Stress biomarker and self-report measures show negative correlations with simulation performance across outcome categories¶

Claim · All claims
Evidence · 1 study (2 entries) · quant-synthesis r2 · q2
Currency · newest study 2024 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q2 i? Five of 11 impaired-performance studies used salivary cortisol and/or heart rate, and all five showed increases in both markers from baseline to high-stress conditions. → Vage A 2024 q2 i? In the unaltered-performance category, all six biomarker studies displayed negative correlations between cortisol/heart rate and performance, and all eight used the STAI with a dominant theme of negative correlation between perceived anxiety/stress and performance. → Vage A 2024 (2)

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? · quant-synthesis · r2

Review synthesis of biomarker use in impaired-performance studies; increases in salivary cortisol and/or heart rate from baseline to high-stress conditions are reported descriptively, with no effect sizes printed.

"Five of 11 (45 %) studies reporting performance impairment used either salivary cortisol and/or heart rate as markers for stress; with all five studies displaying an increase in both markers from baseline to high-stress conditions."

Vage A 2024 (2)¶

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

Review synthesis of the unaltered-performance category; negative correlations are reported as themes without printed coefficients. The review notes Hunziker et al (2012) stated self-reported anxiety was the only predictor for low CPR performance.

"In terms of biomarker analysis, six studies reporting unaltered performance utilised salivary cortisol and/or heart rate; all displayed negative correlations between these markers and performance. All eight studies included a form of the STAI as a metric for perceived stress and, again, the dominant theme was a negative correlation between perceived anxiety/ stress and performance."

Discussion¶

Learner Variables¶

• Affect Regulation — predictor: learners who differ on it differ in outcomes

Related Claims¶

• Participation in neonatal simulation raises salivary cortisol, but the rise is not dependent on whether the manikin dies — related
• Inducing a high-stress environment during healthcare simulation is generally associated with impaired performance — a broader claim this one bears on
• 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 — related
• Increased physiological arousal and higher physiological synchrony relate to more monitoring with negative valence — related
• The LF/HF heart rate variability ratio increases significantly when surgeons perform or train under stressful situations — related