Effects of brief mental skills training on emergency medicine residents' stress response during a simulated resuscitation: A prospective randomized trial

Authors

Matthew Aronson, Advocate Aurora HealthFollow
Timothy Henderson, Advocate Aurora Health
Kenneth W. Dodd, Advocate Aurora HealthFollow
Michael Cirone, Advocate Aurora HealthFollow
Margaret Putman, Advocate Aurora HealthFollow
David Salzman, Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine and Department of Medical Education, Chicago, Illinois.
Elise O. Lovell, Advocate Aurora HealthFollow
Kelly Williamson, Advocate Aurora HealthFollow

Recommended Citation

Aronson M, Henderson T, Dodd KW, et al. Effects of Brief Mental Skills Training on Emergency Medicine Residents' Stress Response During a Simulated Resuscitation: A Prospective Randomized Trial. West J Emerg Med. 2021;23(1):79-85. Published 2021 Jan 3. doi:10.5811/westjem.2021.10.53892

Affiliations

Advocate Christ Medical Center

Abstract

Background: Acute stress impairs physician decision-making and clinical performance in resuscitations. Mental skills training, a component of the multistep, cognitive-behavioral technique of stress inoculation, modulates stress response in high-performance fields.

Objective: We assessed the effects of mental skills training on emergency medicine (EM) residents' stress response in simulated resuscitations as well as residents' perceptions of this intervention.

Methods: In this prospective, educational intervention trial, postgraduate year-2 EM residents in seven Chicago-area programs were randomly assigned to receive either stress inoculation training or not. One month prior to assessment, the intervention group received didactic training on the "Breathe, Talk, See, Focus" mental performance tool. A standardized, case-based simulation was used for assessment. We measured subjective stress response using the six-item short form of the Spielberger State-Trait Anxiety Inventory (STAI-6). Objective stress response was measured through heart rate (HR) and heart rate variability (HRV) monitoring. We measured subjects' perceptions of the training via survey.

Results: Of 92 eligible residents, 61 participated (25 intervention; 36 control). There were no significant differences in mean pre-/post-case STAI-6 scores (-1.7 intervention, 0.4 control; p = 0.38) or mean HRV (-3.8 milliseconds [ms] intervention, -3.8 ms control; p = 0.58). Post-assessment surveys indicated that residents found this training relevant and important.

Conclusion: There was no difference in subjective or objective stress measures of EM resident stress response after a didactic, mental performance training session, although residents did value the training. More extensive or longitudinal stress inoculation curricula may provide benefit.

Document Type

Article

PubMed ID

35060868