Effectiveness of Finnish SISU training in enhancing prehospital personnels' work performance: A randomised controlled pilot study.

Abstract

Background: Resilience means coping with and recovering quickly from adversities. This is a highly beneficial quality for prehospital personnel, who encounter many unforeseen stressors while on duty. This study investigated whether a novel pre-emptive resilience coaching programme, 'Finnish SISU training' (hereafter SISU), based on the validated International Performance Resilience and Efficacy Program (iPREP), would improve the work performance by enhancing situational and decision-making skills of prehospital personnel. 'Sisu' is a Finnish word meaning the combination of toughness and resilience.

Methods: This randomised controlled pilot study was conducted in Päijät-Häme, Finland. The sample comprised 16 paramedics, divided equally between the intervention and control groups. SISU was administered to the intervention group. Three full-scale simulation scenarios were then conducted. A blinded observer evaluated the participants' situational awareness and decision-making skills using a structured observer form, awarding them a maximum of 10 points. Participants completed a self-evaluation form before and after each simulation scenario and the responses were rated on a 5-point Likert scale. The results of these forms were compared between groups. We also compared the median values of heart rate variability (HRV), maximum heart rate, and respiratory rate between the groups.

Results: After 16 h of pre-emptive SISU, the intervention group improved their situational awareness and decision-making skills in the third simulation scenario (observer form results: intervention group median 10 [IQR 9-10] and control group median 6 [IQR 5-7], p ≤ 0.01). In contrast, observer ratings of the control group showed a diminishing trend in work performance across the three simulation scenarios. Self-evaluation revealed increased confidence in work performance in both study groups, in contrast to the blinded observer findings. Regarding HRV, the intervention group in contrast to the control group, recovered in minutes following the simulation scenarios, especially after the third simulation scenario (third defusing session: intervention group median HRV 27 [IQR 21-28], control group median HRV 21 [IQR 17-22], p < 0.01).

Conclusion: SISU improved work performance, which was measured by situational awareness and decision-making skills under stressful conditions. Resilience, a skill gained from this novel training, may have positive effects on coping with stress.

Trial registration: ISRCTN10221308. Registered at 19.3.2024. Retrospectively registered. https//www.isrctn.com/ISRCTN10221308.