How does practising simulated emergency medical situations physically and mentally affect medical students?

ISRCTN ISRCTN32132176
DOI https://doi.org/10.1186/ISRCTN32132176
Secondary identifying numbers PI-033/18
Submission date
25/12/2019
Registration date
03/01/2020
Last edited
24/03/2025
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Signs and Symptoms
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
The world of teaching of Health Sciences is experiencing a revolution. Virtual reality and other simulation technologies are a powerful tool teaching and training of future healthcare professionals in techniques, procedures and skills. Current and future generations of students have integrated the use of mobile devices and computer technologies into their daily lives, and are very used to interacting with a virtual environment. Advanced clinical simulations provide two substantial advantages. The first is patient safety, since the student can repeat the techniques that they did not fully master. The second advantage is that their performance can be recorded, which enables detailed feedback from instructors.
This study aims to investigate the physical responses and perceptions of medical students participating in an Advanced Clinical Simulation Subject.

Who can participate?
Students in the final year of a Medicine degree

What does the study involve?
Students who have agreed to participate will fill out questionnaires to assess their anxiety level, level of physical activity and lifestyle habits. They will also have their heart rate, blood pressure and temperature measured and will provide a saliva sample and a have a finger-prick to collect a drop of blood. They will then be randomly allocated to perform one of four simulated medical situations as either the leader or assistant in a team of two students. After the simulation, they will repeat the tests from before the simulation.

What are the possible benefits and risks of participating?
There are no direct benefits to participants, but this research should benefit future students in helping to identify those who might develop anxiety during the simulation. The study has no risks apart from the pain potentially involved in the finger prick.

Where is the study run from?
University of Valladolid (Spain)

When is the study starting and how long is it expected to run for?
September 2019 to June 2021

Who is funding the study?
The study is funded by the researchers themselves.

Who is the main contact?
Dr Francisco Martín-Rodríguez, fmartin@saludcastillayleon.es

Contact information

Dr Francisco Martín-Rodríguez
Scientific

Facultad de Medicina
Universidad de Valladolid
Avda. Ramón y Cajal 7
Valladolid
47005
Spain

ORCiD logoORCID ID 0000-0002-1773-2860
Phone +34 686452313
Email fmartin@saludcastillayleon.es

Study information

Study designDouble-blind randomized controlled clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)School
Study typeOther
Scientific titleRandomized controlled clinical trial on the influence of physiological, metabolic and anxiety parameters on high fidelity clinical simulation
Study acronymACSC-ax
Study objectivesThe anxiety that students endure when carrying out a case of advanced clinical simulation can influence the physiological and metabolic sphere.
Ethics approval(s)Approved 10/04/2018, Comité de Ética de la Investigación con medicamentos (CEIm) Area de Salud de Valladolid Oeste [Drug Research Ethics Committee of West Valladolid Health Region] (Río Hortega University Hospital, Dulzaina 2, 47012 Valladolid, Spain; +34 983 420 400; rconvi@saludcastillayleon.es), ref: PI033-18
Health condition(s) or problem(s) studiedMetabolic and physiological fatigue
InterventionThere are 4 simulation scenarios. Each case will be solved by two students, one will act as a team leader and the other as an assistant, solving the situation according to the pre-established protocols and procedures for the management of each pathology. The cases are of similar difficulty, and all have a maximum duration of 10 min.

Before starting any of the cases, it will be explained to the students that they must perform the techniques and procedures in the simulator as correctly as possible.

Once the students are in the debriefing classroom and have signed the informed consent, they must fill out a form to describe their basal level of anxiety (STAI questionnaire), and proceed to the baseline taking of heart rate, systolic and diastolic blood pressure, tympanic temperature, saliva pH, capillary lactic acid, and to fill in a brief epidemiological survey, asking about lifestyle habits (alcohol, tobacco, coffee, etc.). In addition, weight and height are measured and they perform the International IPAQ Physical Activity Questionnaire.

