Subjective and Objective Stress Responses of Third-Year Veterinary Students During Deliberate Practice on an Ovariohysterectomy Surgical Simulation Trainer.

Abstract

This study evaluated 68 third-year veterinary students' subjective and objective stress level changes at baseline (laboratory orientation session), prior to (pre-task), and following (post-task) a laboratory-simulated ovariohysterectomy (OVH) using a surgical simulation trainer. Using a pre-post experimental design, salivary alpha amylase (sAA) and cortisol (sC) samples were evaluated as markers of the students' physiologic stress response over three time points. NASA task load index (NASA-TLX) scores were correlated to salivary biomarker results. There was no association for change in salivary biomarkers accounting for age, gender, or NASA-TLX scores. However, stress levels did change based on sampling timing compared with performing the simulated OVH. sAA levels were lowest at baseline and increased post-task (p < 0.050). sC levels were highest at baseline and decreased pre-task (p < 0.016) and post-task (p < 0.001). sC levels were highest at baseline (average 77^th percentile) and decreased pre-task (average 71^st percentile) and post-task (average 52^nd percentile). Veterinary students performing a simulated OVH demonstrated high baseline levels of subjective and objective stress. However, sC levels decreased significantly following the simulated OVH, and sAA levels followed a normal circadian rhythm following OVH completion. These findings suggested that students with adequate resources, such as a strong surgical skills foundation, can assess a surgical task as a challenge, which can result in learning. Further evaluation of implementation of surgical simulation trainers and investigation into the role of stress on performance is indicated to support this group of learners.