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Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial

Introduction The simulation of patient death remains controversial in simulation-based education. We investigated the effect of simulated patient death on learners' skill retention, stress levels, and emotions. Methods After ethics approval, we recruited residents at two Canadian universities....

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Autores principales: Khanduja, Kristina, Bould, M. Dylan, Andrews, Meghan, LeBlanc, Vicki, Schebesta, Karl, Burns, Joseph K, Waldolf, Richard, Nambyiah, Pratheeban, Dale-Tam, Jennifer, Houzé-Cerfon, Charles Henri, Boet, Sylvain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309656/
https://www.ncbi.nlm.nih.gov/pubmed/37398706
http://dx.doi.org/10.7759/cureus.39715
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author Khanduja, Kristina
Bould, M. Dylan
Andrews, Meghan
LeBlanc, Vicki
Schebesta, Karl
Burns, Joseph K
Waldolf, Richard
Nambyiah, Pratheeban
Dale-Tam, Jennifer
Houzé-Cerfon, Charles Henri
Boet, Sylvain
author_facet Khanduja, Kristina
Bould, M. Dylan
Andrews, Meghan
LeBlanc, Vicki
Schebesta, Karl
Burns, Joseph K
Waldolf, Richard
Nambyiah, Pratheeban
Dale-Tam, Jennifer
Houzé-Cerfon, Charles Henri
Boet, Sylvain
author_sort Khanduja, Kristina
collection PubMed
description Introduction The simulation of patient death remains controversial in simulation-based education. We investigated the effect of simulated patient death on learners' skill retention, stress levels, and emotions. Methods After ethics approval, we recruited residents at two Canadian universities. Participants were randomized to manage a simulated cardiac arrest ending with either the unexpected death (intervention group) or survival (control group) of the simulated patient (i.e., manikin). Three months later, all participants performed the same scenario but with the opposite outcome. Blinded video raters assessed participants' non-technical and technical crisis resource management (CRM) skills at both time points. Stress levels (represented by anxiety level, salivary cortisol concentration, and cognitive appraisal) and emotional valence were measured. Outcomes were analyzed using analysis of covariance (ANCOVA) or generalized estimating equations as appropriate. Results The analysis included 46 participants (intervention: n=24; control: n=22). Simulated death neither affected retention of non-technical CRM skills (mean retention Ottawa Global Rating Scale score in the death group [29.4, 95% CI: 27.0, 31.8] versus control group [29.4, 95% CI: 26.8, 32.0; p=0.87]) nor technical CRM skills (mean retention task-specific checklist score in the manikin death group [11.8, 95% CI: 10.5, 13.0] versus the control group [12.5, 95% CI: 11.3, 13.7; p=0.69]). The simulated death had negative effects on participants' anxiety levels, cognitive appraisal, and emotions. Conclusion Simulated patient death did not affect the retention of non-technical or technical CRM skills but led to greater levels of short-term anxiety, stress, and negative emotions among learners.
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spelling pubmed-103096562023-06-30 Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial Khanduja, Kristina Bould, M. Dylan Andrews, Meghan LeBlanc, Vicki Schebesta, Karl Burns, Joseph K Waldolf, Richard Nambyiah, Pratheeban Dale-Tam, Jennifer Houzé-Cerfon, Charles Henri Boet, Sylvain Cureus Anesthesiology Introduction The simulation of patient death remains controversial in simulation-based education. We investigated the effect of simulated patient death on learners' skill retention, stress levels, and emotions. Methods After ethics approval, we recruited residents at two Canadian universities. Participants were randomized to manage a simulated cardiac arrest ending with either the unexpected death (intervention group) or survival (control group) of the simulated patient (i.e., manikin). Three months later, all participants performed the same scenario but with the opposite outcome. Blinded video raters assessed participants' non-technical and technical crisis resource management (CRM) skills at both time points. Stress levels (represented by anxiety level, salivary cortisol concentration, and cognitive appraisal) and emotional valence were measured. Outcomes were analyzed using analysis of covariance (ANCOVA) or generalized estimating equations as appropriate. Results The analysis included 46 participants (intervention: n=24; control: n=22). Simulated death neither affected retention of non-technical CRM skills (mean retention Ottawa Global Rating Scale score in the death group [29.4, 95% CI: 27.0, 31.8] versus control group [29.4, 95% CI: 26.8, 32.0; p=0.87]) nor technical CRM skills (mean retention task-specific checklist score in the manikin death group [11.8, 95% CI: 10.5, 13.0] versus the control group [12.5, 95% CI: 11.3, 13.7; p=0.69]). The simulated death had negative effects on participants' anxiety levels, cognitive appraisal, and emotions. Conclusion Simulated patient death did not affect the retention of non-technical or technical CRM skills but led to greater levels of short-term anxiety, stress, and negative emotions among learners. Cureus 2023-05-30 /pmc/articles/PMC10309656/ /pubmed/37398706 http://dx.doi.org/10.7759/cureus.39715 Text en Copyright © 2023, Khanduja et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Khanduja, Kristina
Bould, M. Dylan
Andrews, Meghan
LeBlanc, Vicki
Schebesta, Karl
Burns, Joseph K
Waldolf, Richard
Nambyiah, Pratheeban
Dale-Tam, Jennifer
Houzé-Cerfon, Charles Henri
Boet, Sylvain
Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title_full Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title_fullStr Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title_full_unstemmed Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title_short Impact of Unexpected Death in a Simulation Scenario on Skill Retention, Stress, and Emotions: A Simulation-Based Randomized Controlled Trial
title_sort impact of unexpected death in a simulation scenario on skill retention, stress, and emotions: a simulation-based randomized controlled trial
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309656/
https://www.ncbi.nlm.nih.gov/pubmed/37398706
http://dx.doi.org/10.7759/cureus.39715
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