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April 2, 2026Frontiers in Disaster and Emergency MedicineOpen Access

Resident stress levels during simulated patient encounters

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Key result

Simulated encounters linked to physiologic stress in emergency residents, with heart rates averaging ~89 bpm.

  • n=26

Why the study?

Simulation aims to mimic real-world emergency department stress, but the feasibility of measuring resident physiologic stress parameters and their relationship to cognitive performance improvements during simulation required assessment.

Comparison

Physiologic stress parameters and cognitive testing before vs during a standardized simulation scenario

Design

Pilot study

Authors

ACAngela CorneliusOffice of the DirectorCOCharles Phillip OrrLone Star College KingwoodBGBrad GoldmanAdena Health System

Discussion

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Implication

Wearables feasibly quantify simulation stress in EM residents; leaves open effects on performance and training modifications.

Study Design

Type

Observational (n=26)

Multicenter

Yes

Structured PICO

P
Population
26 emergency medicine residents (7 PGY1, 8 PGY2, 11 PGY3) at two ACGME accredited programs, mean age 30.7 years, 42.3% female.
I
Intervention
Standardized simulation scenario with physiologic monitoring (HR, HRV, EDA) via wearable device and cognitive testing.
O
Outcome
Physiologic indicators of stress (HR, HRV, EDA) and cognitive test performance (time of completion).surrogate

Simulation scenarios successfully induce physiologic stress in emergency medicine residents, which can be feasibly measured using wearable devices to tailor educational effectiveness.

Limitations

  • Lack of variability in the simulated clinical scenarios
  • Incomplete data collected from the device for some measures due to suspected interference from ambient temperature and subject movement
  • Only physiologic signs of stress were assessed, giving a limited picture of the stress response
  • No direct comparison of the same study participants between simulated stress and clinical stress
  • Evaluated only resident participants, so it is unknown if changes would be seen in more experienced learners
  • Participants were not screened for behaviors like smoking, energy drink intake, or medications such as beta blockers

Cite This Study

Cornelius et al. (2026) conducted an observational in Resident stress (n=26). Simulated patient encounter was evaluated on Physiologic change in residents associated with stress during simulation cases (Heart Rate, Heart Rate Variability, Electrodermal Activity). Simulated patient encounters induced physiologic indications of stress in emergency medicine residents, evidenced by an average mean heart rate of 88.5 bpm and increased electrodermal activity.

synapsesocial.com/papers/6a0eb7efb7cc3b883f22aafbhttps://doi.org/10.3389/femer.2026.1773676

Topics

Cardiac Rehabilitation and Lifestyle Interventions
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