, Penrith, New South Wales, Australia.
ATS Sch. 2023 Aug 31;4(4):474-489. doi: 10.34197/ats-scholar.2022-0042OC. eCollection 2023 Dec.
Simulation-based learning is an important educational medium that is being implemented increasingly for the purpose of improved patient care and safety. However, there is evidence to suggest that simulation-based education (SBE) may increase anxiety, as illustrated through self-reporting and physiological responses. Despite such data, no studies have investigated whether anxiety and stress can be manipulated through SBE scenario design and delivery to facilitate optimal learning conditions.
This pilot study examined perceived anxiety and physiological stress experienced by entry-level physiotherapy students while learning a skill using SBE and the relationship between this anxiety and their subsequent skill performance.
Final-year physiotherapy students were randomly allocated to one of three SBE experiences: low, medium, or high stress. The experiences were designed to induce increasing levels of stress and anxiety. Performance of the learned skill (endotracheal airway suctioning) was measured after the SBE using a bespoke assessment form. Cortisol levels, heart rate, and perceived anxiety measurements (State-Trait Anxiety Inventory and visual analog scale) were also collected.
Twenty-seven participants completed the trial. There were significant differences in perceived stress and physiological response between the groups. The low-stress group demonstrated significantly better performance of airway suctioning than the higher-stress groups ( = 0.02). Higher anxiety was correlated with poorer skill performance ( = -0.410).
Students report SBE to be stressful, and scenarios themselves can influence the stress and anxiety experienced. Greater stress is associated with poor learning outcomes during SBE. Healthcare educators involved in SBE scenario design need to consider the stress levels experienced. Future research to determine optimal stress and embed measurement of stress in SBE experiences is warranted.
基于模拟的学习是一种重要的教育媒介，正越来越多地被用于改善患者护理和安全。然而，有证据表明，基于模拟的教育（SBE）可能会增加焦虑，这通过自我报告和生理反应得到了体现。尽管有这些数据，但尚无研究调查焦虑和压力是否可以通过SBE场景设计和实施来加以控制，以促进最佳学习条件。
这项试点研究考察了入门级物理治疗专业学生在使用SBE学习一项技能时所感受到的焦虑和生理压力，以及这种焦虑与他们随后的技能表现之间的关系。
将物理治疗专业的最后一年学生随机分配到三种SBE体验之一：低压力、中等压力或高压力。这些体验旨在引发不断增加的压力和焦虑水平。在SBE之后，使用定制的评估表测量所学技能（气管内气道吸引）的表现。还收集了皮质醇水平、心率和感知焦虑测量值（状态-特质焦虑量表和视觉模拟量表）。
27名参与者完成了试验。各组之间在感知压力和生理反应方面存在显著差异。低压力组在气道吸引方面的表现明显优于高压力组（=0.02）。更高的焦虑与更差的技能表现相关（=-0.410）。
学生报告SBE有压力，并且场景本身会影响所体验到的压力和焦虑。更大的压力与SBE期间较差的学习结果相关。参与SBE场景设计的医疗保健教育工作者需要考虑所体验到的压力水平。有必要进行未来研究以确定最佳压力，并将压力测量纳入SBE体验中。
