Psychophysiological Modifications of Nurse Students in Hospital Clinical Simulations

Abstract

The aim of this study was to analyze the psychophysiological responses of nursing students during a clinical simulation, as well as their psychological profile in relation to their coping style in stressful situations and its impact on academic performance. We analyzed several variables in three students: i) heart rate variability (HRV) at 5 moments: pre-session, beginning part, middle part, last part of the session and post-session; ii) cortical arousal by Critical Flicker Fusion Threshold; iii) brain oscillations by means of electroencephalography; iv) perceived stress before and after starting the practice; and v) the objective and subjective evaluation of academic performance. We expected to find psychophysiological markers indicating a habituation to the situation. However, the results based on HRV and the parameters of related indexes failed to indicate the expected autonomic adaptation during the practice, showing a high sympathetic autonomic nervous system modulation. This non-habituation outcome might be related to the students’ high scores in the perceived stress scale associated with non-adaptive coping styles. In conclusion, a nursing clinical simulation scenario produced an anticipatory anxiety response in the students, which prevented them from achieving a habituation response, decreasing the Critical Flicker Fusion Threshold, and increasing anterior and decreasing temporal electroencephalogram activity.