Clinical Science Research
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Stressful situations pervade emergency medicine. Many studies demonstrate the deleterious impacts of stress on a physician’s immediate actions and lasting mental health. It is well-documented in the literature that preparedness can help mediate stress. Stress inoculation training (SIT) is utilized to prevent adverse stress response. This training teaches coping skills and defensive thinking to actively mitigate the negative physiological effects that occur during stressful events. SIT theory involves a conceptualization phase, skills training phase and application phase. The goal of this study is to evaluate the effect of SIT on endotracheal intubation performance of novice intubators.
The study consists of a population of medical students without prior airway training who are randomly assigned to control and intervention groups. Both groups will receive a didactic lecture on airway management followed by a brief intubation attempt on a standard dummy. The experimental group will subsequently receive a lecture on the principles of SIT where they learn to use focused intervention shown to reduce the physiological effects of stress. These techniques include box breathing, positive self-talk and imagery. All participants will then intubate the standard dummy in three different scenarios of varying environmental stressors. The main outcome will be the participant’s ability to successfully perform the procedure. Secondary outcomes will be the number of attempts and time required to successfully intubate, as well as, the participant's post event response to the Perceived Stress Questionnaire. To evaluate the lasting effects of SIT, both groups will return in a month and repeat the intubation scenarios.
Due to COVID-19 restrictions, pilot testing has been postponed until Fall 2020. Data analysis will focus on participant’s ability to perform the procedure under stressful conditions, their perception of stress, time to intubation and number of attempts.
The study evaluates the teaching of stress inoculation training (SIT) on emergency airway management. We hope this application of SIT will not only contribute to a growing body of literature on stress management, but also enhance patient safety and better prepare medical students for career resiliency.
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VCU School of Medicine GME Resident and Fellow Research Day Posters