ABSTRACT

Objectives

Coping with the stress of real and simulated disasters is thought to be integral to the performance of emergency medicine providers. Yet, little is known about which coping strategies are employed in these scenarios and whether differential use of strategies predicts actual clinical and interpersonal performance.

Methods

Thirty-four medical students were evaluated by trained simulated patients and physician observers across 111 clinical encounters during a simulated disaster. Linear Mixed Effects Modelling was used to test study hypotheses while accounting for demographic variables, psychological factors, and the dependency of multiple encounters for each participant.

Results

Results indicated that multilevel modeling was necessary. Positive thinking positively predicted observed clinical performance whereas avoidant coping was a negative predictor. Anticipatory anxiety and positive affect, but not reported coping, positively predicted student interpersonal performance.

Conclusions

The present study indicates that the way medical students report managing the stress of disaster scenarios has clear links to their observed clinical performance above and beyond demographic and psychological factors. It further demonstrates the feasibility of empirically identifying specific coping strategies that may be important targets for disaster response training.

中文翻译：

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医学生在模拟灾难中的应对和表现

摘要

目标

应对真实和模拟灾难的压力被认为是急诊医疗提供者绩效不可或缺的一部分。然而，对于在这些场景中采用哪些应对策略以及策略的不同使用是否可以预测实际的临床和人际关系表现，我们知之甚少。

方法

34 名医学生接受了模拟灾难期间 111 次临床遭遇的训练有素的模拟患者和医师观察员的评估。线性混合效应模型用于测试研究假设，同时考虑人口统计变量、心理因素以及每个参与者多次遭遇的依赖性。

结果

结果表明多层次建模是必要的。积极思考积极预测观察到的临床表现，而回避应对是消极预测因素。预期的焦虑和积极的影响，但没有报告应对，积极预测学生的人际关系表现。

结论

本研究表明，医学生报告管理灾难情景压力的方式与他们观察到的临床表现有着明显的联系，超出了人口统计学和心理因素。它进一步证明了根据经验确定可能是灾害响应培训重要目标的具体应对策略的可行性。