Does psychological stress improve physical performance?

Does the Cognitive Reflection Test Work with Chinese College Students? Evidence from a Time-Limited Study

The cognitive reflection test (CRT) is an experiment task commonly used in Western countries to test intuitive and analytical thinking styles. However, the validity of this task for Chinese participants has not been explored. Therefore, this study recruited Chinese college students to finish CRT tasks with various experimental designs. To gauge the accuracy of the CRT tasks, 438 Chinese college students first completed online questionnaires. Participants were then invited to participate in an offline laboratory with the same experimental settings. Finally, time pressure was used to strictly control intuition and analytical thinking to explore the performance of Chinese college students on CRT tasks. The results show that of the three experiments, Chinese college students had the highest accuracy in the offline test, and the CRT's intuitive conflict problem still applies to Chinese students under the time-limited condition. This study demonstrates the validity of the CRT in China and proves that time pressure is an effective method for identifying individuals with strong logic ability.

Improving surgical skills with feedback: directly-observed versus video-recorded practice

OBJECTIVE

This study aimed to compare two methods of feedback: verbal face-to-face feedback after direct observation (F2F-feedback) versus electronic-written feedback after observation of recorded-VDO of student's performance (VDO-feedback), in terms of effectiveness in improving skill, effects on motivation and satisfaction.

BACKGROUND

Medical schools are responsible for teaching and ensuring proficiency of basic surgical skills. Feedback is effective in developing psychomotor skills; by providing information of learner's current performance, how to improve, and enhancing motivation.

MATERIALS AND METHOD

Fifty-eight medical students (3rd- 4th year) were trained to perform vertical mattress suture in small groups. Then, during 6-week period of self-directed practice, students were randomized into group1 VDO-feedback (male:female = 21:8) and group 2 F2F-feedback (male:female = 20:9). Feedbacks were provided once every 2 weeks (Week2, Week4). End-of-rotation OSCE was at Week6, and retention tested was at Week8. Performance checklist (Cronbach's Alpha 0.72) was used to assess skill at 4 timepoints; pre- and post- small group learning, OSCE, and retention phase. Questionnaire was used to assess motivation, learning strategies and satisfaction (Cronbach's Alpha 0.83).

RESULT

After in-class learning, further significant improvement of skills could be gained by both F2F- and VDO- feedbacks (p < 0.0001). Both could similarly retain skill for at least 4 weeks later without additional practice. Self-efficacy, test anxiety, and cognitive strategies scores were significantly increased in both groups (p < 0.05). Extrinsic motivation was increased in VDO-feedback group. No difference in satisfaction between groups was observed.

DISCUSSION AND CONCLUSION

VDO-feedback could be alternative to F2F-feedbacks for basic surgical skill training when limitation for simultaneous meeting of teacher and students occurs.

TRIAL REGISTRATION

This study has been registered to Thai Clinical Trial Registry (WHO International Clinical Trial Registry Platform) on 11/07/2023 (TCTR20230711005).

The effects of personal protective equipment on airway management: An in-situ simulation

The novel coronavirus disease (COVID-19) was declared a pandemic by the World Health Organisation on 11th March and has led to over 41,000 deaths in the UK. Public Health England guidance for aerosol generating procedures (AGP) requires the donning of personal protective equipment (PPE). We evaluated airway management skills using an in-situ emergency simulation. The scenarios were video recorded and scored by two independent assessors using a skill specific checklist. A total of 34 airway management procedures were evaluated. The checklist involved 13 steps with a maximum score of 26. The median (IQR [range]) checklist score was 25 (24-25 [20-26]). Four teams failed to intubate the trachea and proceeded to manage the airway using a supraglottic airway device. The mean (SD) intubation time was 47.9 (16.5) seconds and two anaesthetists (7%) required a second attempt. Our results show that airway management can be carried out successfully whilst donned in PPE. However, additional training in using newly introduced devices such as a McGrath® video laryngoscope is of paramount importance.

The effectiveness of educational methods for cricothyroid membrane identification by dental students: A prospective study using neck photographs and tracheotomy trainers

The purpose of this study was to evaluate the accurate identification of the cricothyroid membrane (CTM) by fifth grade dental students, before undergoing the relevant anesthesiology practicum. Moreover, we aimed to determine the educational effectiveness of the cricothyrotomy practicum in anesthesiology. Before the lecture and without prior notification, 119 students were provided with a photograph of a man's neck and instructed to attach a blue sticker to the cricothyrotomy puncture site and to a palpable tracheotomy trainer, after applying sufficient palpation. After this, students attended a 60-min lecture on the emergency airway management method. Two and 16 days after the lecture and practicum, students were presented with a new neck photograph and the tracheotomy trainer and asked again to place stickers (red stickers: at 2 days; green stickers: at 16 days) on the cricothyrotomy penetration site. The data were analyzed with an image processing software, by superimposing the 119 stickers on the neck photographs and tracheotomy trainers, to visually examine the accuracy of CTM identification. The rate of correct sticker placement in the neck photographs was 41.2% before the lecture, 80.7% 2 days after the lecture, and 77.3% 16 days after the lecture (before vs. 2 and 16 days after, p value < 0.01). For the tracheotomy trainer, the rate was 36.1% before the lecture, 97.5% 2 days after the lecture, and 94.1% 16 days after the lecture (before vs. 2 and 16 days after, p value < 0.01). Furthermore, the proportion of students with mistakes above and below the CTM was higher than that of students with mistakes to the right or left. In conclusion, the rate of accurate CTM identification among dental students was low before they underwent the relevant practicum, but most students were able to identify the CTM accurately after the lecture and practicum in a small class.

