Cortisol and alpha-amylase as stress response indicators during pre-hospital emergency medicine training with repetitive high-fidelity simulation and scenarios with standardized patients

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Stefan K Beckers⁵  Rolf Rossaint²  Clemens Kirschbaum⁶  Michael P Müller⁴  Christina Fitzner³  Marie-Therese Mennig¹  Daniel Rörtgen²  Harold Fischermann²  Sebastian Bergrath²  Max Skorning²  Oliver Grottke²  Bernd Valentin⁷ 

[1] Centre for Learning and Knowledge Management and Information Management in Mechanical Engineering RWTH Aachen University, Aachen, Germany;Department of Anesthesiology, RWTH Aachen University Hospital, Aachen, Germany;Department of Medical Statistics, RWTH Aachen University Hospital, Aachen, Germany;Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Dresden, Germany;AIXTRA - Interdisciplinary Centre for Medical Education, RWTH Aachen University Hospital, Aachen, Germany;Institute of Psychology I, University of Technology, Dresden, Germany;AIXSIM - Simulation Centre for Anesthesiology, Intensive Care and Emergency Medicine, RWTH Aachen University Hospital, Aachen, Germany

关键词: Post-graduate medical education;    Standardized patients;    High-fidelity simulation;    Salivary cortisol;    Salivary alpha-amylase;    Stress response;   

Others  :  1174961
DOI  :  10.1186/s13049-015-0110-6

 received in 2014-09-22, accepted in 2015-03-11,  发布年份 2015

【 摘 要 】

Background

In emergency medicine, the benefits of high-fidelity simulation (SIM) are widely accepted and standardized patients (SP) are known to mimic real patients accurately. However, only limited data are available concerning physicians’ stress markers within these training environments.

The aim of this pilot study was to investigate repetitive stress among healthcare professionals in simulated pre-hospital emergency scenarios using either SIM or SPs.

Methods

Teams with one emergency medical services (EMS) physician and two paramedics completed three SIM scenarios and two SP scenarios consecutively. To evaluate stress, salivary cortisol and alpha-amylase were measured in saliva samples taken before, during and after the scenarios.

Results

A total of 14 EMS physicians (29% female; mean age: 36.8 ± 5.0 years; mean duration of EMS-experience: 9.1 ± 5.8 years) and 27 paramedics (11% female; age: 30.9 ± 6.9 years; EMS experience: 8.1 ± 6.0 years) completed the study. Alpha-amylase and cortisol levels did not differ significantly between the two professions. Cortisol values showed a gradual and statistically significant reduction over time but little change was observed in response to each scenario. In contrast, alpha-amylase activity increased significantly in response to every SIM and SP scenario, but there was no clear trend towards an overall increase or decrease over time.

Conclusion

Increases in salivary alpha-amylase activity suggest that both SIM and SP training produce stress among emergency healthcare professionals. Corresponding increases in salivary cortisol levels were not observed. Among physicians in the emergency setting, it appears that alpha-amylase provides a more sensitive measure of stress levels than cortisol.

【 授权许可】

   
2015 Valentin et al.; licensee BioMed Central.

【 图 表 】

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