Daniel Aiham Ghazali, Stéphanie Ragot and Denis Oriot
Objective: Simulated life-threatening medical emergencies generate stress that can be apprehended by measurement of salivary cortisol (SC). The aim of this study was to analyze SC level in multidisciplinary teams (MDTs) members during immersive simulation and to study its evolution over time with repetition of simulation sessions in all team members.
Methods: 48 participants constituted 12 Emergency Medical Service MDTs made up of 4 members each. Six MDTs underwent 9 simulations (experimental group) and 6 underwent 3 simulations over one year (control group). SC was assessed the day prior to simulation (T0), before simulation (T1), after simulation (T2) and after debriefing (T3). 1152 samples were analyzed by ELISA. Variation over time was analyzed using ANOVA for repeated measures. Mann-Whitney test was used for comparison between groups at two times and Kruskal-Wallis test was used to study stress response in the different status of teams. A p value <0.05 was considered significant.
Results: SC increased from 0.16 ± 0.12 (T0) to 0.26 ± 0.14 (T1). SC level continued to rise up to 0.39 ± 0.27 at T2 before decreasing to 0.21 ± 0.12 at T3, p<0.0001. SC increase was found in all team members with no status effect. SC level was not blunt after repetition of sessions regardless of the frequency of sessions.
Conclusion: SC raised during immersive simulation and this variation was not blunt after repetition of simulation sessions. No status effect was found among the MDTs’ members. Future study should investigate on other markers of stress response and correlate them to team performance.
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