Stress Evaluation and Management Using High Fidelity Simulation in Medical Education

The Role of High-fidelity Medical Simulation in Managing Emotional Components and Stress During Emergency and Urgent Care

The goal of this interventional study is to collect clinical and neurophysiological information to determine whether high-fidelity simulation can serve as a stress-inducing stimulus in a population of healthy residents (Emergency medicine, Anesthesia and Intensive care medicine, Paediatrics), both male and female, aged between 25 and 40 years. The main questions it aims to answer are:

1. Define in which phase of the simulation the highest level of stress is observed.
2. Determine the level of stress reached after performing a second high-fidelity simulation after a period of time.
3. Identify whether specific brain areas are activated during high-fidelity simulation.

Participants will form teams, consisting of three medical trainees from the same specialty training program, that will undergo two high-fidelity simulations based on a clinical scenario relevant to their residency.

• During the simulation, automatic pupillometry will be performed on all team members at the four time points.
• Additionally, a two-lead ECG will be recorded for all team members at baseline and end of the debriefing
• One team member will undergo EEG monitoring throughout the entire simulation. The EEG recordings will be sampled at baseline, during the simulation and end of the debriefing.

Inclusion Criteria:

• Medical trainees from the specialties of Emergency Medicine, Anesthesia and Intensive Care, Clinical Toxicology, Pediatrics, and Neonatology.
• Normal hearing and vision, or corrected to normal.

Exclusion Criteria:

• Known history of psychiatric disorders, cognitive impairment, or cardiac arrhythmias.
• Current treatment with psychoactive, cardio-stimulant, or cardio-inhibitory medications.
• Significant stressful life events in the past six months (e.g., family bereavement).
• Previous systematic experience in meditation.