Shaken and stirred: emotional state, cognitive load, and performance of junior residents in simulated resuscitation

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DOI:

https://doi.org/10.36834/cmej.71760

Abstract

Background: Patient resuscitation can be overwhelming for junior postgraduate medical residents due to its inherent complexity and high-stakes environment. Emotional states of unpleasant hyperarousal burden cognitive resources, contributing to cognitive overload and performance decline. Our objective is to characterize the associations between pre-scenario emotional state and junior residents’ cognitive load and performance in a simulated-resuscitation, to provide evidence for informed curricular development.

Methods: PGY-1 residents self-rated their emotional state before four simulated-resuscitation scenarios, and their cognitive load after. Faculty assessed performance with entrustment scores. Factor analysis identified the principal components of emotional state data. Linear regression models examined the relationship between pre-scenario emotional components, cognitive load, and performance scores. 

Results: 47/47 medical and surgical residents (100%) participated and completed Emotional State (99.5%) and Cognitive Load (98.9%) surveys. Positive invigoration and negative tranquility were the principal components. Pre-scenario tranquility was negatively associated with cognitive load (b= -0.23, p < 0.0001), and cognitive load was negatively associated with performance scores (b= -0.27, p < 0.0001). Pre-scenario invigoration was negatively associated with cognitive load (b=-0.18,p = 0.0001), and positively associated with performance scores (b= 0.08, p = 0.0193). 

Conclusion: Amongst junior residents participating in simulated resuscitation scenarios, pre-scenario agitation (negative tranquility) is associated with increased cognitive load, which itself is associated with lower performance scores. These findings suggest residency programs should consider developing curriculum aimed at modulating residents’ emotional agitation and reducing residents’ cognitive burden to improve resuscitation performance.

Author Biographies

Shyan Van Heer, Queen's University

Shyan Van Heer, BSc, is a third-year medical student in the School of Medicine at Queen’s University, Kingston, ON, Canada.

Nicholas Cofie, Queen's University

Nicholas Cofie, PhD, is a Health Education Researcher and Consultant in the Faculty of Health Sciences at Queen’s University, Kingston, ON, Canada.

Gilmar Gutiérrez, Queen's University

Gilmar Gutiérrez, BSc, is a third-year medical student in the School of Medicine at Queen’s University, Kingston, ON, Canada.

Chandak Upagupta, Queen's University

Chandak Upagupta, PhD, BSc is a second-year medical student in the School of Medicine at Queen’s University, Kingston, ON, Canada.

Adam Szulewski, Queen's University

Adam Szulewski, MD, FRCPC, MHPE, PhD, is Associate Professor in the Department of Emergency Medicine and cross-appointed in the Department of Psychology, Queen’s University, Kingston, ON, Canada.

Timothy Chaplin, Queen's University

Timothy Chaplin, MD, FRCPC, is Assistant Professor in the Department of Emergency Medicine, Queen’s University, Kingston, ON, Canada.

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Published

2021-11-02 — Updated on 2021-11-02

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1.
Van Heer S, Cofie N, Gutiérrez G, Upagupta C, Szulewski A, Chaplin T. Shaken and stirred: emotional state, cognitive load, and performance of junior residents in simulated resuscitation. Can. Med. Ed. J [Internet]. 2021Nov.2 [cited 2021Dec.1];12(5):24-33. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/71760

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