Perceived stress, anxiety, and coping states in medical and engineering students during examinations

AIM

This study aims to study the factors associated with stress, anxiety, and coping states in students of 1^st and 2^nd year in medical and engineering colleges during examinations.

MATERIALS AND METHODS

This prospective, longitudinal study was conducted on 200 undergraduate medical and engineering students from 1^st to 2^nd year (50 in each year), after obtaining ethical approval from the institutional ethics committee. All the participants gave written informed consent. All students filled a questionnaire which consisted of a general information sheet, perceived stress scale, Hamilton Anxiety Rating Scale, brief COPE inventory, and sources of stress questionnaire 1 month before and 1 month after their university examinations. Data were analyzed using t-test, Mann-Whitney U-test, Kruskal-Wallis test, and Chi-square test as appropriate.

RESULTS

In medical students, perceived stress was significantly higher in those in the management quota (both years), living in shared accommodation and from nuclear family (1^st year) and male (2^nd year). Only accommodation had a statistically significant relationship with perceived stress in 2^nd year engineering students. A statistically significant association of perceived stress and anxiety with academic performance was observed. Anxiety in students was significantly more before the examination compared to after the examination. The association of all the coping strategies used, with the academic performance, was statistically significant.

CONCLUSIONS

In both medical and engineering students, there was a significant association of perceived stress and anxiety with academic performance. Both medical and engineering students used active coping a little more than avoidant coping strategies during the examination time. The association of all the coping strategies used, with the academic performance, was statistically significant, thereby proving the importance of coping states in academic performance.

Comparison of cricothyroidotomy on manikin vs. simulator: a randomised cross-over study

We compared the time taken to perform cricothyroidotomy on a manikin to that on a medium fidelity simulator, to assess the effect of psychological stress and time pressure on performance. Seventy anaesthetists participated in this randomised cross-over study. Fifty-four (77%) anaesthetists took longer on the simulator, with the mean (SD) time taken to perform the procedure on the manikin and simulator 34 (18) and 48 (11) s, respectively (p < 0.001). Anaesthetists with more experience performed the procedure more quickly on both manikin and simulator. We conclude that psychological stress and time pressure in real-life scenarios can affect the performance of cricothyroidotomy.

Stress Perception and Social Indicators for Low Back, Shoulder and Joint Pains in Japan: National Surveys in 1995 and 2001

This study aims to clarify the effects of stress perception and related social indicators on three major musculoskeletal symptoms: low back, shoulder, and joint pains in a Japanese population. Twenty health-related variables (stress perception and 19 social indicators) and the three symptoms were obtained from the following Japanese national surveys: the Comprehensive Survey of Living Condition of the People on Health and Welfare, the System of Social and Demographic Statistics of Japan, and the Statistical Report on Health Administration Services. The results were compared among 46 Japanese prefectures in 1995 and 2001. By factor analysis, the 19 indicators were classified into three factors of urbanization, aging and life-regularity, and individualization. The prevalence of stress perception was significantly correlated to the 8 indicators of urbanization factor. Although simple correlation analysis revealed a significant relationship of stress perception only to shoulder pain (in both years) and low back pain (in 2001), the results of multiple regression analysis showed that stress perception and some urbanization factors were significantly associated with all the three symptoms in both years exclusive of joint pain in 1995. Taking the effects of urbanization into consideration, stress perception seems to be closely related to the complaints of musculoskeletal symptoms in Japan.

Effects of novelty stress on neuroendocrine activities and running performance in thoroughbred horses

This study investigated the effects of novelty stress on neuroendocrine activities and running performance in Thoroughbred horses. First, to examine the neuroendocrine responses to novelty stress, we exposed horses to two types of novel environmental stimuli (audiovisual or novel field stimuli). After the stimuli, plasma concentrations of vasopressin, catecholamines and adrenocorticotropin (ACTH), as well as heart rates, were significantly increased in each experiment. Second, we investigated neuroendocrine activities during incremental exercise. Plasma concentrations of vasopressin, catecholamines, ACTH and blood lactate increased as the exercise load increased. Finally, we investigated the effects of novelty stimuli on neuroendocrine activities and running performance during supra-maximal exercise (110% VHRmax). When the novelty stimuli were presented to horses, the increases in plasma vasopressin and catecholamines due to exercise load were significantly smaller than those in the control experiments. Blood lactate during supra-maximal exercise was also significantly lower and total run time until exhaustion was prolonged in the novel environmental stimuli compared to the control. These results suggest that novelty stimuli facilitate vasopressin release from the posterior pituitary in addition to activating the sympatho-adrenomedullary and the hypothalamic-pituitary-adrenocortical axes in thoroughbred horses, and increase exercise capacity, resulting in improvement of running performance during supra-maximal exercise.