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The effects of active (hot-seat) versus observer roles during simulation-based training on stress levels and non-technical performance: a randomized trial

Overview of attention for article published in Advances in Simulation, March 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Average Attention Score compared to outputs of the same age and source

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Title
The effects of active (hot-seat) versus observer roles during simulation-based training on stress levels and non-technical performance: a randomized trial
Published in
Advances in Simulation, March 2017
DOI 10.1186/s41077-017-0040-7
Pubmed ID
Authors

Choon Looi Bong, Sumin Lee, Agnes Suah Bwee Ng, John Carson Allen, Evangeline Hua Ling Lim, Arpana Vidyarthi

Abstract

Active 'hands-on' participation in the 'hot-seat' during immersive simulation-based training (SBT) induces stress for participants, which is believed to be necessary to improve performance. We hypothesized that observers of SBT can subsequently achieve an equivalent level of non-technical performance as 'hot-seat' participants despite experiencing lower stress. We randomized 37 anaesthesia trainees into two groups to undergo three consecutive SBT scenarios. Eighteen 'hot-seat' trainees actively participated in all three scenarios, and 19 'observer' trainees were directed to observe the first two scenarios and participated in the 'hot-seat' only in scenario 3. Salivary cortisol (SC) was measured at four time points during each scenario. Primary endpoint for stress response was the change in SC (ΔSC) from baseline. Performance was measured using the Anaesthetist's Non-Technical Skills (ANTS) Score. Mean SC increased in all participants whenever they were in the 'hot-seat' role, but not when in the observer role. Hot-seat ΔSC (mcg/dL) for scenarios 1, 2, and 3 were 0.122 (p = 0.001), 0.074 (p = 0.047), and 0.085 (p = 0.023), respectively. Observers ΔSC (mcg/dL) for scenarios 1, 2, and 3 were -0.062 (p = 0.091), 0.010 (p = 0.780), and 0.144 (p = 0.001), respectively. Mean ANTS scores were equivalent between the 'hot-seat' (40.0) and 'observer' (39.4) groups in scenario 3 (p = 0.733). Observers of SBT achieved an equivalent level of non-technical performance, while experiencing lower stress than trainees repeatedly trained in the 'hot-seat'. Our findings suggest that directed observers may benefit from immersive SBT even without repeated 'hands-on' experience and stress in the hot-seat. The directed observer role may offer a less stressful, practical alternative to the traditional 'hot-seat' role, potentially rendering SBT accessible to a wider audience. ClinicalTrials.gov Identifier NCT02211378, registered August 5, 2014, retrospectively registered.

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The data shown below were collected from the profiles of 31 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 50 100%

Demographic breakdown

Readers by professional status Count As %
Other 9 18%
Unspecified 5 10%
Student > Master 5 10%
Student > Bachelor 4 8%
Researcher 4 8%
Other 11 22%
Unknown 12 24%
Readers by discipline Count As %
Medicine and Dentistry 13 26%
Nursing and Health Professions 6 12%
Unspecified 5 10%
Social Sciences 3 6%
Psychology 2 4%
Other 7 14%
Unknown 14 28%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 February 2018.
All research outputs
#1,746,507
of 24,950,117 outputs
Outputs from Advances in Simulation
#78
of 262 outputs
Outputs of similar age
#33,580
of 315,076 outputs
Outputs of similar age from Advances in Simulation
#4
of 6 outputs
Altmetric has tracked 24,950,117 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 262 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.1. This one has gotten more attention than average, scoring higher than 70% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 315,076 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.