Cognitive Appraisals and Team Performance Under Stress in Simulated Trauma Care

NCT05083871 | Completed

• 1 other identifier: 798-2021-OSS-AUSLBO
• Study Type: observational
• Target: 136
• Locations: 1 country
• Sites: 1

Brief Summary

Medical teams work in demanding situations that are often uncertain, changeable and require accurate decision-making, skilled movement and coordinated action. How teams perform matters for patient outcomes. In addition to medical expertise, how individuals and the team collectively respond and manage the psychological stress of the situation has a significant impact on performance. One approach, which attempts to explain the facilitating and debilitating effects of stress on performance is the biopsychosocial model of challenge and threat. A challenge state occurs when perceived personal resources meet or exceed the situation's demands, whereas threat occurs when demands exceed resources. Challenge states have been consistently associated with improved performance in a range of environments and activities, including medical settings. In a recent study conducted during a national simulation-based training event for residents (the SIMCUP Italia 2018) it was found that a high level of resources is associated with better performance until demands become very high. The present study builds on previous work to explore how challenge and threat states are linked to performance. It includes a more recently developed and robust measure of demands and resource appraisals. In addition, secondary aims include the exploration of how psychological variables, specifically cognitive anxiety, somatic anxiety, self-confidence and social identity (connection with other members of the medical team) are linked to challenge and threat and performance. Understanding the psychological determinants of performance in critical care can provide the basis for individual and team-based interventions to improve critical care team performance.

Conditions

Trauma; Stress, Emotional; Cognitive Change

Keywords

Medical simulation, Cognitive appraisal, Stress psychology

Outcome Measures

Primary Outcomes (1)

• Performance in simulated emergency trauma care

  Composite outcome measure taking into account both technical and non technical skills evaluation from the course instructors

  3 days

Secondary Outcomes (3)

• participants' perceptions of task demands vs. personal resources

  3 days

• mental readiness

  3 days

• Social identity

  3 days

Study Arms (1)

Learners of the European Trauma Course

Learners attending the European Trauma Course

Other: European Trauma Course

Interventions

European Trauma Course OTHER

Structured learning program specifically focused on Trauma management. The course provides frontal lessons, workshops for the technical skills and simulated scenarios. Please see https://www.erc.edu/courses/european-trauma-course for additional details

Learners of the European Trauma Course

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population will include all the learners attending the European Trauma Course in Italy, independently from their previous work experience and educational background

You may qualify if:

• Learners of the European Trauma Course in Italy

You may not qualify if:

• Age \< 18 years

Sponsors & Collaborators

• Azienda Usl di Bologna: lead
• Manchester Metropolitan University: collaborator
• Humanitas Clinical and Research Center: collaborator
• Azienda Sanitaria Universitaria Friuli Centrale: collaborator

Study Sites (1)

Azienda Unità Sanitaria Locale

Bologna, Bologna, 40100, Italy

Location

Related Publications (8)

• Mendes WB, Major B, McCoy S, Blascovich J. How attributional ambiguity shapes physiological and emotional responses to social rejection and acceptance. J Pers Soc Psychol. 2008 Feb;94(2):278-91. doi: 10.1037/0022-3514.94.2.278.

  PMID: 18211177 BACKGROUND

• Tomaka J, Blascovich J, Kibler J, Ernst JM. Cognitive and physiological antecedents of threat and challenge appraisal. J Pers Soc Psychol. 1997 Jul;73(1):63-72. doi: 10.1037//0022-3514.73.1.63.

  PMID: 9216079 BACKGROUND

• Blascovich J, Mendes WB, Hunter SB, Salomon K. Social "facilitation" as challenge and threat. J Pers Soc Psychol. 1999 Jul;77(1):68-77. doi: 10.1037//0022-3514.77.1.68.

  PMID: 10434409 BACKGROUND

• Turner MJ, Jones MV, Sheffield D, Slater MJ, Barker JB, Bell JJ. Who thrives under pressure? Predicting the performance of elite academy cricketers using the cardiovascular indicators of challenge and threat states. J Sport Exerc Psychol. 2013 Aug;35(4):387-97. doi: 10.1123/jsep.35.4.387.

  PMID: 23966448 BACKGROUND

• Vine SJ, Freeman P, Moore LJ, Chandra-Ramanan R, Wilson MR. Evaluating stress as a challenge is associated with superior attentional control and motor skill performance: testing the predictions of the biopsychosocial model of challenge and threat. J Exp Psychol Appl. 2013 Sep;19(3):185-94. doi: 10.1037/a0034106.

  PMID: 24059821 BACKGROUND

• Carenzo L, Braithwaite EC, Carfagna F, Franc J, Ingrassia PL, Turner MJ, Slater MJ, Jones MV. Cognitive appraisals and team performance under stress: A simulation study. Med Educ. 2020 Mar;54(3):254-263. doi: 10.1111/medu.14050. Epub 2020 Feb 7.

  PMID: 32034800 BACKGROUND

• Mendes WB, Gray HM, Mendoza-Denton R, Major B, Epel ES. Why egalitarianism might be good for your health: physiological thriving during stressful intergroup encounters. Psychol Sci. 2007 Nov;18(11):991-8. doi: 10.1111/j.1467-9280.2007.02014.x.

  PMID: 17958714 BACKGROUND

• Franc JM, Verde M, Gallardo AR, Carenzo L, Ingrassia PL. An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance. Intern Emerg Med. 2017 Aug;12(5):651-656. doi: 10.1007/s11739-016-1486-7. Epub 2016 Jun 16.

  PMID: 27312510 BACKGROUND

Related Links

• European Trauma Course official site

MeSH Terms

Conditions

Wounds and Injuries; Stress, Psychological

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 6, 2021
• First Posted: October 19, 2021
• Study Start: October 20, 2021
• Primary Completion: November 30, 2024
• Study Completion: November 30, 2024
• Last Updated: April 8, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)