Type of Activity
Original Presentation Date
Date of Submission
A 4.5 day full immersion intensive skills week for emergency medicine and surgical training for finishing second year medical students was performed on a 20 acre movie studio. Utilizing hyper-realistic medical emergency scenarios, we simulated all events beginning at the point of injury, continuing to treatment en route, and ending at transition of care to surgical intervention. The trainees staffed an emergency room (ER) and two operating rooms (OR), triaged multiple victims and performed real surgical procedures on role-playing actors wearing the Human Worn Partial Task Surgical Simulator. Saliva was collected before and after scenarios (i.e., multiple victims from an accident, gun fight, and improvised explosive device) and assayed for cortisol and alpha-amylase (sAA). In addition EKG data looking at R-R interval data was collected. Results from the salivary biometrics and heart rate variability data about the stress response and learning suggests that we are able to identify not only habituation but also whether the student is capable of learning/performing in a given scenario.
Can biometrics measuring the stress response be used to identify habituation?
1)THIS PROJECT IS TO IDENTIFY THE CORRECT PHYSIOLOGIC MARKERS OF STRESS AND HABITUATION THOUGHT TO BE ASSOCIATED WITH IMPROVED COMPLEX EDUCATION.
2)LONG TERM OUR OBJECTIVE IS TO SHOW THAT REALISTIC IMMERSION SIMULATION TRAINING IS BETTER THAN CONVENTIONAL EDUCATION METHODS.
1. Gottlieb, G. (1992). Individual development and evolution: The genesis of novel behavior. New York: Oxford University Press.
2. Chrousos, G. P., & Gold, P. W. (1992). The concepts of stress and stress system disorders: Overview of physical and behavioral homeostasis. Journal of the American Medical Association, 267, 1244-1252.
3. Weiner, H. (1992). Perturbing the organism: The biology of stressful experience. University of Chicago Press.
4. Lundberg, U., & Frankenhaeuser, M. (1980). Pituitary-adrenal and sympathetic-adrenal correlates of distress and effort. Journal of Psychosomatic Research, 24, 125-130. Hutchinson 18
5. Henry, J. P. (1993). Biological basis of the stress response. News in Physiological Sciences, 8, 69-73.
6. Kirschbaum, C., & Hellhammer, D. H. (1994). Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrinology, 19, 3 13-333.
7. Peters, M. L., Godaert, G. L., Ballieux, R. E., van Vliet, M., Willemsen, J. J., Sweep, F. C. G. 3., & Heijnen, C. J. (1998). Cardiovascular and endocrine responses to experimental stress: effects of mental effort and controllability. Psychoneuroendocrinology, 23, 1-17.
8. Folkow, B. (1985). Stress and blood pressure in adrenergic blood pressure regulation. In W. H. Birkenhager, B. Folkow, & H. A. J. Struykeer (Eds.), Current clinical practice series (pp. 87-93). Amsterdam: Excerpta Medica.
9. Frankenhaeuser, M., Lundberg, U., & Forsman, L. (1980). Dissociation between sympathetic-adrenal and pituitary-adrenal responses to an achievement situation characterized by high controllability: comparison between type A and type B males and females. Biological Psychology, 10, 79-91.
10. Schommer, N. C., Hellhammer, D. H., & Kirschbaum, C. (2003). Dissociation between reactivity of the hypothalamus-pituitary adrenal and the sympathetic-adrenal-medullary system to repeated psychosocial stress. Psychosomatic Medicine, 65, 450-460.
11. Hellhammer, D. H., Kirschbaum, C., & Belkien, L. (1987). Measurement of salivary cortisol under psychological stimulation. In J. N. Hingtgen, D. H. Hellhammer, & G. Huppmann (Eds.), Advanced methods in psychobiology (pp.281-289). Toronto: Hogrefe.
12. Granger, D. A., Kivlighan, K. T., El-Sheikh, M., Gordis, H. B., & Stroud, L. R. (2007). Salivary alpha amylase in biobehavioral research: recent developments and applications. Annals of the New York Academy of Sciences, 1098, 122-144.
13. Nater, U.M., Rohleder, N., Gaab, J., Berger, S., Jud, A., Kirschbaum, C., & Ehlert, U. (2005). Human salivary alpha-amylase reactivity in a psychosocial stress paradigm. International Journal of Psychophysiology, 55, 333-342.
14. Nater, U. M., & Rohleder, N. (2009). Salivary alpha-amylase as a noninvasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology, 34, 486-496.
15. Rohieder, N., & Nater, U. M. (2009). Determinants of salivary alphaamylase in humans and methodological considerations. Psychoneuroendocrinology, 34, 469-485.
16. McGraw, L. K., Out, D., Hammermeister, J. J., Ohison, C. J., Pickering, M. A., & Granger, D. A. (2013). Nature, correlates, and consequences of stress-related biological reactivity and regulation in Army nurses during combat casualty simulation. Psychoneuroendocrinology, 38(1), 135-144.
© The Author(s)
Is Part Of
VCU Medical Education Symposium