Immediate changes in self-reported apprehension and uncertainty across 41 emergency scenarios following a structured emergency medicine course

Background Emergency physicians face high cognitive and emotional stress in acute care, especially in prehospital settings. Structured training is an essential component of emergency medicine education and may increase familiarity with high-pressure clinical situations. In Germany, an 80-hour standardized emergency physician course is mandatory for certification. Objective/design This study evaluated the impact of this course on physicians’ self-perceived apprehension and uncertainty in acute emergency scenarios using a prospective pre–post design. Settings and participants The study was conducted in five consecutive emergency courses. 162 physicians from different specializations and departments throughout Germany completed pre- and post-course questionnaires. Intervention Participants completed the standardized 80 h course, which combines theoretical instruction, structured decision-making, team communication, and high-fidelity simulation. Analysis The primary endpoint was the change in a single combined self-reported rating of apprehension and uncertainty, assessed using a 5-point Likert scale across 41 questionnaire items. Analyses of the predefined categories constituted secondary analyses, while analyses of the 41 individual items and subgroup analyses were exploratory. Results A significant overall reduction in combined self-reported apprehension and uncertainty was observed. Improvements occurred across all seven predefined categories. The greatest reductions were found for intraosseous access and ocular emergencies. Pediatric and neonatal emergencies remained the most apprehension-provoking scenarios. Exploratory subgroup analyses provided no evidence of differences in improvement across medical specialties or according to board certification status, whereas participants with prior EMS experience showed a smaller improvement than those without prior EMS experience. Conclusion Course participation was associated with lower immediate post-course self-reported apprehension/uncertainty scores.