Inducing a high-stress environment during healthcare simulation is generally associated with impaired performance¶

Claim · All claims
Evidence · 1 study · review r3 · q2
Currency · newest study 2024 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q2 i? Across 20 included studies, 11 (55%) reported impaired performance under high-stress simulation, eight (40%) reported no effect, and one (5%) reported enhanced performance. → Vage A 2024

Evidence¶

Vage A 2024¶

Vage A, Spence AD, McKeown G, Gormley GJ, Hamilton PK. (2024). Simulate to stimulate? A systematic review of stress, learning, and performance in healthcare simulation. The Ulster Medical Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591218/

q2 · i? · review · r3

Systematic review synthesis of 20 included studies (926 total participants; individual sizes 13 to 120) identified via EMBASE, Ovid MEDLINE and PsycINFO searches to November 2023. The review reports "11 (55 %) detailed impaired performance". Heterogeneity precluded meta-analysis, so no pooled effect size is available.

"The identified studies have shown that exposure to high-stress simulation scenarios, consisting of noise, simulated patients, the presence of faculty, and increased task difficulty can elicit a variety of effects on participant performance, 11 (55 %) detailed impaired performance, eight (40 %) reported no effect on performance, and one (5 %) reported enhanced performance."

Discussion¶

Related Claims¶

• Impaired performance under simulation stress is concentrated among healthcare students and junior residents, with rising perceived anxiety, cognitive load and stress linked to poorer performance — a narrower finding that bears on this claim
• Stress biomarker and self-report measures show negative correlations with simulation performance across outcome categories — a narrower finding that bears on this claim
• Studies finding unaltered performance under simulation stress tended to involve more experienced participants and smaller samples — related
• The single study reporting enhanced performance under stress may reflect stressors that failed to induce sufficient stress — a narrower finding that bears on this claim
• Structured briefing and debriefing were largely absent from studies showing stress-impaired performance, and may contribute to impaired outcomes — related
• High stress and healthcare environment complexity are the primary barriers to effective decision-making — a broader claim this one bears on