The impact of simulated patient death on medical students’ stress response and learning of ACLS
| Autor: | Christian Hamilton Williams, Samuel DeMaria, John Spivack, Eric R. Silverman, Kyle A.B. Lapidus, Andrew Goldberg, Adam I. Levine |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Health Knowledge Attitudes Practice medicine.medical_specialty Students Medical Hydrocortisone Advanced Cardiac Life Support Manikins Simulated patient Education Fight-or-flight response 03 medical and health sciences 0302 clinical medicine Heart Rate Heart rate Humans Learning Medicine 030212 general & internal medicine Saliva Simulation Training Salivary cortisol business.industry Biochemical stress 030208 emergency & critical care medicine Dehydroepiandrosterone General Medicine Death Life support Anesthesia Physical therapy Female Clinical Competence business Biomarkers Stress Psychological |
| Zdroj: | Medical Teacher. 38:730-737 |
| ISSN: | 1466-187X 0142-159X |
| Popis: | There is considerable controversy as to whether the simulator should die during high-fidelity simulation (HFS). We sought to describe the physiologic and biochemical stress response induced by simulated patient death as well as the impact on long-term retention of Advanced Cardiovascular Life Support (ACLS) knowledge and skills.Twenty-six subjects received an American Heart Association (AHA) ACLS provider course. Following the course, subjects participated in HFS and were randomized to simulated death or survival. Heart rate and salivary cortisol (SC) and dihydroepiandrosterone (DHEA) were collected at this time. Subjects returned six months later for a follow-up simulation in which ACLS knowledge and skills were tested.For all participants, there was an increase in heart rate during simulation compared with baseline heart rate (+ 32 beats/minute), p0.0001. Similarly, SC and DHEA were higher compared with baseline levels (+ 0.115 μg/dL, p0.01 and + 97 pg/mL, p0.001, respectively). However, the only statistically significant difference between groups was an increase in heart rate response at the end of the simulation compared with baseline in the death group (+ 29.2 beats/minute versus + 18.5 beats/minute), p0.05. There was no difference on long-term knowledge or skills.Learners experience stress during high-fidelity simulation; however, there does not appear to be a readily detectable difference or negative response to a simulated patient death compared with simulated survival. |
| Databáze: | OpenAIRE |
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