Evaluation of stress induced by high-fidelity simulation among anesthesiology and emergency residents: impact of oral debriefing versus video assisted Section Pedagogy


Saida Zelfani
Safia Othmani
Islem Ouanes
Rafika Ben Chihaoui
Afef Chakroun
Héla Manai
Teycir Kharraz


Aim: To describe the level of stress in emergency medicine and anesthesia residents during high fidelity simulation sessions and to evaluate the effect of video-assisted debriefing versus no-video assisted debriefing on stress level.

Methods: Prospective randomized study. Inclusion: emergency medicine and anesthesia residents consenting. Stress was assessed, before and after the training session, by: Blood Pressure (BP), Heart Rate (HR), Simple Numerical Scale (SNS), Scale trait anxiety inventory-YA (STAI-YA). Heart Rate and SNS were measured after debriefing. Residents were randomized into two groups according to the debriefing modality. The design of the simulation session was evaluated by the Simulation design scale (SDS). 

Results: Thirty-six residents were included. We observed significant increase in the mean HR and mean Systolic BP before briefing and after the scenario respectively from 83.8±9.97   cpm to 101.3±17.84   cpm (p <0.001) and from 112.2±8.3 mmHg to 149.6±16.8 (p <0.001). Mean SNS and mean STAY-YA increased before the briefing and after the scenario respectively from 5±2.11 to 6±1.52 (p=0.004) and from 40±6.6 to 57.8±12.3 (p=0.01). HR and SNS decreased significantly after debriefing regardless of modality. The mean SDS was 84.53±5.8. After scenario, we found significant negative correlation between HR and time needed to initiate symptomatic treatment (r = - 0.449, p = 0.019).

Conclusion: Learning by simulation of critical situations is associated with significant stress which decreased after debriefing.


Simulation, Stress, Pedagogy, Evaluation study, Emergencies



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