Rising to the challenge: acute stress appraisals and selection centre performance in applicants to postgraduate specialty training in anaesthesia

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• 作者：Martin J. Roberts ; Thomas C. E. Gale…
• 关键词：Anaesthesia ; Challenge and threat ; Non ; technical skills ; Psychological stress ; Specialty training
• 刊名：Advances in Health Sciences Education
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：21
• 期：2
• 页码：323-339
• 全文大小：663 KB
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• 作者单位：Martin J. Roberts (1)
  Thomas C. E. Gale (1) (2)
  John S. McGrath (3) (4)
  Mark R. Wilson (5)
  
  1. Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine and Dentistry, Portland Square, Drake Circus, Plymouth, PL4 8AA, UK
  2. Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK
  3. Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  4. University of Exeter Medical School, Exeter, UK
  5. College of Life and Environmental Sciences, University of Exeter, Exeter, UK
  
• 刊物类别：Humanities, Social Sciences and Law
• 刊物主题：Education
  Medical Education
  
• 出版者：Springer Netherlands
• ISSN：1573-1677

文摘

The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants’ reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates’ pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation—the cognitive appraisal ratio (CAR)—and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates’ demographic and professional profiles, the CAR significantly predicted station performance: ‘challenge’ evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions.