Characterization of anesthetists’ behavior during simulation training: performance versus stress achieving medical tasks with or without physical effort

Decades of research about stress have shown that it could be source of performance but also of cognitive deficit. The studies have led to highlight occupational stress variables that researchers have characterized by physiological measurements, data treatments and protocols becoming more and more complex with time. If these devices are gaining in precision, they are now too complex to allow non-specialist users to produce a quick interpretation of results. Yet for vocational training, specifically on simulators, trainers need to know in real time whether or not what they implement allows the trainees to learn in good conditions, i.e. by favoring the behavior produced by the positive effect of stress on performance. The present paper addresses the performance versus occupational stress during training sessions of anesthetists on simulator. We studied the performance and stress with or without physical effort using a simple protocol based on the use of basic heart parameters in order to obtain a quasi-instantaneous interpretation of the data. We identified cognitive deficit zone during training according to the Yerkes & Dodson (1908) relationship between performance and stress. We showed that performance versus stress during simulation training with or without physical efforts could be successfully analyzed for immediate assessment of stress influencing performance. Suggestions have been made for improving training sessions and avoid trainees’ behavior induced by cognitive deficit. Limits of the protocol are exposed

Heart rate vs stress indicator for short term mental stress

Heart rate variation (HR) being identified as depending on subjects’ stress state when submitted to short term mental stress, this study aimed at analyzing whether or not it could be possible to find a mathematical relationship between the average heart rate variation and the intensity S of a stress indicator in case of short term mental stress, whatever the stress indicator is. The method consisted in working the hypothesis by gathering data providing HR and ratio of frequency power of HRV (Heart Rate Variability) for different level of stress, HRV being considered as a stress indicator and presenting the advantage of being widely used in studies, therefore providing numerous data in the literature. From this data, a mathematical model was designed and then assessed by testing its reliability when applied to HR variation versus different types of stress indicators (EMG, GSR, Work Load, questionnaires such as STAI-S, ALES). The correlation obtained between the model and the data provided by the literature (24 points from 8 studies gathering 272 subjects) gave r=.95 (p<.0001) which allowed us to validate the model. Limits of the model were identified and discussed