Examining the effects of stress on the driving abilities of paramedic students

2019 ◽  
Vol 9 (4) ◽  
pp. 76-83
Author(s):  
Trevor Hines Duncliffe ◽  
Brittany D'Angelo ◽  
Michael Brock ◽  
Cal Fraser ◽  
Jake Lamarra ◽  
...  
Keyword(s):  
Driving Simulator ◽  
Acute Stress ◽  
Clinical Performance ◽  
Seat Belt ◽  
Task Load ◽  
Stress Levels ◽  
Before And After ◽  
Negative Effect ◽  
Effects Of Stress ◽  
Nasa Task Load Index

Background: Research has suggested that stress may have a negative effect on paramedics' clinical performance. Stress has also been demonstrated to negatively affect the driving abilities of the general population, increasing the number of driving errors. However, no studies have explored stress and its potential impact on the non-clinical performance of paramedics, particularly their driving abilities. Methods: Paramedic students underwent emergency driving assessment in a driving simulator before and after exposure to a stressful medical scenario. The number and type of errors were documented before and after through the use of both driving simulator software and observation by two members of the research team. The NASA Task Load Index (TLX) was used to record self-reported stress levels. Results: Thirty-six students participated in the study. Following exposure to a stressful medical scenario, paramedic students had no rise in overall error rate, but demonstrated increases in three critical driving errors: namely, failure to wear a seat belt (three baseline versus 10 after stress); failing to stop for red lights or stop signs (seven versus 35); and losing control of the vehicle (two versus 11). Self-reported stress levels also increased after the clinical scenario, particularly in the area of mental (cognitive) demand. Conclusion: Paramedics are routinely exposed to acute stress in their everyday work, and this stress could affect their non-clinical performance. The critical errors committed by participants in the present study closely matched those considered to be contributory factors in many ambulance collisions. These results illustrate the need for further research into the effects of stress on non-clinical performance in general, and highlight the potential need to consider additional driver training and stress management education to mitigate the frequency and severity of driving errors among paramedics.

scholarly journals The effects of stress on the driving abilities of paramedic students: a pilot, simulator-based study

2019 ◽  
Author(s):  
Trevor Hines Duncliffe ◽  
Brittany D’Angelo ◽  
Michael Brock ◽  
Cal Fraser ◽  
Jake Lamarra ◽  
...  
Keyword(s):  
Driving Simulator ◽  
Negative Impact ◽  
Clinical Performance ◽  
Significant Risk ◽  
List Type ◽  
Clinical Scenario ◽  
Clinical Scenarios ◽  
Stress Levels ◽  
Before And After ◽  
Effects Of Stress

AbstractBackgroundPrevious research has suggested that stress may have a negative effect on the clinical performance of paramedics. In addition, stress has been demonstrated to have a negative impact the driving abilities of the general population, increasing the number of driving errors. However, to date no studies have explored stress and its potential impact on non-clinical performance of paramedics, particularly their driving abilities.MethodsParamedic students underwent emergency driving assessment in a driving simulator before and after exposure to a stressful medical scenario. Number and type of errors were documented before and after by both driving simulator software and observation by two observers from the research team. The NASA Task Load Index (TLX) was utilised to record self-reported stress levels.Results36 students participated in the study. Following exposure to a stressful medical scenario, paramedic students demonstrated no increase in overall error rate, but demonstrated an increase in three critical driving errors, namely failure to wear a seatbelt (3 baseline v 10 post stress), failing to stop for red lights or stop signs (7 v 35), and losing control of the vehicle (2 v 11). Self-reported stress levels also increased after the clinical scenario, particularly in the area of mental (cognitive) demand.ConclusionParamedics are routinely exposed to acute stress in their everyday work, and this stress could affect their non-clinical performance. The critical errors committed by participants in this study closely matched those considered to be contributory factors in many ambulance collisions. These results stimulate the need for further research into the effects of stress on non-clinical performance in general, and highlight the potential need to consider additional driver training and stress management education in order to mitigate the frequency and severity of driving errors.Key pointsParamedics are exposed to stressful clinical scenarios during the course of their workMany critical and serious clinical calls require transport to hospitalAmbulance crashes occur regularly and pose a significant risk to the safety and wellbeing of both patients and paramedicsThis simulated clinical scenario followed by a simulated driving scenario has highlighted that stress appears to affect driving abilities in paramedic studentsThe findings of this study, although conducted in paramedic students in simulated environments, highlight the need to further investigate the effects of stress on driving abilities among paramedics

scholarly journals Driving me crazy: the effects of stress on the driving abilities of paramedic students

