Relationships between cognitive appraisals of threat and challenge, psychophysiological responses, and clinical performance during high-stress simulated osces

These findings suggest that the way students cognitively appraise high-pressure clinical scenarios can meaningfully influence both their biological stress responses and their ability to perform effectively. This study highlights the importance of fostering challenge appraisals which may enhance students' resilience under pressure and ultimately improve patient care outcomes in real-world emergency settings.