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Does prior exposure to clinical critical events influence stress reactions to simulation session in nursing students:
Sébastien Couarraze1, Michèle Saint-Jean2, Fouad Marhar3
1Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Education Sciences, University Toulouse 2 - Jean Jaurès, Toulouse, France; Fire Department of Haute-Garonne, Toulouse, France.
Background:
Simulation is a pedagogical method known to be a generator of stress, that could be influenced by previous stressful experiences.
Objectives:
The purpose of this study was to determine the impact of previous experience with a clinical critical event on the stress experienced by nursing students during simulation session of critical events, and on the stress experienced during clinical critical events subsequent to the training.
Design:
Observational case-control study.
Settings:
Four critical event scenarios were created using full-scale simulation.
Participants:
Two hundred and fifteen undergraduate nursing students of semester four. The control group (n = 112) consisted of learners who had not previously experienced a critical event. The prior exposure group (n = 103) consisted of learners who had experienced a critical event prior to the course.
Methods:
Stress levels were assessed using the self-report stress numerical rating scale-11.
Results:
There was no significant difference in the level of stress between the prior exposure group and the control group before, during or expected after the simulation session. A significant decrease in stress was observed in both groups from before the course to during the session (p < 0.05) and expected after the session (p < 0.05). There was no significant difference between the expected post-session stress level and the stress levels reported four months after the training (p = 0.966). At four months, there was no significant difference in stress levels between the groups (p = 0.212).
Conclusions:
The prior experience of a clinical critical event before a simulation course did not influence their reported stress level during the simulation session. Conversely, simulation-based training of critical situations appears to reduce the level of self-assessed stress during critical events in clinical practice after the training.
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