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Trevor Hines Duncliffe ◽  
Brittany D'Angelo ◽  
Michael Brock ◽  
Cal Fraser ◽  
Nick Austin ◽  
...  
Keyword(s):  
Driving Simulator ◽  
Acute Stress ◽  
Management Education ◽  
Negative Impact ◽  
Driving Ability ◽  
Driver Training ◽  
Before And After ◽  
Effects Of Stress ◽  
Working Day ◽  
Post Stress

<p><strong>Background</strong></p><p>Previous research has demonstrated that stress has a negative impact on the performance of paramedics while performing medical related tasks. Acute stress has also been shown to negatively impact the driving abilities of the general population increasing the number of critical driving errors performed. No literature was discovered that discussed the effects of stress on the driving abilities of paramedics.</p><p><strong>Methods</strong></p><p>Paramedic students underwent a driving ability assessment in a driving simulator. We then exposed them to a stress inducing medical scenario. Another driving assessment was then conducted. The numbers, and types of errors were documented before and after the scenario.</p><p><strong>Results</strong></p><p>36 students participated in the study. Paramedic students demonstrated no increase in overall error rate after a stressful scenario, but demonstrated an increase in three critical driving errors; failure to wear a seatbelt (3 baseline v 10 post stress, p= 0.0087), failing to stop for red lights or stop signs (7 v 35, p= &lt;0.0001), and losing controlling of the vehicle (2 v 11, p= 0.0052).</p><p><strong>Conclusion</strong></p><p>Paramedic students demonstrated an increase in critical driving errors after a stressful simulated clinical scenario. Paramedics are routinely exposed to acute stress during the course of their working day. This stress could increase the number of critical driving errors that occur. These results reinforce the need for further research, and highlight the potential need for increased driver training and stress management education in order to mitigate the frequency and severity of driving errors made by paramedics.</p>

Vigilance: Where Has All the Workload Gone?

1993 ◽  
Vol 37 (19) ◽  
pp. 1383-1387 ◽  
Author(s):  
David A. Sawin ◽  
Mark W. Scerbo
Keyword(s):  
False Alarm ◽  
Perceptual Sensitivity ◽  
Video Display ◽  
Task Load ◽  
Time Performance ◽  
Instruction Type ◽  
Before And After ◽  
Different Color ◽  
Nasa Task Load Index ◽  
Over Time

The present study explored whether instructions given to subjects at the outset of a vigilance experiment impact their ratings of frustration and workload. The present task consisted of monitoring a video display terminal (VDT) of uniform color for 30 min. Subjects were asked to respond to occasional 3 ms “flickers” to a different color. Half of the subjects were told to relax by focusing on the display, but to respond to any flickers observed. The remaining subjects were given traditional vigilance instructions emphasizing the importance of detecting as many “critical signals” or flickers as possible. Before and after the vigil, subjects completed the NASA Task Load Index (TLX; Hart and Staveland, 1988) which measured the subjective workload for the vigil. Hits and false alarm data were recorded for each 10 min period within the 30 min vigil. A significant reduction in mean number of hits was observed over the three periods for all subjects. A subsequent analysis showed that perceptual sensitivity also declined significantly over time. Performance, however, was not affected by instruction type. Subjects who received relaxation-emphasis instructions did report significantly lower workload and frustration for the vigil than those receiving detection-emphasis instructions. These results indicate that much of what individuals find unpleasant about participating in vigilance experiments may lie with the expectations outlined in the initial instructions.

Measuring Driver’s Perceived Workload Using Fractal Dimension of Pupil Dilation

2020 ◽  
Vol 64 (1) ◽  
pp. 1620-1624
Author(s):  
Jung Hyup Kim ◽  
Xiaonan Yang
Keyword(s):  
Fractal Dimension ◽  
Driving Simulator ◽  
Significant Negative Correlation ◽  
Pupillary Response ◽  
Pupil Dilation ◽  
Physiological Measures ◽  
Simulation Environment ◽  
Task Load ◽  
Perceived Workload ◽  
Nasa Task Load Index

Many physiological measures have been proposed for quantifying the workload in a driving environment. Among them, pupillary response has been identified as an effective workload indicator that can be measured less intrusively and without disrupting the worker’s ongoing activities. The purpose of this study is to investigate the fractal dimension of pupil dilation (FDPD) to measure perceived workload in a driving simulation environment. For the experiment, two different driving scenarios were developed and tested by using the OpenDS driving simulator. The results demonstrate that one of the scenarios shows a significant negative correlation between FDPD and the perceived workload outcome from NASA-Task Load Index (TLX) questionnaires.

