Anxiety levels in interprofessional teams during training with clinical simulation
Section: Originals
How to quote
Martínez-Arce A, Maestre-Alonso JM, Bermejo-Cantarero A, Rodríguez de Guzmán-Sánchez de La Nieta J, Baladrón-González V, Redondo-Calvo FJ. Niveles de ansiedad de los equipos interprofesionales durante el entrenamiento con simulación clínica. Metas Enferm jun 2021; 24(5):7-13. Doi: https://doi.org/10.35667/MetasEnf.2021.24.1003081761
Authors
Alejandro Martínez-Arce1, José María Maestre-Alonso2, Alberto Bermejo-Cantarero1,Juan Rodríguez de Guzmán-Sánchez de La Nieta3, Víctor Baladrón-González3, Francisco Javier Redondo-Calvo4
Position
1Máster en Investigación. Centro de Simulación Avanzada. Hospital General Universitario de Ciudad Real. Ciudad Real 2Doctor. Hospital virtual Valdecilla. Santander3Diplomado en Enfermería. Centro de Simulación Avanzada. Hospital General Universitario de Ciudad Real. Ciudad Real 4Doctor. Centro de Simulación Avanzada. Hospital General Universitario de Ciudad Real. Ciudad Real
Contact address
Alejandro Martínez Arce. C/ Castillejos, 31. 13195 Poblete (Ciudad Real).
Contact email: amarce@sescam.jccm.es
Abstract
Objective: to analyze the effect of clinical simulation in the level of anxiety pre- and post- training activity in different professional groups and Nursing students, and to assess the self-confidence perceived before/after the simulation in each group.
Methods: a quasi-experimental study in healthcare professionals (nurses, assistant nursing technicians or TCAE, and doctors), and Nursing students (4th year), who underwent for the first time a clinical simulation intervention at the Hospital General Universitario de Ciudad Real. The level of anxiety was evaluated before/after the simulation, through Spielberger’s STAI questionnaire, and the level of self-confidence perceived was also evaluated before / after the simulation. Descriptive analysis was conducted, and Student’s t test was used for mean comparison. Statistical significance was established at p< 0.05.
Results: the study included 53 subjects: 43 (81.2%) were professionals and 10 (18.8%) were Nursing students; their mean age (SD) was 39 (11.8) years; and 84.9% (n= 45) were female. The mean anxiety level (SD) at the start of the simulation was higher in Nursing students, with 24.6 (5.4), and lower in doctors, with 14.4 (5.8). After the intervention, the mean (SD) level of anxiety-status was reduced in all groups; it was significant (p< 0.001) in the TCAE group, with -13.1 (6.9) and nurses, with -12.5 (8.4). There was an increase in the level of self-confidence in all participants by the end of the activity.
Conclusions: the professionals who participated for the first time in a clinical simulation activity presented a high level of anxiety, though this was lower among doctors. There was a reduction in anxiety and increase in confidence by the end of the clinical simulation.
Keywords:
patient simulation; anxiety; learning; clinical simulation
Versión en Español
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Bibliography
- McGaghie WC, Draycott TJ, Dunn WF, López CM, Stefanidis D. Evaluating the Impact of Simulation on Translational Patient Outcomes. Simul Healthc 2011; 6(Suppl):S42-7. Doi: https://doi.org/10.1097/SIH.0b013e318222fde9
- Daglius R, Scalabrini A. Stress levels during emergency care: A comparison between reality and simulated scenarios. J Crit Care 2016; 33:8-13. Doi: https://doi.org/10.1016/j.jcrc.2016.02.010
- Nielsen B, Harder N. Causes of Student Anxiety during Simulation: What the Literature Says. Clin Sim Nurs 2013 ;9:507-12. Doi: https://doi.org/10.1016/j.ecns.2013.03.003
- Shearer JN. Anxiety, Nursing Students, and Simulation: State of the Science. J Nurs Educ. 2016; 55(10):551-4.
- Szarek JL. Students experience positive emotions more frequently than negative emotions during simulations: Contributions to learning. Poster presented at the International Meeting on Simulation in Healthcare, 2010. Phoenix, AZ.
- Bong C, Lightdale J, Fredette M, Weinstock P. Effects of simulation versus traditional tutorial-based training on physiologic stress levels among clinicians: A pilot study. Simul Healthc 2010; 5:272-8. Doi: https://doi.org/10.1097/SIH.0b013e3181e98b29
- DeMaria S, Bryson EO, Mooney TJ, Silverstein JH, Reich DL, Bodian C, et al. Adding emotional stressors to training in simulated cardiopulmonary arrest enhances participant performance. Med Educ 2010; 44:1006-15. Doi: https://doi.org/10.1111/j.1365-2923.2010.03775.x
- Labrague LJ, MacEnroe-Petitte DM, Bowling AM, Nwafor CE, Tsaras K. High-fidelity simulation and nursing students’ anxiety and self-confidence: A systematic review. Nurs Forum. 2019; 54:358-68. Doi: https://doi.org/10.1111/nuf.12337
- Roussin C, Larraz E, Jamieson K, Maestre JM. Psychological Safety, Self-Efficacy, and Speaking Up in Interprofessional Healthcare Simulation. Clin Sim Nurs 2018; 17:38-46. Doi: https://doi.org/10.1016/j.ecns.2017.12.002
- Rudolph JW, Raemer DB, Simon R. Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simul Healthc 2014; 9:339-49. Doi: https://doi.org/10.1097/SIH.0000000000000047
- Strickland HP, Cheshire MH, March AL. Clinical Judgment During Simulation: A Comparison of Student and Faculty Scores. Nurs Educ Perspect 2017; 38:85-6. Doi: https://doi.org/10.1097/01.nep.0000000000000109
- Keeley J, Zayac R, Correia C. Curvilinear relationships between statistics anxiety and performance among undergraduate students: Evidence for optimal anxiety. Stat Educ Res J 2008; 7:4-15.
