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Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations.

ABSTRACT: Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are related to the technical and non-technical skills of medical students participating in medical simulations in pediatrics. The study included 153 final-year medical students. A total of 306 high-fidelity simulations of life-threatening situations involving children were conducted. Results: Stress and the coping mechanism of the participants were correlated to their skills during pediatric simulations. Some components of mindfulness, such as non-judgment and conscious action, were positively related to the skills of medical team leaders. Executive functions correlated with the non-technical skills and mindfulness of the medical students. Conclusions: Stress, mindfulness, and executive functions modeled the behavior and skills of medical students during pediatric simulations of life-threatening events. Further research in this area may prove whether mindfulness training will improve learning outcomes in pediatric emergency medicine.

SUBMITTER: Los K

PROVIDER: S-EPMC7142723 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations.

Łoś Kacper K Chmielewski Jacek J Łuczyński Włodzimierz W

International journal of environmental research and public health 20200319 6

Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are relat ...[more]

PMID: 32204436

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Project description:PurposeThe aim of this study was to investigate the indirect effects of cardiorespiratory fitness on scholastic performance through executive functions. More precisely, we examined the contribution of the different domains of executive functions, and whether this relationship was specific to certain school topics.MethodsChildren 8-12 yr old completed nine cognitive tests and the multistage fitness test. Structural equation modeling techniques were used to analyze the role of different domains of executive functions (inhibition, working memory, cognitive flexibility, and a common factor to all tasks) in the relationship between cardiorespiratory fitness and school grades in three domains: (i) mathematics; (ii) grammar, spelling, and vocabulary; and (iii) text comprehension and expression. Covariate analyses included age and socioeconomic status.ResultsThe results of this study showed that an indirect effect of the various domains of executive functions explained, in part, the relationship between cardiorespiratory fitness and (i) mathematics (β = 0.12, SE = 0.03, P < 0.001), and between cardiorespiratory fitness and (ii) grammar, spelling, and vocabulary (β = 0.12, SE = 0.03, P < 0.001). No relationship between cardiorespiratory fitness and (iii) text comprehension and expression was observed. Although executive functions correlated with school grades, cognitive flexibility drove the indirect effect when all executive function domains were simultaneously taken into account.ConclusionsThese results show the role that executive functions play in understanding the relationship between cardiorespiratory fitness and scholastic performance. Importantly, not all executive function domains contributed equally because cognitive flexibility played a leading role in this wide age range. Furthermore, the relationship between cardiorespiratory fitness and scholastic performance was strongest for mathematics and for low-level language topics but nonsignificant for higher-level language topics, providing a more modulated view of the effect of cardiorespiratory fitness on language.

Project description:Functional status assessment methods are important as outcome measures for pediatric critical care studies.To investigate the relationships between the 2 functional status assessment methods appropriate for large-sample studies, the Functional Status Scale (FSS) and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category (POPC/PCPC) scales.Prospective cohort study with random patient selection at 7 sites and 8 children's hospitals with general/medical and cardiac/cardiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Research Network. Participants included all PICU patients younger than 18 years.Functional Status Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge. We investigated the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores within each of the POPC/PCPC ratings, and the relationship between the FSS neurologic components (FSS-CNS) and the PCPC.We included 5017 patients. We found a significant (P?<?.001) difference between FSS scores in each POPC or PCPC interval, with an FSS score increase with each worsening POPC/PCPC rating. The FSS scores for the good and mild disability POPC/PCPC ratings were similar and increased by 2 to 3 points for the POPC/PCPC change from mild to moderate disability, 5 to 6 points for moderate to severe disability, and 8 to 9 points for severe disability to vegetative state or coma. The dispersion of FSS scores within each POPC and PCPC rating was substantial and increased with worsening POPC and PCPC scores. We also found a significant (P?<?.001) difference between the FSS-CNS scores between each of the PCPC ratings with increases in the FSS-CNS score for each higher PCPC rating.The FSS and POPC/PCPC system are closely associated. Increases in FSS scores occur with each higher POPC and PCPC rating and with greater magnitudes of change as the dysfunction severity increases. However, the dispersion of the FSS scores indicated a lack of precision in the POPC/PCPC system when compared with the more objective and granular FSS. The relationship between the PCPC and the FSS-CNS paralleled the relationship between the FSS and POPC/PCPC system.

Dataset Information

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations.

Publications

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations.

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