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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
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Performance Under Stress Conditions During Multidisciplinary Team Immersive Pediatric Simulations
Daniel Aiham Ghazali1,2, Ivan Darmian-Rafei3, Stéphanie Ragot4
1Department of Emergency and Emergency Medical Service, University Hospital of Bichat, Paris, France.
Summary
Technical and nontechnical performances in Emergency Medical Service workers correlated positively. Self-confidence boosted performance, while dissatisfaction hindered it, with no link found between stress markers and performance outcomes.
Area of Science:
- Medical Simulation
- Emergency Medicine
- Human Factors in Healthcare
Background:
- Assessing performance in high-fidelity simulations is crucial for Emergency Medical Services (EMS).
- Understanding the interplay between technical skills, nontechnical skills, and stress response is vital for improving team performance.
- Previous research has explored these factors individually, but comprehensive correlation studies in EMS are limited.
Purpose of the Study:
- To determine the correlation between technical and nontechnical performances in French EMS workers during immersive simulation.
- To assess the relationship between physiological and affective stress markers and performance.
- To evaluate the impact of self-reported confidence and dissatisfaction on team performance.
Main Methods:
- A prospective observational study involving 48 EMS participants within 12 teams.
- High-fidelity simulation used to assess individual and team technical (intraosseous access, Team Average Performance Assessment Scale) and nontechnical (Behavioral Assessment Tool, Clinical Teamwork Scale) performance.
- Physiological stress markers (salivary cortisol, heart rate, pNN50, LF/HF ratio) and self-reported affective data (stress, confidence, dissatisfaction) were collected pre- and post-simulation.
Main Results:
- Strong positive correlations were found between leader performance (Behavioral Assessment Tool) and team performance (Clinical Teamwork Scale, Team Average Performance Assessment Scale).
- Self-confidence positively correlated with performance scores, while dissatisfaction negatively correlated.
- All measured stress markers (salivary cortisol, heart rate, pNN50, LF/HF ratio) increased from pre- to post-simulation, but no significant correlation was found between stress response and performance outcomes.
Conclusions:
- Leader and team performance in EMS simulations are positively correlated.
- Self-confidence and dissatisfaction are significant predictors of performance, independent of physiological stress markers.
- While stress levels increase during simulation, they do not appear to directly impact performance in this context.
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