Abstract 15361: Self-reported Overwhelmingness is Independently Associated With Worst Performance on Advanced Cardiac Life Support Training Course Practical Examination

Abstract

Background: It remains controversial whether acute mental stress negatively influences provider performance during Advanced Cardiac Life Support (ACLS) courses. The aim of this study was to evaluate the influence of self-reported acute stress measurements and socio-demographic features on provider performance on ACLS practical exams. Methods: At total of 326 consecutive attendees of ACLS courses were included in a prospective observational study performed by Sociedade Mineira de Terapia Intensiva (SOMITI) training centre, Brazil. Self-reported measures (stress related to the instructor and evaluation, felling overwhelmed and a combination of evaluation-related stress and felling overwhelmed known as the stress/overload index) were provided after attendees completed their practical examinations. We performed multivariate and automated conditional inference tree analyses to appraise the factors that influence provider performance. Poor performance was defined as not passing the practical exam. Results: Thirty-six providers showed poor performance on the practical evaluation. Failing the practical examination was associated with both felling overwhelmed (OR: 1.63 [95% CI: 1.37-1.93], p<0.001) and the stress/overload index (OR: 1.77 [95% CI: 1.37-2.29], p<0.001). Both variables were the most prominent factors associated with poor performance according to conditional inference tree analysis. However, stress related to the evaluation was not independently associated with non-approval. Multivariate analysis revealed that increased age, a lower percentage of ACLS materials studied before the course, stress related to the instructor and occupation as a nurse were also independently associated with poor performance. Conclusion: Self-reported felling overwhelmed was robustly associated with poor performance on the ACLS course practical examinations.