Impact of Mental Training on the Stress of Anaesthesiology Residents Before Performing Obstetrical Epidural Analgesia

Impact of Mental Training on the Stress of Anaesthesiology Residents Before Performing Obstetrical Epidural Analgesia: a Prospective Randomized Educational Trial

Anaesthetists are trained from the beginning of their residency to perform high-risk procedures, often in high-stress environments, that can adversely affect both their technical and non-technical performance. Effective stress management is therefore essential, particularly before executing technical procedures. Recently, mental training has been introduced in the education of surgical residents to enhance performance under pressure. This study aimed to assess, using simulation, the impact of mental preparation on stress levels among anaesthesia residents before performing obstetric epidural analgesia.

Residents were randomly assigned to either a "Control" group or a "Mental Training" group, the latter undergoing a mental preparation session before performing lumbar epidural anaesthesia. Randomisation was performed in blocks of eight by an external party and stratified by training year (second or third) and gender. Residents were informed they would be participating in a training session involving anaesthetic practice on a low-fidelity simulator.

On the day of the simulation, residents were individually welcomed in a briefing room by an anaesthetist specialised in mental preparation. Group assignment was revealed from a sealed envelope and residents were informed that the simulation would involve acting as the on-call anaesthesia resident in a maternity ward. The scenario began with a call from a midwife requesting an epidural placement for a laboring patient. Depending on their assigned group, residents either received a mental preparation session or proceeded without it. Both groups participated in a ten-minute briefing session.

Inclusion Criteria: Eligible subjects for this study were anaesthesia and intensive care residents enrolled at the Faculty of Medicine and Pharmacy in Rouen. Residents were eligible if they were in the early stages of training (second and third years of residency) and had previously performed lumbar epidural anaesthesia multiple times in a maternity setting.

Exclusion Criteria: Exclusion criteria included first-year residents, as not all had performed obstetric lumbar epidural anaesthesia at the time of the study, and senior residents (fourth and fifth years).