Author:
Schlatter Sophie T.,Thérond Corentin C.,Guillot Aymeric,Louisy Simon P.,Duclos Antoine,Lehot Jean-Jacques,Rimmelé Thomas,Debarnot Ursula S.,Lilot Marc E.
Abstract
Abstract
Background
Active participation in high-fidelity simulation remains stressful for residents. Increased stress levels elicited during such simulation impacts performance. We tested whether relaxing breathing, paired or not with cardiac biofeedback, could lead to enhanced performance of residents during simulation.
Methods
This randomized pilot study involved the fifth-year anesthesiology and critical care residents who participated in high-fidelity at Lyon medical simulation center in 2019. Residents were randomized into three parallel interventions: relaxing breathing, relaxing breathing paired with cardiac biofeedback, and control. Each intervention was applied for five minutes immediately after the scenario briefing. The primary endpoint was the overall performance during the simulation rated by two blinded independent investigators. The secondary endpoints included component scores of overall performance and changes in psychological states.
Results
Thirty-four residents were included. Compared to the control group, residents in the relaxing breathing (+ 7%, 98.3% CI: 0.3 to 13.7, P = 0.013) and relaxing breathing paired with cardiac biofeedback (+ 8%, 98.3% CI: 0.82 to 14.81, P = 0.009) groups had a higher overall performance score. Following the interventions, compared to the control group, stress level was lower when participants had performed relaxing breathing alone (P = 0.029) or paired with biofeedback (P = 0.035). The internal relaxation level was higher in both the relaxing breathing alone (P = 0.016) and paired with biofeedback groups (P = 0.035).
Conclusions
Performing five minutes of relaxing breathing before the scenario resulted in better overall simulation performance. These preliminary findings suggest that short breathing interventions are effective in improving performance during simulation.
Trial registration
The study protocol was retrospectively registered on clinicaltrials.gov (NCT04141124, 28/10/2019).
Publisher
Springer Science and Business Media LLC
Subject
Education,General Medicine
Reference35 articles.
1. Isbell LM, Boudreaux ED, Chimowitz H, Liu G, Cyr E, Kimball E. What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care. BMJ Qual Saf. 2019;0:1–11.
2. Harvey A, Bandiera G, Nathens AB, LeBlanc VR. Impact of stress on resident performance in simulated trauma scenarios. J Trauma Acute Care Surg. 2012;72:497–503.
3. Krage R, Zwaan L, Tjon Soei Len L, Kolenbrander MW, Di Van G, Loer SA, et al. Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: Does stress have an influence? Emerg Med J. 2017;34:728–33.
4. Leblanc VR. The Effects of Acute Stress on Performance: Implications for Health Professions Education. Acad Med. 2009;84:25–33.
5. Hawryluck L, Brindley PG. Psychological burnout and critical care medicine: big threat, big opportunity. Intensive Care Med. 2018;44:2239–41. https://doi.org/10.1007/s00134-018-5063-6.