Acute stress management training for elite performance under pressure

Effective approaches to acute stress management in healthcare are more urgently needed than ever, given the increasing pressures teams face, generating chronic stress, which can decrease overall baseline resilience. While these chronic stressors range from waning resources to growing medical deserts, acute sources of stress emerge from deteriorating patients, leadership or personnel crises, or rapidly developing medical innovations with increasing clinical time demands given provider coverage gaps. Traditional wellness or stress-management curricula at the undergraduate, graduate, and continuing education levels focus heavily on individual provider betterment and resilience to deal with everyday chronic stressors. However, they lack a focus on teaching specific skills to manage these acutely stressful situations, which can occur regardless of specialty. Just as elite athletes must prepare for the most stressful aspects of their careers, we should also be training with techniques to perform at our best in these moments, whether they involve a deteriorating patient, ongoing team conflict, or sudden systemwide challenges. In this article we review the case for acute stress training at all levels of education within healthcare and propose tactics from multiple high-stress disciplines, including those outside of healthcare, to fortify clinician performance no matter the circumstances.