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.
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.
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.
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.