- Martínez A, Rojo E, Maestre JM, Labrada M, Calvo Y, Valverde G, et al. La simulación clínica. Entrenamiento de equipos clínicos y facilitador de cambios asistenciales. Rev ROL Enf 2013; 36:684-93.
- Birnbach DJ, Bateman BT. Obstetric Anesthesia: Leading the Way in Patient Safety. Obstet Gynecol Clin North Am 2019; 46:329-37. Doi: https://doi.org/10.1016/j.ogc.2019.01.015
- Spielberger CD. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press Inc; 1983.
- Evain JN, Zoric L, Mattatia L, Picard O, Ripart J, Cuvillon P. Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study. Anaesth Crit Care Pain Med 2017; 36:205-12. Doi: https://doi.org/10.1016/j.accpm.2016.09.008
- Paskins Z, Peile E. Final year medical students views on simulation-based teaching: A comparison with the best evidence medical education systematic review. Med Teach 2010; 32:569-77. Doi: https://doi.org/10.3109/01421590903544710
- Gore T, Hunt CW, Parker F, Raines KH. The Effects of Simulated Clinical Experiences on Anxiety: Nursing Students’ Perspectives. Clin Sim Nur 2011; 7:e175-80. Doi: https://doi.org/10.1016/j.ecns.2010.02.001
- White AH. Clinical decision making among fourth-year nursing students: An interpretive study. J Nurs Educ 2003; 42:113-20. Doi: https://doi.org/10.3928/0148-4834-20030301-06
- Clarke S, Horeczko T, Cotton D, Bair A. Heart rate, anxiety and performance of residents during a simulated critical clinical encounter: a pilot study. BMC Med Educ. 2014; 14:153. Doi: https://doi.org/10.1186/1472-6920-14-153
- Bauer C, Rimmelé T, Duclos A, Prieto N, Cejka JC, Carry PY, et al. Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions. Anaesth Crit Care Pain Med 2016; 35:407-16. Doi: https://doi.org/10.1016/j.accpm.2016.01.004
- Gouin A, Damm C, Wood G, Cartier S, Borel M, Villette-Baron K, et al. Evolution of stress in anaesthesia registrars with repeated simulated courses: An observational study. Anaesth Crit Care Pain Med 2017; 36:21-6. Doi: https://doi.org/10.1016/j.accpm.2016.02.008
- Cantrell ML, Meyer SL, Mosack V. Effects of Simulation on Nursing Student Stress: An Integrative Review. J Nurs Educ 2017; 56:139-44. Doi: https://doi.org/10.3928/01484834-20170222-04
- Bates TA, Moore LC, Greene D, Cranford JS. Comparing Outcomes of Active Student and Observer Roles in Nursing Simulation. Nurse Educ 2019; 44:216-21. Doi: https://doi.org/10.1097/NNE.0000000000000603
- De Souza CR, Kusumota L, Alves MC, Merizio FT, Pirani V, Mara C, et al. Anxiety and performance of nursing students in regard to assessment via clinical simulations in the classroom versus filmed assessments. Invest Educ Enferm 2014; 32(2):270-9. Doi: https://doi.org/10.17533/udea.iee.v32n2a10
- Erickson M, Black J, Clark L, Carstens P, Jenkins LD, Promes J, et al. Effect of High-Fidelity Simulation on Pediatric Nursing Students’ Anxiety. Clin Sim Nurs 2012; 8:419-28. Doi: https://doi.org/10.1016/j.ecns.2011.03.006
- León-Castelao E, Maestre JM. Prebriefing en simulación clínica: análisis del concepto y terminología en castellano. Educ Med 2019; 20:238-48. Doi: https://doi.org/10.1016/j.edumed.2018.12.011
- Lilot M, Evain JN, Bauer C, Cejka JC, Faure A, Balança B, et al. Relaxation before Debriefing during High-fidelity Simulation Improves Memory Retention of Residents at Three Months: A Prospective Randomized Controlled Study. Anesthesiology 2018; 128:638-49. Doi: https://doi.org/10.1097/ALN.0000000000002045
- Cook DA, Hamstra SJ, Brydges R, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hatala R. Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach 2013; 35:e867-98. Doi: https://doi.org/10.3109/0142159X.2012.714886