Format

Send to

Choose Destination
Anaesth Crit Care Pain Med. 2017 Aug;36(4):205-212. doi: 10.1016/j.accpm.2016.09.008. Epub 2016 Nov 17.

Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study.

Author information

1
Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France. Electronic address: jnevain@hotmail.com.
2
Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France.

Abstract

BACKGROUND:

High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (residual anxiety [RA]). Secondary goals were to evaluate the instructors' ability to estimate students' RA and to identify potential risk factors for high RA.

SUBJECTS AND METHODS:

Following IRB approval and informed consent, data from a cohort of subjects were prospectively collected by an independent expert. State-anxiety after debriefing (RA) was prospectively measured using the State-Trait Anxiety Inventory (a score varying from 20 to 80/80). RA was considered significant when≥36/80. Instructors simultaneously estimated the levels of subjects' RA via a visual analogue scale. Data about subjects, stress during scenarios (including continuous heart rate monitoring), and debriefings (including DASH© quality scores) were also collected.

RESULTS:

Seventy study subjects (30 residents, 26 nurses and 14 anaesthetists) were enrolled during 52 HFS sessions. As concerns the primary endpoint, RA was≥36/80 in 15 subjects (21%; 95% CI: 13-32). The median RA was 30/80 [25-35]. For secondary endpoints, the instructors' estimations poorly correlated with measurements: rho=0.36 (P<0.01); limits of agreement: -16 and 22. Subjects with RA≥36/80 had significantly higher trait-anxiety (P<0.01). An easy scenario (P=0.04) and low quality debriefing (P=0.04) were associated with higher RAs.

CONCLUSION:

Most students experienced low anxiety after debriefing. Instructors seem to be unable to reliably estimate students' RA. Students with an anxious personality are more likely to be anxious after debriefing.

KEYWORDS:

Anaesthesiology; Anxiety; Debriefing; High fidelity simulation; Medical education; Stress

Comment in

PMID:
27867134
DOI:
10.1016/j.accpm.2016.09.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center