SESSION TITLE: Critical Care 1 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: The optimal level of physiologic stress during training is unclear, especially when learning procedures typically performed during a crisis. Extreme levels of stress can be deleterious to performance, but stress inoculation through activities that approximate the unease encountered in real-world scenarios has been shown to subsequently enhance performance. High-fidelity simulation offers many advantages, including broad exposure to procedures, their complications, and the opportunity for repetitious learning in a non-clinical setting. The stress of learners undergoing simulation events is a growing field of interest. Proponents of training with live-anesthetized animals argue the associated stress response cannot be equated with inanimate models, and therefore leads to an inferior learning experience with negative implications for future performance. METHODS: A randomized controlled study of 277 army combat medics was performed comparing procedural training and assessment on a live tissue (LT) goat model versus the best-in-class synthetic training models (STM). Participants were randomized twice, first to train on LT or STM, then to determine whether final assessment would be performed on LT or STM. Simulated procedures included hemorrhage control, needle thoracostomy, tube thoracostomy and cricothyrotomy. Physiologic stress responses of the medics were evaluated during the final assessment. Salivary amylase and cortisol levels were measured at baseline, t+5, 15, 25, 35, and 45 minutes post event start. RESULTS: No significant differences were seen for peak stress response of salivary cortisol or amylase, regardless of LT or STM method for training or assessment. In addition, the stress response did not correlate significantly with total performance score. CONCLUSIONS: Synthetic models can produce a stress response equivalent to that of live tissue during simulation training. This is the largest study to date indicating synthetic models produce a sufficient immersive and realistic experience for trainees. CLINICAL IMPLICATIONS: Stress inoculation while learning critical medical procedures can be achieved with synthetic models. Training programs may be able to reduce the use of live animals for training without sacrificing educational quality. DISCLOSURES: No relevant relationships by Tyler Bonnett, source=Web Response No relevant relationships by Danielle Hart, source=Web Response No relevant relationships by Jonathan Keller, source=Web Response No relevant relationships by Gregory Rule, source=Web Response Consultant relationship with Olympus Please note: $1-$1000 Added 03/02/2018 by Robert Sweet, source=Web Response, value=Consulting fee Owner/Founder relationship with Simagine Health Please note: $1-$1000 Added 03/02/2018 by Robert Sweet, source=Web Response, value=Ownership interest