Measures of stress and learning seem to be equally affected among all roles in a simulation scenario

Simulation scenarios provide a realistic, stressful environment in which participants can gain new clinical knowledge. It is unclear whether the role a participant plays in a scenario affects these goals. We measured heart rate, self-perceived stress and learning value, and objective written test results of participants in two simulation scenarios. Our hypothesis was that measurements of participants' stress and learning would be similar among all team members in our simulated scenarios.

Residents and medical students were prospectively randomized to take part in two difficult airway scenarios in the roles of team leader, procedure chief, or team member. Heart rate was recorded using pulse oximetry preprocedure and at the critical airway intervention. After debriefing, participants completed a data collection form that included visual analog scales for perceived stress and learning and objective questions related to scenario teaching points.

We obtained 53 measurements during a single day. Heart rates increased during the airway intervention (median 4 beats per minute, P = 0.04). Self-reported learning values increased with self-reported stress level (rs = 0.373, P = 0.01); however, no correlation was found between a participant's role in the scenario and heart rate, test score, stress level, or perceived learning benefit.

In our limited scenarios, measurements of stress and learning did not differ by role. Our results support the concept that all participants may benefit from simulation scenarios.