Abstract 194: Cortisol and Alpha-Amylase During High-Fidelity-Simulation and Standardized Patients in a Pre-Hospital Emergency Setting
Introduction: Benefits of high-fidelity simulation (SIM) are widely accepted as well as standardized patients (SP) are known for its realistic mimic of real patients, but rare data exist about comparable stress markers within these training environments. This pilot study aims to investigate repetitive performance and stress in interprofessional teams in pre-hospital setting of emergency medical system(EMS).
Methods: This prospective controlled study was approved by the local institutional ethics board. Teams with 1 EMS-physician&2 paramedics had to run through 3 SIM and 2 SP sessions consecutively. Standardized scenarios were designed and tested by experts before. Scenarios of hypoglycemia, severe burn injury, intoxication with tricyclic antidepressant, scuba diving accident, and renal colic were each finished after 10 min. Totally 14 saliva samples were taken before, during as well as after scenarios, and alpha-amylase and cortisol were measured. Statistical analysis was performed using ANCOVA for repeated measurements (SAS, Version 9.1.3, SAS Institute Inc., Cary, NC, USA).
Results: Teams consisted of 16 EMS-physicians (75% male; age 36.8±5.0 years; EMS-experience: 9.1±5.8 years) and 32 paramedics (91% male, age 30.9±6.9 years; EMS-experience: 8.1±6.0 years). All were able to run through scheduled scenarios. Alpha-amylase and cortisol did not differ significantly between professions. Cortisol values showed adaption over time; alpha-amylase activity but not cortisol concentration showed reproducible and significant movements (p<0.00038) in 5 of 13 paired comparison of SIM and SP sessions.
Conclusions: SIM as well as SP training produces stress in interprofessional EMS-teams. Stress response measured by salivary alpha-amylase but not cortisol was reproducible in SIM and SP scenarios. Further research is needed to validate these findings in different settings. Alpha-amylase might be a reliable parameter for easy measurement of stress levels in SIM or real emergency settings for future studies.
- © 2010 by American Heart Association, Inc.