Through the XLAT BIOMED program a randomization of the clinical case that should be performed and the role (leader or assistant) was performed.

The clinical simulation scenarios proposed and that will be randomized are:
1. Young woman, with a poorly tolerated supraventricular tachycardia
2. Elderly woman, with a drug poisoning by benzodiazepines
3. Elderly male, in a coma due to a hypoglycemia situation
4. Young male, with arm and leg burns and smoke inhalation

At the end of the simulation and just before debriefing the two students who have done the case (team leader and assistant) perform a new STAI questionnaire and have heart rate, systolic and diastolic blood pressure, tympanic temperature, pH in saliva and capillary lactic acid measured again.
Intervention typeBehavioural
Primary outcome measure1. Heart rate, assessed using a Physio LifePAK® 15 monitor, immediately before and after the simulation
2. Blood pressure, assessed using a Physio LifePAK® 15 monitor, immediately before and after the simulation
3. Tympanic temperature, assessed using a Braun model ThermoScan® PRO 6000, immediately before and after the simulation
4. Lactic acid levels, assessed using an Accutrend® Plus meter, immediately before and after the simulation
5. Saliva pH, assessed using saliva strips, immediately before and after the simulation
6. Level of anxiety, assessed using using the State-Trait Anxiety Inventory (STAI) questionnaire, immediately before and after the simulation
7. Level of physical activity, assessed using the International Physical Activity Questionnaire (IPAQ), immediately before and after the simulation
Secondary outcome measuresThe following are assessed before and after the simulation:
1. Anthropometric study, carried out with the Tanita BC541-N smart scale
2. Demographic data and lifestyle habits, assessed through a direct response questionnaire.
Overall study start date10/09/2019
Completion date10/06/2021

Eligibility

Participant type(s)Other
Age groupAdult
Lower age limit18 Years
Upper age limit65 Years
SexBoth
Target number of participants180
Key inclusion criteria1. Aged 18-65 years
2. Students of the Faculty of Medicine in the 4th, 5th or 6th year of the course
Key exclusion criteria1. Basal heart rate greater than 120 or less than 35 beats per min
2. Systolic or diastolic blood pressure greater than 160 or 95 mmHg respectively
3. Systolic blood pressure less than 80 mmHg
4. Body mass index greater than 40 kg/m2
5. Severe visual or hearing impairment
6. Disability or injury that prevents the participant from physically conducting the simulation
7. Capillary hemoglobin less than 8 g/dl
8. Temperature greater than 38º C
9. Major surgery up to 30 days before
10. Cutaneous diseases in acute phase
11. Epilepsy
12. Anticoagulation
13. Infections in progress
14. Systemic immunological diseases
Date of first enrolment10/10/2019
Date of final enrolment23/12/2019

Locations

Countries of recruitment

  • Spain

Study participating centre

Valladolid University
Faculty of Medicine
Advanced Clinical Simulation Center
Avda. Ramón y Cajal, 7
Valladolid
47005
Spain

Sponsor information

Universidad de Valladolid
University/education

Facultad de Medicina
Avda. Ramón y Cajal 7
Valladolid
47005
Spain

Phone +34 983336390
Email csca@uva.es
Website http://www.med.uva.es
ROR logo "ROR" https://ror.org/01fvbaw18

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date31/12/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planThe intention of the research team is to begin the publications derived from the trial in journals that were prepared in simulation as 2020.

Likewise, specialized congresses will be used to launch abstracts of the first data that are obtained.
IPD sharing planThe datasets generated and/or analysed during this study will be included in the subsequent results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 23/03/2025 24/03/2025 Yes No

Editorial Notes

24/03/2025: Publication reference added.
03/01/2020: Internal review.
02/01/2020: Trial's existence confirmed by Comité de Ética de la Investigación con medicamentos (CEIm) Area de Salud de Valladolid Oeste [Drug Research Ethics Committee of West Valladolid Health Region]