Resilience, Performance and Stress in Anaesthesia

Resilience,Performance and Stress in Anaesthesia Professionals: a Simulation-based Observational Study

The aim of this study was to determine whether there was an association between resilience and the performance of student nurse anaesthetists in simulated critical situations.

Study Overview

• Status: Completed
• Conditions: Stress, Psychological; Resilience

Detailed Description

This trial will take place at the Grenoble Alpes University Hospital. Volunteer nurse anaesthetists students will perform a simulation scenario. This scenario generates a high level of stress and focuses on the management of anaphylactic shock in the operating room, which is a good teaching tool for the participants.

The simulation is performed in a dedicated simulation room configured as an operating theatre. In this environment, a high-fidelity manikin is intubated and ventilated on an anaesthesia ventilator. The manikin is perfused. The anaesthesia cart is replicated with the same equipment and drugs as the anaesthesia carts in the operating theatre. A person playing the role of a nurse anaesthetist will conduct transmissions before leaving the room replaced by the participant. One person will play the role of the surgeon in the room. The simulation will take place as follows:

Briefing :

Welcome and explanation of the session. Collection of age, gender, number of years in anaesthesia, number of years as a nurse.

The simulation room, the mannequin and the anaesthesia trolley are presented by a simulation trainer before starting the scenario.

First evaluation of the acute stress perceived by the VAS stress(visual analogue stress scale) which triggers the beginning of the scenario.

The patient is introduced by the nurse anaesthetist present in the room and explanations are given on how to reach the anaesthetist by phone. Once the transmissions are completed, the preoperative checklist is carried out by the surgeon with the nurse anaesthetist and the student nurse anaesthetist who takes over. Once the checklist is completed the simulation timer is started and the nurse anaesthetist leaves the room leaving the patient alone on the anaesthesia side.

Scenario:

On arrival at the room:

→ Vitals on arrival: BP (blood pressure)= 100/50, HR(heart rate) = 60, Spo2 = 99%, EtC02 (end tidal C02) = 36 mmHg

T0: Surgical incision

→ Vitals at incision: BP = 120/70, HR = 70, SpO2 = 99%, EtCo2 = 39 mmHg

T1 = 3 min: BP = 90/55, HR = 95, SpO2 = 98%, EtCo2 = 34 mmHg

T2 = 6 min: BP = 78/45, HR = 110, SpO2 = 97%, EtCo2 = 30 mmHg, if possible: vary the SpO2 signal if possible

T3 = 9 min: BP = 65/32, HR = 130, SpO2 = no signal, EtCO2 = 28 mmHg

T4 = 12 min: BP = 56/28, HR = 150, SpO2 = no signal, EtCO2 = 25 mmHg

If no communication with the surgical team before T3, the facilitating surgeon mentions a skin rash to guide management.

The study stops at 12 minutes when the anaesthetist enters the operating room.

Debriefing: The debriefing is conducted by a simulation trainer accordance with the guidelines of the French Society of Health Simulation.

The main objective of this study is to investigate an association between the level of resilience of student nurse anaesthetists and their performance (Performance score N°1) under stress.

The secondary objectives of this study are to investigate the correlation between :

• Performance score N°2 (without taking into account the notion of time in scale N°1) and resilience by ConnorDavison Resilience scale (CDRISC 10).
• Work experience and performance score 1
• Years of specialisation in anesthesia and Performance score 1
• Age and performance score 1

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• France
  • Grenoble, France
    • university grenoble hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Nurse in the first or second year of specialisation as a nurse anaesthetist.

Description

Inclusion Criteria:

• Voluntary first or second year nurse anaesthetist student

Exclusion Criteria:

• pregnant woman

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Resilience	Measurement of resilience by Connor-Davidson Resilience Scale 10 (CD RISC 10 from 0 to 40) in participants. A high score indicates better resilience.	at Day 0 : 10 minutes before simulation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance score 1	Performance scale with 15 items based on the recommendations for the management of anaphylactic shock by the French Society of Anaesthesia and Intensive Care. The time taken to perform the procedure is noted and influences the score. The final score ranges from 0 to 60 points. A higher score indicates a higher performance.	at Day 0 during the simulation between T: 0 minute (begin simulation) and T:12 minutes (end of simulation) (during of simulation is 12 minutes))
Performance score 2	Performance scale with 15 items based on the recommendations for the management of anaphylactic shock by the French Society of Anaesthesia and Intensive Care. The final score ranges from 0 to 15 points. A higher score indicates a higher performance.	at D0 during the simulation between T: 0 minute (begin simulation) and T:12 minutes (end of simulation) (during of simulation is 12 minutes)
Age of anaesthesia professionals	Age of anesthesia professionals: (quantitative variable)	at Day 0 : 10 minutes before simulation
work experience	number of years since first nursing practice (quantitative variable)	at Day 0 : 10 minutes before simulation
year of specialisation	Year of specialisation : first year or second year(qualitative variable)	at Day 0 : 10 minutes before simulation

Collaborators and Investigators

• Sponsor: University Hospital, Grenoble
• Investigators: Principal Investigator: Julien Picard, University Hospital, Grenoble

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2023
• Primary Completion (Actual): June 15, 2023
• Study Completion (Actual): September 1, 2023

Study Registration Dates

• First Submitted: May 3, 2023
• First Submitted That Met QC Criteria: May 15, 2023
• First Posted (Actual): May 18, 2023

Study Record Updates

• Last Update Posted (Estimated): December 5, 2023
• Last Update Submitted That Met QC Criteria: December 4, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: Performance; Resilience; Simulation; Acute stress; Anaesthetist student
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological
• Other Study ID Numbers: IRB 00010254 - 2023 - 030

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No