Stress levels during emergency care: a comparison between reality and simulated scenarios

Abstract Purpose 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. Materials and Methods 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 (HR), systolic (SBP) and diastolic blood pressure (DBP), salivary alpha amylase (AA), salivary interleukine-1 beta (IL-1β) and State Anxiety Inventory (STAI-s). Results 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 < 0.05) between T1 and T2. In the simulation group, only HR and IL-1β increased significantly after emergencies. The comparison between groups demonstrates that acute stress response (T2 – T1) and STAI-s (in T2) did not differ between both groups. Conclusions 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.