Making MATB-II medical: Pilot testing results to determine a novel lab-based, stress-inducing task

2017 ◽  
Vol 6 (1) ◽  
pp. 201-208 ◽  
Author(s):  
Lauren Kennedy ◽  
Sarah Henrickson Parker
Keyword(s):  
Acute Stress ◽  
High Stress ◽  
Medical Knowledge ◽  
Physiological Data ◽  
Task Load ◽  
Surgical Residents ◽  
Computer Based ◽  
Overall Performance ◽  
General Populations ◽  
Nasa Task Load Index

The purpose of this project was to adapt an existing computer-based task called Multi-Attribute Task Battery (MATB-II), developed by NASA and frequently used to induce acute stress among air craft crew members and general populations, for use in medical populations. We gathered continuous electrocardiography (ECG) data while medical students completed four different versions of the MATB-II of varying difficulties alongside questions probing medical knowledge, comprising a new task called medically-focused multitasking game (MFMG). After completing each version, participants responded to questionnaires to assess subjective states of stress (State Trait Anxiety Inventory for Adults) and cognitive workload (NASA Task Load Index). Responses to these questionnaires, physiological data from continuous ECG, and overall performance scores were combined to determine one version of MFMG that represented the highest level of elicited stress, and one that represented the lowest level of elicited stress. The results of this pilot study are promising, and have converged to reveal one high-stress and one low-stress version of MFMG, which will later be used to induce acute stress in biofeedback intervention studies among surgical residents and fellows. Beyond this specific application, MFMG can have broader applications in measuring acute stress induction and/or reduction among populations of healthcare practitioners.

scholarly journals Desktop lighting for comfortable use of a computer screen

Work ◽  
2021 ◽  
Vol 68 (s1) ◽  
pp. S209-S221
Author(s):  
Lu Han ◽  
Hechen Zhang ◽  
Zhongxia Xiang ◽  
Jinze Shang ◽  
Shabila Anjani ◽  
...  
Keyword(s):  
High Intensity ◽  
Motion Tracking ◽  
Tracking System ◽  
Computer User ◽  
Eye Tracker ◽  
Computer Screen ◽  
Task Load ◽  
Trunk Movements ◽  
Motion Tracking System ◽  
Nasa Task Load Index

BACKGROUND: The contrast between a bright computer screen and a dark ambient environment may influence comfort of the users, especially on their eyes. OBJECTIVE: The objective of this research is to identify the optimal desktop lighting for the comfortable use of the computer screen in a dark environment. METHODS: An experiment was designed where seven illumination setups were introduced for the users to perform their leisure tasks on a computer screen. Fifteen healthy subjects participated in the experiments. During each session, durations of the eye blinks, fixations and saccades of the user were recorded by an eye tracker. His/her neck and trunk movements were recorded by a motion tracking system as well. The comfort/discomfort questionnaire, localized postural discomfort questionnaire, NASA task load index and computer user questionnaire were used to record the overall comfort/discomfort, the local perceived physical discomfort, the cognitive workload, and general/eye health problems, respectively. RESULTS: Subjective and objective measurement results indicated that users felt more comfortable with high intensity warm lights using a computer screen. We also identified that the eye fixation durations, as well as the scores of two questions in the computer user questionnaire, have significant negative correlations with comfort. On the other side, the durations of blinks and the scores of three questions in the computer user questionnaire, were significantly correlated with discomfort. CONCLUSION: The warm (3000K) and high intensity (1500 lux) light reduced the visual and cognitive fatigue of the user and therefore improve the comfort of the user during the use of a computer screen.

Lymphocyte subsets are influenced by positivity levels in healthy subjects before and after mild acute stress

2017 ◽  
Vol 188 ◽  
pp. 13-20 ◽  
Author(s):  
Gian Vittorio Caprara ◽  
Roberto Nisini ◽  
Valeria Castellani ◽  
Pasquali Vittorio ◽  
Guido Alessandri ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Lymphocyte Subsets ◽  
Acute Stress ◽  
Before And After

scholarly journals Effects of Open-Label Placebos on State Anxiety and Glucocorticoid Stress Responses

2021 ◽  
Vol 11 (4) ◽  
pp. 508
Author(s):  
Michael Schaefer ◽  
Julian Hellmann-Regen ◽  
Sören Enge
Keyword(s):  
Stress Responses ◽  
Acute Stress ◽  
Stress Test ◽  
Self Report ◽  
Control Group ◽  
Relaxation Techniques ◽  
Open Label ◽  
Before And After ◽  
Cortisol Responses ◽  
Negative Feelings

