Cognitive Appraisals and Team Performance Under Stress in Simulated Trauma Care

Trauma Clinical Trial

Official title:

Cognitive Appraisals and Team Performance Under Stress in Simulated Trauma Care

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05083871
• Other study ID #: 798-2021-OSS-AUSLBO
• Status: Recruiting
• Start date: October 20, 2021
• Est. completion date: December 31, 2025

Study information

• Verified date: April 2024
• Source: Azienda Usl di Bologna
• Contact: Lorenzo Gamberini, MD
• Phone: +393403550540
• Email: l.gamberini[@]118er.it
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 130
• Est. completion date: December 31, 2025
• Est. primary completion date: December 31, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Learners of the European Trauma Course in Italy

Exclusion Criteria:

• Age < 18 years

Related Conditions & MeSH terms

• Cognitive Change
• Stress, Emotional
• Stress, Psychological
• Trauma
• Wounds and Injuries

Intervention

Other:
• European Trauma Course
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

Locations

Country	Name	City	State
Italy	Azienda Unità Sanitaria Locale	Bologna

Sponsors (4)

Lead Sponsor	Collaborator
Azienda Usl di Bologna	Azienda Sanitaria Universitaria Friuli Centrale, Humanitas Clinical and Research Center, Manchester Metropolitan University

Country where clinical trial is conducted

Italy, 

References & Publications (8)

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. — View Citation

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. — View Citation

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 — View Citation

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. — View Citation

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. — View Citation

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. — View Citation

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):3 — View Citation

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 P — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	participants' perceptions of task demands vs. personal resources	Evaluation of the evolution of the participants' perceptions of task demands vs. personal resources throughout the course	3 days
Secondary	mental readiness	Evaluation of the evolution of the participants' mental readiness throughout the course	3 days
Secondary	Social identity	Evaluation of the evolution of the participants' social identity throughout the course	3 days

External Links

•   European Trauma Course official site