A simulation workshop to introduce coping skills

Experiencing clinical catastrophes can result in long-lasting emotional and psychological impacts. In other fields, crisis simulation has been used to train professionals in coping skills. Our workshop combined a simulated case with a clinical debrief and expert-led teaching on coping skills. The '4Rs' mnemonic, Recognise, Reflect, Reframe and Reach-out, describes the key elements. This is grounded in social, cognitive and behavioural theories of stress and coping. All 96 anesthesiology residents from one residency programme participated, in small groups, and a mixed methods analysis was used. The scenario was deemed stressful. The workshop introduced new techniques, with 72/87 (82.75%) reporting new coping skills in use at 1-month follow-up. For many residents, the descriptive language regarding their performance and abilities shifted from critical, negative self-talk to positive and team-focused immediately following the workshop. A striking finding from evaluations at all timepoints was that negative comments were typically self-referencing whereas positive ones referenced colleague support and the team. Combining stress exposure with formal exploration of emotional responses and coping skills teaching in this workshop was feasible, with benefits at 1-month follow-up. This laid the groundwork for a resilience curriculum and wider departmental interest in the topic of coping and stress responses.