Stress belongs to the most frequent negative feelings people are confronted with in daily life. Strategies against acute stress include, e.g., relaxation techniques or medications, but it is also known that placebos can successfully reduce negative emotional stress. While it is widely held that placebos require deception to provoke a response, recent studies demonstrate intriguing evidence that placebos may work even without concealment (e.g., against anxiety or pain). Most of these studies are based on self-report questionnaires and do not include physiological measures. Here we report results of a study examining whether placebos without deception reduce acute stress. A total of 53 healthy individuals received either placebos without deception or no pills before participating in a laboratory stress test (Maastricht Acute Stress Test, MAST). We recorded self-report stress measures and cortisol responses before and after the MAST. Results showed no significant differences between the placebo and the control group, but when comparing participants with high relative to low beliefs in the power of placebos we found significant lower anxiety and cortisol responses for the placebo believers. These results show that non-deceptive placebos may successfully reduce acute anxiety and stress, but only in participants who had a strong belief in placebos. We discuss the results by suggesting that open-label placebos might be a possible treatment to reduce stress at least for some individuals.

Neural Correspondence to Human Cognition from Analysis to Intuition – Implications of Display Design for Cognition

2017 ◽  
Vol 61 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Joseph K. Nuamah ◽  
Younho Seong
Keyword(s):  
Objective Measure ◽  
Mental Effort ◽  
Human Cognition ◽  
Behavioral Measures ◽  
Display Design ◽  
Percent Correct ◽  
Task Load ◽  
Frontal Midline Theta ◽  
General Difference ◽  
Nasa Task Load Index

Psychophysiological measures can be used to determine whether a particular display produces a general difference in brain function. Such information might be valuable in efforts to improve usability in display design. In this preliminary study, we aimed to use the electroencephalography (EEG) task load index (TLI), given by the ratio of mean frontal midline theta energy to mean parietal alpha energy, to provide insight into the mental effort required by participants performing intuition-inducing and analysis-inducing tasks. We employed behavioral measures (reaction time and percent correct), and a subjective measure (NASA-Task Load Index) to validate the objective measure (TLI). The results we obtained were consistent with our hypothesis that mental effort required for analysis-inducing tasks would be different from that required for intuition-inducing tasks. Although our sample size was small, we were able to obtain a significant positive correlation between NASA-Task Load Index and TLI.

Acute cold stress in rheumatoid arthritis inadequately activates stress responses and induces an increase of interleukin 6

2008 ◽  
Vol 68 (4) ◽  
pp. 572-578 ◽  
Author(s):  
R H Straub ◽  
G Pongratz ◽  
H Hirvonen ◽  
T Pohjolainen ◽  
M Mikkelsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Stress Response ◽  
Cold Stress ◽  
Stress Responses ◽  
Plasma Levels ◽  
Acute Stress ◽  
Whole Body ◽  
Cold Therapy ◽  
Before And After ◽  
Sympathetic Stress

Objective:Acute stress in patients with rheumatoid arthritis (RA) should stimulate a strong stress response. After cryotherapy, we expected to observe an increase of hormones of the adrenal gland and the sympathetic nervous system.Methods:A total of 55 patients with RA were recruited for whole-body cryotherapy at −110°C and −60°C, and local cold therapy between −20°C and −30°C for 7 days. We measured plasma levels of steroid hormones, neuropeptide Y (sympathetic marker), and interleukin (IL)6 daily before and after cryotherapy.Results:In both therapy groups with/without glucocorticoids (GC), hormone and IL6 levels at baseline and 5 h after cold stress did not change over 7 days of cryotherapy. In patients without GC, plasma levels of cortisol and androstenedione were highest after −110°C cold stress followed by −60°C or local cold stress. The opposite was found in patients under GC therapy, in whom, unexpectedly, −110°C cold stress elicited the smallest responses. In patients without GC, adrenal cortisol production increased relative to other adrenal steroids, and again the opposite was seen under GC therapy with a loss of cortisol and an increase of dehydroepiandrosterone. Importantly, there was no sympathetic stress response in both groups. Patients without GC and −110°C cold stress demonstrated higher plasma IL6 compared to the other treatment groups (not observed under GC), but they showed the best clinical response.Conclusions:We detected an inadequate stress response in patients with GC. It is further shown that the sympathetic stress response was inadequate in patients with/without GC. Paradoxically, plasma levels of IL6 increased under strong cold stress in patients without GC. These findings confirm dysfunctional stress axes in RA.

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