Acute Effects of the Intensive Trauma and Surgical Skills Course on Psychological Symptoms

Active duty military personnel are often exposed to physical and psychological stressors, which may increase their risk for psychological disorders and insomnia. These exposures can impact cognitive function, memory, and emotional regulation, which, in turn, may impact performance. To build resilience and prepare for occupational stressors, service members regularly participate in training events, such as the Intensive Trauma and Surgical Skills Course (ITSSC). To increase preparedness for combat stressors, these training exercises must mimic high-stress scenarios as closely as possible, including the potential to evoke psychological symptom changes. Therefore, it is important to understand potential changes in psychological symptoms occurring during training events. Thus, the present study aimed to measure the acute effects of the ITSSC on military medical students' psychological symptoms and sleep. A total of 47 second-year medical students attending the ITSSC self-reported psychological and sleep symptoms before and after the 5 day training. Paired Wilcoxon Signed-Rank tests were conducted to examine the acute effects of the ITSSC on psychological and sleep symptoms. Additionally, exploratory analyses were conducted to determine whether sleep problems moderated changes in psychological symptoms. Somatic, obsessive-compulsive, and anxiety symptoms increased from pre- to post-ITSSC training. Further, change in sleep scores moderated the relationship between pre- and post-training somatic symptoms, such that greater increases in sleep symptoms were related to greater increases in somatic symptoms from pre- to post-training. Though somatic, obsessive-compulsive, and anxiety symptoms increased during the ITSSC, the changes did not meet the threshold for clinical significance, suggesting long-term negative psychological effects are unlikely. The increase in psychological symptoms per self-report of participants during ITSSC indicates the training successfully approximates real-world conditions. However, the use of objective measures, to monitor underlying changes in physiology related to observed psychological symptoms during comparable training may be useful to understand the impact of stress on performance during military training.