Faculty of Health, Australian Catholic University, Building 403, Daniel Mannix Building, 8 - 14 Brunswick St, Fitzroy, VIC, 3065, Australia.
School of Health and Medical Sciences, Centre for Health Research, University of Southern Queensland, Ipswich, Australia.
BMC Med Educ. 2024 Sep 11;24(1):990. doi: 10.1186/s12909-024-05949-3.
The practise of paramedicine can be highly stressful particularly where urgent lifesaving decisions need to be made. Traditionally, educators have adopted the approach of placing students in simulated stressful situations as a way of learning to cope with these challenges. It is unclear from the literature whether traditional stress inoculation enhances or hinders learning. This scoping review aims to identify and examine both the peer-reviewed and grey literature reporting physiological stress responses to high-acuity scenarios in paramedicine and cognate healthcare disciplines.
Adhering strictly to JBI Evidence Synthesis Manual for conducting a scoping review, medical subject headings and areas, keywords and all other possible index terms were searched across EBSCOhost (Medline, CINAHL and APA PsycInfo), Scopus and, PubMed. English language articles both published (peer-reviewed academic papers, reports and conference proceedings) and unpublished (grey literature, Google Scholar reports) were included, and publications citing retrieved articles were also checked.
Searches performed across five electronic databases identified 52 articles where abstracts indicated potential inclusion. From this, 22 articles which reported physiological or psychophysiological responses to stressful scenario-based education were included.
This review identified that an acceptable level of stress during simulation can be beneficial, however a point can be exceeded where stress becomes a hinderance to learning resulting in underperformance. By identifying strategies to moderate the impact of acute stress, educators of paramedic and other healthcare students can utilise high-acuity clinical scenarios to their andragogical armamentarium which has the potential to improve real-world clinical outcomes.
急救医学实践可能压力非常大，特别是需要做出紧急救生决策的情况下。传统上，教育者采用让学生置身于模拟紧张情境中的方法来学习应对这些挑战。但文献中尚不清楚传统的应激接种是否会增强或阻碍学习。本范围综述旨在确定和检查急救医学和相关医疗保健学科中报告高敏场景下生理应激反应的同行评议和灰色文献，以及报告高敏场景下生理应激反应的同行评议和灰色文献。
严格按照 JBI 证据综合手册进行范围综述，在 EBSCOhost（Medline、CINAHL 和 APA PsycInfo）、Scopus 和 PubMed 中搜索医学主题词和领域、关键词和所有其他可能的索引词。包括已发表的英语文章（同行评议的学术论文、报告和会议论文）和未发表的文章（灰色文献、Google Scholar 报告），并检查检索文章的引用出版物。
在五个电子数据库中进行的搜索确定了 52 篇摘要表明可能包含的文章。其中，有 22 篇文章报告了应激情景教育的生理或心理生理反应。
本综述发现，模拟过程中可接受的压力水平可能是有益的，但压力可能会超过学习的阻碍，导致表现不佳。通过确定缓解急性应激影响的策略，急救医学和其他医疗保健学生的教育者可以利用高敏临床场景来充实他们的成人教育武器库，从而有可能改善现实世界的临床结果。
