Objective and Subjective Stress Parameters in Response to High and Low-Fidelity Simulation Activities.

Marta Czekirda,Mariusz Sutryk,Joanna Girzelska,Mateusz Cybulski,Patrycja Misztal-Okońska,Krystyna Kowalczuk,Maria Pyć,Wioletta Tuszyńska-Bogucka,Ahmed M Al-Wathinani,Krzysztof Goniewicz,Mariusz Gnat,Anna Włoszczak-Szubzda,Mariusz Goniewicz,Ewa Guz,Amir Khorram-Manesh,Noemi Jaszyna

doi:10.3390/ijerph19052980

Abstract

Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve competences, simulation exercises can be beneficial to even reduce the stress that each individual may face during emergency management of patients. A total of 146 first-year nursing students participated in the study, including 124 women and 22 men aged between 19 and 50 years, with a mean age of 32 years. The objective method estimated psychophysiological parameters (serum cortisol). Objective and subjective methods were used. The subjective method assessed stress experienced by students based on the standardized Stress Appraisal Questionnaire Version B for dispositional assessment. The study was conducted in the Monoprofile Medical Simulation Centre at the University of Economics and Innovation in Lublin, Poland and was approved by the University Research Ethics Committee. Both participants under and over 25 years of age showed increased levels of stress after low and high-fidelity simulations, with statistically significantly higher stress levels found for the low fidelity method. Low-fidelity simulation methods generated a greater increase in cortisol levels, indicating a higher stress level than the high-fidelity methods. The analysis of the scores obtained in the Stress Appraisal Questionnaire (KOS-B) showed that higher cortisol levels after the low-fidelity simulation reduced the subjective perception of a threat, while higher cortisol levels before the high-fidelity simulation promoted higher intellectual activity among the students. Levels of stress in the education of nursing students using low and high-fidelity methods can limit the sense of threat and activate professional task performance. The use of low and high-fidelity simulation does not generate destructive stress levels.

Highlights

The use of modern technologies has become a standard in the educational process.In the case of medical universities, this approach guarantees the development of skills, competences and professionalism in students
In two cortisol measurements performed after the low-fidelity and high-fidelity simulation sessions, the distributions of the results were close to a normal distribution (Table 3)
Our study indicates that low-fidelity simulation induced more physiological and subjectively perceived stress than high-fidelity sessions

Summary

Introduction

The use of modern technologies has become a standard in the educational process. In the case of medical universities, this approach guarantees the development of skills, competences and professionalism in students. A special role is played by simulation-based education, which offers the possibility to recreate potential clinical cases to enable students gain experience and learn about medical procedures in a safe environment [1]. Simulators give students the opportunity to intervene and evaluate treatment and care outcomes [2]. Simulators, models and phantoms allow for the acquisition and consolidation of technical skills related to manual procedures, e.g., cardiopulmonary resuscitation, catheterization, intubation, insertion of an infusion [3]. There are many scientific reports confirming that simulation is an effective educational tool in the field of medicine, including nursing [3–9]

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Discussion

Conclusion