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. 2024 Jul 26:58:e20230279.
doi: 10.1590/1980-220X-REEUSP-2023-0279en. eCollection 2024.

Association between cortisol levels and performance in clinical simulation: a systematic review

[Article in English, Portuguese]
Jackson Gois Teixeira  1 , Lucas Tomaz Benigno Lima  2 , Elaine Carvalho Cunha  1 , Flavia Oliveira de Almeida Marques da Cruz  1 , Karen Karoline Gouveia Carneiro  3 , Laiane Medeiros Ribeiro  4 , Guilherme da Costa Brasil  1
Affiliations

Association between cortisol levels and performance in clinical simulation: a systematic review

[Article in English, Portuguese]
Jackson Gois Teixeira et al. Rev Esc Enferm USP. .

Abstract
in English, Spanish

Objective: To identify how stress measured by salivary cortisol during clinical simulation-based education, or simulation and another teaching method, impacts performance.

Method: Systematic review of the association between cortisol and performance in simulations. The following databases were used: PubMed, LIVIVO, Scopus, EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS) and Web of Science. Additional searches of gray literature were carried out on Google Scholar and Proquest. The searches took place on March 20, 2023. The risk of bias of randomized clinical trials was assessed using the Cochrane Collaboration Risk of Bias Tool (RoB 2). Inclusion criteria were: simulation studies with salivary cortisol collection and performance evaluation, published in any period in Portuguese, English and Spanish.

Results: 11 studies were included which measured stress using salivary cortisol and were analyzed using descriptive synthesis and qualitative analysis.

Conclusion: Some studies have shown a relationship between stress and performance, which may be beneficial or harmful to the participant. However, other studies did not show this correlation, which may not have been due to methodological issues.

Objetivo:: Identificar cómo el estrés medido por el cortisol salival durante la enseñanza basada en la simulación clínica, o la simulación y otro método de enseñanza, influye en el rendimiento.

Método:: Revisión sistemática de la asociación entre cortisol y rendimiento en simulaciones. Se utilizaron las siguientes bases de datos: PubMed, LIVIVO, Scopus, EMBASE, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Web of Science. Se realizaron búsquedas adicionales de literatura gris en Google Scholar y Proquest. Las búsquedas se realizaron el 20 de marzo de 2023. El riesgo de sesgo de los ensayos clínicos aleatorios se evaluó mediante la Herramienta de Riesgo de Sesgo (RoB 2) de la Colaboración Cochrane. Los criterios de inclusión fueron: estudios de simulación con recogida de cortisol salival y evaluación del rendimiento, publicados en cualquier periodo en portugués, inglés y español.

Resultados:: Se incluyeron 11 estudios que midieron el estrés mediante cortisol salival y se analizaron mediante síntesis descriptiva y análisis cualitativo.

Conclusión:: Algunos estudios mostraron una relación entre el estrés y el rendimiento, que puede ser beneficiosa o perjudicial para el participante. Sin embargo, otros estudios no mostraron esta correlación, lo que puede no haberse debido a cuestiones metodológicas.

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Figures

Figure 1
Figure 1. Flowchart of the literature search process and study selection criteria (adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA 2020), Brasília, DF, Brazil, 2024.
Figure 2
Figure 2. Methodological evaluation of included studies based on the Cochrane tool(21). Brasília, DF, Brazil, 2024.
Figura 1
Figura 1. Fluxograma do processo de busca na literatura e critérios de seleção dos estudos (adaptado do Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA 2020), Brasília, DF, Brasil, 2024.
Figura 2
Figura 2. Avaliação metodológica de estudos incluídos com base na ferramenta Cochrane(21). Brasília, DF, Brasil, 2024.
See this image and copyright information in PMC

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