None listed
Conditions
Brief summary
Team leading the resuscitation of a seriously injured or critical unwell patient can be stressful and this stress may affect the clinician’s ability to perform optimally, potentially adversely affecting patient care. Our recent systematic review of the literature revealed a paucity of studies looking at strategies for mitigating the effects of stress on clinician performance and this randomised controlled study will look at whether the deleterious effects of stress on clinician performance can be mitigated by a novel stress mitigation method. Our plain language research question: During a simulated stressful resuscitation can a novel stress mitigation method ameliorate the effects of stress on: 1. Objective physiological stress measures 2. Subjective stress assessment 3. Decision-making performance The primary outcome will be the ability of the intervention to ameliorate the change in physiological stress measures (based on real-time assessment of participants heart rate variability (HRV) during the simulated scenario as compared to their baseline). Secondary outcomes will be subjective measures of stress as well as an assessment of the effect of the intervention on the decision-making performance related to the scenario.
Interventions
A stress mitigation intervention in the form of a smart phone app which will train the participants in stress-mitigation strategies:
The app will include training modules on the human stress response and evidenced based stress mitigation strategies such as resonant frequency breathing. Content will be in the form of text, explanatory diagrams and short video lectures. Participants will be expected to interact with app for 5-10 minutes each day for one month, to reiterate the concepts and practic
A stress mitigation intervention in the form of a smart phone app which will train the participants in stress-mitigation strategies: The app will include training modules on the human stress response and evidenced based stress mitigation strategies such as resonant frequency breathing. Content will be in the form of text, explanatory diagrams and short video lectures. Participants will be expected to interact with app for 5-10 minutes each day for one month, to reiterate the concepts and practice some of the techniques. App analytics will be used to assess adherence to the intervention. The simulated resuscitation will involve the participant undertaking the role of team leader for a simulated trauma resuscitation lasting for approximately 7 minutes. Participants will undertake two simulations, one low stress (LS) and one high stress (HS) with stressors identified from a prior systematic review by the authors. The simulation will be undertaken in the Centre for Health Innovation (CHI) simulation centre affiliated with the author's hospital. The simulation will be administered by the authors and an invited simulation expert who will give all participants (intervention and control) tailored feedback on their performance. Following the intervention period participants will return to the the simulation centre and undertake a further HS scenario (HS2). Stressors have been identified from our previous research (systematic review and survey study) including: patient illness severity / acuity, noise, conflict, time pressure, and socio-evaluative stress.
Sponsors
The National Trauma Research Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
21 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Emergency medicine trainees (registrar level doctors registered with the Australasian College for Emergency Medicine (ACEM)).
Exclusion criteria
Prior simulation fellowship training. Simulation phobia (anticipated extreme response to simulation scenarios). Antiarrhythmic medication (distortion of HRV markers).
Outcome results
None listed