Can anxiety in undergraduate students in a high-fidelity clinical simulation be predicted? A randomized, sham-controlled, blinded trial

Abstract

IntroductionHigh-fidelity clinical simulation has implied a revolution in health science training. Despite its benefits, some drawbacks could hinder the learning process, especially the anxiety produced during such scenarios. ObjectivesThe aim of the present work is to develop a predictive model capable of determining which students will present high levels of anxiety. DesignWe performed a randomized, sham-controlled, blinded trial in which students were randomly assigned to four scenarios and played one of two possible roles. MethodsBefore and after the simulation we assessed the anxiety level along with physiological and analytical parameters. The main analyzed outcome was an increase of ≥25% in anxiety compared with baseline. ResultsThe type of scenario or the role played had no effect on anxiety. The predictive model presented an Area Under the Receiver Operating Characteristics of 0.798 (95% CI: 0.69–0.90; p < 0.001), with age and systolic blood pressure being protective factors against anxiety. ConclusionsOur results showed that the anxiety level developed during simulation could be predicted. The application of this predictive model when associated to appropriate techniques to deal with increased anxiety levels could improve the learning process of medical students during simulations.