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Comparison of the psychological and physiological effects on students of a video-assisted or text introduction to a simulated task
  1. Anne AC van Tetering1,
  2. Jacqueline LP Wijsman2,3,
  3. Sophie EM Truijens4,
  4. Annemarie F Fransen1,
  5. M Beatrijs van der Hout-van der Jagt4,5,
  6. S Guid Oei4,6
  1. 1 Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2 Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
  3. 3 Holst Centre/Imec–NL, Eindhoven, The Netherlands
  4. 4 Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
  5. 5 Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
  6. 6 Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
  1. Correspondence to Anne AC van Tetering, Department of Obstetrics and gynaecology, Maastricht University Medical Centre, Maastricht 6229 HX, Netherlands; anne_van_tetering{at}


Introduction The use of different methods for introducing the scenario in simulation-based medical education has not been investigated before and may be a useful element to optimise the effectiveness of learning. The aim of this study was to compare an immersive video-assisted introduction to a minimal text-based one, with regard to emotional assessment of the situation.

Methods In this pilot study, 39 students participated in a medical simulated scenario. The students were randomly assigned to an experimental group (video-assisted introduction) or a control group (minimal textual introduction) and both were followed by performing surgery on LapSim (Surgical Science, Gothenburg, Sweden). The emotional assessment of the situation, cognitive appraisal, was defined as the ratio of the demands placed by an individual’s environment (primary appraisal) to that person’s resources to meet the demands (secondary appraisal). Secondary outcomes were anxiety (State-Trait Anxiety Inventory), physiological parameters (heart rate, heart rate variability, skin conductance, salivary cortisol), engagement (Game Engagement Questionnaire), motivation (Intrinsic Motivation Inventory) and performance (mean score in percentage calculated by LapSim of predefined levels).

Results Participants in the immersive video group (n=17) were overloaded in terms of their perceived demands (a ratio of 1.17, IQR 0.30) compared with those in the control group (a ratio of 1.00, IQR 0.42, n=22) (P=0.01). No significant differences were found between the groups in secondary outcomes. Both groups showed an increase of anxiety after the introduction method. In the experimental group, this score increased from 9.0 to 11.0, and in the textual group from 7.5 to 10.5, both P<0.01.

Discussion This study shows that the method of introducing a simulated scenario may influence the emotional assessment of the situation. It may be possible to make your simulation introduction too immersive or stimulating, which may interfere with learning. Further research will be necessary to investigate the impact and usefulness of these findings on learning in simulation-based medical education.

  • simulation training[mesh] or ((simulation*[tiab] or Interactiv…
  • medical education
  • physiological stress
  • cognitive appraisal
  • psychological stress
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  • Contributors All the authors were involved in conception and design of the study. AACvT and JLPW have analysed the data. All authors have contributed to interpretation of the data. AACvT and JLPW have drafted the work. The other authors revised the work critically. All authors gave final approval of the version to be published and agreed to be accountable for all aspects of the work.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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