Excellence in performance and stress reduction during two different full scale simulator training courses: a pilot study.
BACKGROUND
Simulator training is well established to improve technical and non-technical skills in critical situations. Few data exist about stress experienced during simulator training. This study aims to evaluate performance and stress in intensivists before and after two different simulator-based training approaches.


METHODS
Thirty-two intensivists took part in one of six 1-day simulator courses. The courses were randomised to either crew resource management (CRM) training, which contains psychological teaching and simulator scenarios, or classic simulator training (MED). Before and after the course each participant took part in a 10-min test scenario. Before (T1) and after (T2) the scenario, and then again 15 min later (T3), saliva samples were taken, and amylase and cortisol were measured. Non-technical skills were evaluated using the Anaesthetist's Non-Technical Skills (ANTS) assessment tool. Clinical performance of the participants in the test scenarios was rated using a checklist.


RESULTS
Twenty-nine participants completed the course (17-CRM, 12-MED). ANTS scores as well as clinical performances were significantly better in the post-intervention scenario, with no differences between the groups. Both cortisol concentration and amylase activity showed a significant increase during the test scenarios. In the post-intervention scenario, the increase in amylase but not cortisol was significantly smaller. There were no differences between the CRM and MED group.


CONCLUSIONS
High fidelity patient simulation produces significant stress. After a 1-day simulator training, stress response measured by salivary alpha-amylase was reduced. Clinical performance and non-technical skills improved after 1 day of simulator training. Neither stress nor performance differed between the groups.
Müller
Michael P
MP
Dept. of Anaesthesiology and Intensive Care Medicine, Carl Gustav Carus University Hospital, Dresden University of Technology, Fetscherstr. 74, 01307 Dresden, Germany. mp-mueller@web.de
Hänsel
Mike
M
Fichtner
Andreas
A
Hardt
Florian
F
Weber
Sören
S
Kirschbaum
Clemens
C
Rüder
Sebastian
S
Walcher
Felix
F
Koch
Thea
T
Eich
Christoph
C
D000328:Adult; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D010865:Pilot Projects; D015203:Reproducibility of Results; D012151:Resuscitation / Q000193:education* / Q000523:psychology; D012463:Saliva / Q000201:enzymology; D013315:Stress, Psychological / Q000201:enzymology / Q000517:prevention & control*; D013663:Teaching / Q000379:methods; D000516:alpha-Amylases / Q000378:metabolism
D000516:alpha-Amylases