Is the UK Newborn Life Support course really that stressful?

Abstract

Purpose of the study: The Newborn Life Support (NLS) course has been developed under the auspices of the Resuscitation Council (UK). The aims of the study were to determine whether there is a significant stress response to the practical assessment component of this course, the Newborn Life Support airway test (NLSAT); to compare individuals’ level of experience with their stress response and identify whether high stress levels correlate with difficulty passing the NLSAT. Materials and methods: Design: Quantitative observational study measuring stress levels of candidates on the NLS course measuring salivary cortisol levels along with validated anxiety questionnaires (State Trait Anxiety Inventory). Setting: UK NLS course centres. Participants: 80 healthcare professionals (nurses, doctors and midwives) on an NLS course. Interventions: Stress levels measured at baseline (10am), immediately before and 20min after starting the NLSAT. Demographic data including professional experience and prior exposure to the NLS course was collected. Results: Cortisol measurements failed to detect any significant rise in stress levels. Significant stress levels were induced by the NLSAT when measuring anxiety scores; mean baseline score was 39.63 (SD 11.75), mean pre-NLSAT scores were 48.38 (SD 12.89) and mean post-NLSAT scores was 42.82 (SD 13.65). STAI scores rose significantly in all professionals from baseline to post-NLSAT (p<0.001) with greatest change detected for midwives (+11.82 (SD 7.64, p-value <0.001) compared to nurses (+8.86 (SD 12.1, p-value <0.001) and doctors (+7.96 (SD 2.9.69, p-value <0.001). Experience had no impact on stress levels. Determination of stress levels impacting on performance was not possible due to the low re-sit rate (7.5%). Conclusions: Stress levels induced by the NLSAT are significant and should be consideredwhen instructing and developing theNLS course.