P24 The influence of stress management strategies on performance in simulated medical emergencies

BackgroundSurvival of acutely unwell patients depends on prompt recognition and resuscitation.1 Time pressures, workload and the importance of managing such patients is a significant source of stress for junior doctors, making them feel underprepared for their role and contributing to error.2Summary of workOur study aims to investigate the impact of stress management strategies on junior doctors undertaking simulated medical emergencies. We aim to explore how these interventions affect doctors’ self-reported and observed stress, and establish the influence on speed and accuracy of diagnosis. Doctors (n=18) in first and second years of core medical training will be randomised into two groups. Group A will receive specific teaching on cognitive control techniques and controlled breathing prior to high fidelity simulations, whilst participants in Group B will receive a standard simulation course which does not include any specific focus on stress management techniques.Time to various transition points and diagnosis will be recorded for each participant. Stress will be assessed using heart rate variability, participant self-rating questionnaires and stress levels rated by an observer.Summary of resultsThis is an ongoing study, full results will be available for presentation at the conference. Preliminary data indicates that stress management techniques may be effective in reducing observed stress and increasing heart rate variability during medical emergencies, but have less effect on self-reported stress levels.Discussion and conclusionData collection is currently ongoing. Statistical analysis of the data will help us to establish whether cognitive control and controlled breathing techniques improve junior doctors’ coping mechanisms during medical emergencies.ReferencesMcQuillan P, Pilkington S, Allan A, et al. Confidential inquiry into quality of care before admission to intensive care. Br Med J1998;316:1853–8.Tallentire VR, Smith SE, Skinner J, Cameron HS. The preparedness of UK graduates in acute care: A systemic literature review. Postgrad Med J2012;88:365–71.