Impact of acute stress on resident performance during simulated resuscitation episodes: a prospective randomized cross-over study

Teach Learn Med. 2014;26(1):9-16. doi: 10.1080/10401334.2014.859932.


Background: Medical trainees have identified stress as an important contributor to their medical errors in acute care environments.

Purposes: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Conflict, Psychological
  • Cross-Over Studies
  • Female
  • Humans
  • Intensive Care Units
  • Internship and Residency*
  • Male
  • Medical Staff, Hospital / psychology*
  • Ontario
  • Physician-Nurse Relations
  • Prospective Studies
  • Resuscitation / education*
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Task Performance and Analysis
  • Videotape Recording