Does prior exposure to clinical critical events influence stress reactions to simulation session in nursing students: A case-control study

Abstract

Background: Simulation is a pedagogical method known to be a generator of stress, that could be influenced by previous stressful experiences.

Objectives: The purpose of this study was to determine the impact of previous experience with a clinical critical event on the stress experienced by nursing students during simulation session of critical events, and on the stress experienced during clinical critical events subsequent to the training.

Design: Observational case-control study.

Settings: Four critical event scenarios were created using full-scale simulation.

Participants: Two hundred and fifteen undergraduate nursing students of semester four. The control group (n = 112) consisted of learners who had not previously experienced a critical event. The prior exposure group (n = 103) consisted of learners who had experienced a critical event prior to the course.

Methods: Stress levels were assessed using the self-report stress numerical rating scale-11.

Results: There was no significant difference in the level of stress between the prior exposure group and the control group before, during or expected after the simulation session. A significant decrease in stress was observed in both groups from before the course to during the session (p < 0.05) and expected after the session (p < 0.05). There was no significant difference between the expected post-session stress level and the stress levels reported four months after the training (p = 0.966). At four months, there was no significant difference in stress levels between the groups (p = 0.212).

Conclusions: The prior experience of a clinical critical event before a simulation course did not influence their reported stress level during the simulation session. Conversely, simulation-based training of critical situations appears to reduce the level of self-assessed stress during critical events in clinical practice after the training.

Keywords: Critical care; Nursing student; Simulation training; Stress.