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From stress to success: using physiological data to predict cardiopulmonary resuscitation simulation performance
Luca Queirolo1,2,3, Giulia Mormando4, Anna Vittadello4
1Department of Neuroscience, University of Padua, Padua, Italy.
Frontiers in Psychology
|March 23, 2026
Summary
Simulated cardiopulmonary resuscitation (CPR) induces significant psychophysiological stress responses in emergency residents. Physiological data, particularly heart rate variability, can predict CPR performance, highlighting the importance of autonomic flexibility in high-stress medical scenarios.
Area of Science:
- Emergency Medicine
- Psychophysiology
- Cardiopulmonary Resuscitation (CPR)
Background:
- Stress management is crucial in emergency medicine, particularly during cardiopulmonary resuscitation (CPR), where team dynamics are vital.
- Existing research on stress markers during CPR simulations is limited, especially concerning combined subjective and physiological measures.
- The impact of team roles (leader vs. member) and the predictive value of physiological data for CPR performance remain underexplored.
Purpose of the Study:
- To investigate the psychophysiological stress responses during simulated CPR scenarios in emergency medicine residents.
- To examine the influence of team roles (Team Leader vs. Team Member) on stress markers and CPR performance.
- To determine if physiological data can predict CPR performance in a simulated emergency setting.
Main Methods:
- Thirty certified emergency residents were randomly assigned to Team Leader (TL) or Team Member (TM) roles in pairs.
- Participants underwent simulated CPR scenarios with continuous chest compressions, following American Heart Association (AHA) guidelines.
- Physiological data (Heart Rate, Heart Rate Variability, Electrodermal Activity, Skin Conductance Response) were collected using Empatica E4 and eSense devices before, during, and after CPR.
Main Results:
- Simulated CPR triggered significant psychophysiological stress responses, including increased Heart Rate (HR) and Electrodermal Activity (EDA).
- Heart Rate Variability (HRV) showed a significant effect of group condition, with no significant differences between TL and TM roles except for HRV.
- Sympathetic data (EDA, SCR) and HRV-derived SD1 significantly predicted CPR performance, with logistic regression models achieving 86.67% accuracy.
Conclusions:
- Simulated CPR scenarios elicit substantial psychophysiological stress reactions, characterized by increased autonomic nervous system activity.
- Team Leader sympathetic activation may mediate global team activation, despite stable subjective stress ratings across roles.
- A nonlinear relationship between HRV-derived SD1 and performance underscores the relevance of autonomic flexibility for effective CPR.
