Article Text

0177 ‘monitor Stare’: A Manifestation Of Heightened Emotion In High Fidelity Resuscitation Simulation?
  1. Ian Whitehead1,2,
  2. Laura McKenna1,2,
  3. Lewis Potter1,2,
  4. Victoria Whittle1,2
  1. 1Newcastle University, Newcastle Upon Tyne, UK
  2. 2Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK


Background High fidelity simulation (HFS) training offers a safe environment to improve knowledge, skills and team working. Studies have shown HFS to reduce anxiety in clinical practice and increase awareness of human factors in stressful scenarios.

Despite the absence of patient risk, learners still experience negative emotions; fear and anxiety (Lasater, 2007). Negative emotions have detrimental effects on depth and retention of learning (Fraser, 2012). It has been shown that negative emotional states cause attentional narrowing, slow conceptual thought and slow reaction times, (Friedman, 2010) which may have clinical consequences in time critical acute care medical situations. Anecdotally some learners spend long periods focussed on the observations monitor when they appear stressed during HFS. This pilot study aims to identify if the phenomenon of monitor stare is present in individuals who report heightened emotional states and to establish if this has affects on overall performance.

Methods This observational study of 35 final year medical students uses a human patient simulator (Simman-3G®) in ‘acute-care’ HFS scenarios. Situational emotional state during unscheduled resuscitation scenarios was recorded using the validated PANAS-X questionnaire (Watson, 1994). Scenarios were recorded using SMOTS technology with one camera positioned behind the observations monitor. Allowing time and frequency of monitor stare to be established on video analysis. Performance was measured independently by 2 educators using locally established scenario checklists. Correlation between reported emotional state, time and frequency of monitor stare and performance will be analysed.

Results Thirty-five final year Newcastle University medical students with varied exposure to HFS were observed. Data analysis in progress.

Potential impact An observable surrogate marker of heightened emotion will help identify which students are performing sub-optimally due to their situational emotional state. This may allow further educational tools to be incorporated into the programme to help support them and moderate their anxiety, in turn enhancing performance.


  1. Lasater K. Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education 2007;46(11):498–503

  2. Fraser K, Ma I, Teteris E, et al. Emotion, cognitive load and learning outcomes during simulation training. Medical Education 2012;46:1055–1062

  3. Friedman RS, Forster J. Implicit affective cues and attentional tuning: an integrative review. Psychological Bulletin 2010;136(5):875–893

  4. Watson D, Clark LA, (1994). Manual for the Positive and Negative Affect Schedule-Expanded form. Springer Publishing, New York

  • Category: Course or curriculum evaluation/innovation/integration

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.