title: Perceived stress and team performance during a simulated resuscitation.
abstract: OBJECTIVE
  Barriers to optimal performance of cardiopulmonary resuscitation may partly relate to human factors, such as stress and specific emotions. The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers.
  
  
  METHODS
  This prospective, observational study was conducted at the Simulator Center of the University Hospital Basel, Switzerland. A total of 120 medical students (70% female) participated in teams of three. They reported levels of perceived stress, feeling overwhelmed, motivation and specific emotions before, during, and after a simulated resuscitation. The association of stress/overload (index of stress and feeling overwhelmed), motivation, and specific emotions with resuscitation performance defined as hands-on time during the first 180 s after cardiac arrest was investigated.
  
  
  RESULTS
  During resuscitation, levels of stress/overload, motivation, and negative emotions were significantly higher as compared to the periods before and after resuscitation. In contrast, positive emotions were highest before and after resuscitation and significantly lower during resuscitation. In general, females reported higher stress/overload and negative emotions, whereas males reported more positive emotions. A multivariate linear regression model showed negative associations of stress/overload (regression coefficient -18.12, 95% CI -30.73, -5.51, p = 0.006) and positive associations of motivation (regression coefficient 13.45, 95% CI 0.95, 25.95, p = 0.036) with resuscitation performance.
  
  
  CONCLUSIONS
  A simulated cardiac arrest caused substantial perceived stress/overload and negative emotions, particularly in female students, which adversely impacted resuscitation performance. Further studies are required to expand our findings to more experienced medical professionals and investigate whether stress coping strategies improve resuscitation performance.
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA. HunzikerS@post.harvard.edu
authors.forename: Sabina
authors.initials: S
authors.lastname: Hunziker
authors.forename: Laura
authors.initials: L
authors.lastname: Laschinger
authors.forename: Simone
authors.initials: S
authors.lastname: Portmann-Schwarz
authors.forename: Norbert K
authors.initials: NK
authors.lastname: Semmer
authors.forename: Franziska
authors.initials: F
authors.lastname: Tschan
authors.forename: Stephan
authors.initials: S
authors.lastname: Marsch
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D010348:Patient Care Team; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology*; D013557:Switzerland; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D055815:Young Adult