title: Stress levels during emergency care: A comparison between reality and simulated scenarios.
abstract: Medical simulation is fast becoming a standard of health care training throughout undergraduate, postgraduate and continuing medical education. Our aim was to evaluate if simulated scenarios have a high psychological fidelity and induce stress levels similarly to real emergency medical situations.
  
  
  
  Medical residents had their stress levels measured during emergency care (real-life and simulation) in baseline (T1) and immediately post-emergencies (T2). Parameters measuring acute stress were: heart rate, systolic and diastolic blood pressure, salivary α-amylase, salivary interleukin-1β, and State-Trait Anxiety Inventory score.
  
  
  
  Twenty-eight internal medicine residents participated in 32 emergency situations (16 real-life and 16 simulated emergencies). In the real-life group, all parameters increased significantly (P < .05) between T1 and T2. In the simulation group, only heart rate and interleukin-1β increased significantly after emergencies. The comparison between groups demonstrates that acute stress response (T2 - T1) and State-Trait Anxiety Inventory score (in T2) did not differ between groups.
  
  
  
  Acute stress response did not differ between both groups. Our results indicate that emergency medicine simulation may create a high psychological fidelity environment similarly to what is observed in a real emergency room.
authors.affiliation: Emergency Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: roger.daglius@gmail.com.
authors.forename: Roger
authors.initials: R
authors.lastname: Daglius Dias
authors.affiliation: Emergency Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Augusto
authors.initials: A
authors.lastname: Scalabrini Neto
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology* / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology*; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D007388:Internal Medicine / Q000193:education; D008297:Male; D010820:Physicians; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry; D000066908:Simulation Training; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult; D000516:alpha-Amylases / Q000032:analysis
chemical_list: C508585:IL1B protein, human; D053583:Interleukin-1beta; D000516:alpha-Amylases
keywords: Acute stress; Emergency medicine; Medical simulation; Psychologic fidelity