Document Detail


The impact of stress factors in simulation-based laparoscopic training.
MedLine Citation:
PMID:  20414972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study aimed to quantify learner reactions manifesting from a realistic contextual stressor while training with a laparoscopic simulator, and to identify learner-derived stress-modifying behaviors. Stress factors are known to affect cognitive and psychomotor performance. Simulation-based medical training typically occurs in environments that are relatively stress free compared with the applied context. Training is most effective when it occurs in a highly faithful context, so the inclusion of typical clinical stressors in simulated laparoscopic learning environments may be beneficial. METHODS: Preclinical medical students (N = 27) completed tasks using a laparoscopic simulator under the following 2 conditions: faculty direct observation (stressor) and unobserved (no stressor). The data included simulator performance, blood pressure, real-time heart rates, videotaped behavior, and pre/post surveys of latent anxiety and stress factors associated with participating in the research (eg, STAI 9). RESULTS: Physiologic and behavioral manifestations of stress were observed for all participants during the stressor condition and during poor performance on simulator tasks. Stress was highest during periods of poor performance under the stressor condition. Focusing on the task itself mitigated stress reactions and improved performance on the simulator. CONCLUSION: Stress reactions can be induced in a laboratory setting where simulation-based training occurs. Stressors imposed on the learner during simulation-based training may help support the acquisition of stress management skills that are necessary in the applied clinical setting. A ramped-up sequence of acquiring technical skills and clinical decision making, followed by stress management techniques, may lead to a more efficient transfer of learning from the simulated context to the clinical area.
Authors:
Pamela B Andreatta; Miranda Hillard; Lewis P Krain
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  147     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medical Education, University of Michigan Medical School, G1105 Towsley Center, Ann Arbor, MI 48109-5201, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Computer-Assisted Instruction / methods*
Education, Medical, Undergraduate / methods*
Female
General Surgery / education*
Heart Rate
Humans
Laparoscopy*
Male
Psychomotor Performance
Stress, Psychological / psychology*
Students, Medical / psychology*
Test Anxiety Scale
Videotape Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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