Advertisement

Topics

Stress and Clinical Reasoning in Medical Students

2014-08-27 03:16:13 | BioPortfolio

Summary

Solving a problem in ambulatory setting may contain peripheral stress due to socio-evaluative stressors (patient's expectations about explanations) and task contingent stress due to time pressure, the necessity to take into account patient's mood, to deal with uncertainty of their own data collection and with complex clinical situations. In France, excepted for family medicine, undergraduate medical students and residents are currently not trained to perform consultations and are never exposed to ambulatory patients during training. The investigators postulate that this lack of practice may generate a significant state of stress during the first consultations and consequently modify or even impair clinical reasoning.

The primary objective of this study is to compare subjective and physiological levels of acute stress in ambulatory versus hospitalization setting in medical students confronted to a real patient with a diagnostic problem.

Measures: The French version of the Anxiety Spielberger test is administered just before and after each problem solving session.

Cortisol salivary samples are taken before and after each problem solving session. Salivary cortisol levels have been shown to be correlated to stressful situations and some personality traits but with some difference according to gender.

Cognitive appraisal (threat/challenge) is assessed before and after the tasks by the ratio of primary appraisal to secondary appraisal according to Tomaka et al.

Description

Participants and Method:

Year 6 medical students who attend a one-month full-time course in an Internal Medicine Department are eligible.

Since no consultations in the ambulatory setting are currently structured for medical students, the following adjustments have been done within the internal medicine consultation department, with the approval of the department director:

- the consultation duration has been increased (1 hour instead of 30 minutes)

- during the first 30 minutes, consultation is performed by the participant

- during the following 30 minutes, the patient is examined by his/her own physician.

- The consent of the patient has been obtained by phone (prior to the consultation).

Study Design

Allocation: Non-Randomized, Intervention Model: Crossover Assignment, Masking: Open Label

Conditions

Stress

Intervention

Evaluation of the stress

Location

Nantes University Hospital
Nantes
France

Status

Recruiting

Source

Nantes University Hospital

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:16:13-0400

Clinical Trials [2736 Associated Clinical Trials listed on BioPortfolio]

Evaluation of Aromatherapy on Academic Stress

Stress affects the health and is prevalent among medicine and pharmacy students. A number of factors such as busy schedules, course load and lack of recreational time during semesters as w...

Impact of Thermal Stress on Pulmonary Absorption and Toxicokinetics of 3 Organic Solvents

In Quebec, thousands of workers are concomitantly exposed to heat and chemical compounds. Exposure to heat induces physiological responses that help maintaining a stable body temperature. ...

Stress Prevention at Work: Intervention Efficacy and Implementation Process Evaluation

The Stress prevention at work (SPA) project intends to evaluate the method named Productivity Measurement and Enhancement System (ProMES) as a stress preventive approach among health care ...

Evaluation of a Probiotic On Anxiety and Stress in Healthy Adults Sensible to Daily Stress

The purpose of the the study is to determine if PROBIOSTICK® decrease stress and anxiety of people sensible to daily stress.

Evaluation of Transperineal US in Stress Incontinence

Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%.Identified risk factors are aging, obesity and repeated pregnancies and deliveries. Urodynamic remains th...

PubMed Articles [13123 Associated PubMed Articles listed on BioPortfolio]

Reliability of venous gas embolism detection in the subclavian area for decompression stress assessment following scuba diving.

Ultrasonic detection of venous gas emboli (VGE) in the precordial (PRE) region is commonly used in evaluation of decompression stress. While subclavian (SC) VGE detection can also be used to augment a...

Effects of psychological stress during exercise on markers of oxidative stress in young healthy, trained men.

Those engaged in high stress occupations such as firefighters and military personnel are exposed to a variety of psychological and physiological stressors. The combination of mental and physical stres...

Differences between acute and chronic stress granules, and how these differences may impact function in human disease.

Stress granules are macromolecular aggregates of mRNA and proteins assembling in response to stresses that promote the repression of protein synthesis. Most of the work characterizing stress granules ...

Comparing Stress and Arousal Systems in Response to Different Social Contexts in Children with ASD.

Response to psychological stress can vary based on the extent to which the context is perceived as stressful, especially under different social conditions. The purpose of this preliminary study was to...

Immediate and Late Effects of Stress on Kidneys of Prepubertal and Adult Rats.

Stress had been related to physiological and morphological alterations in different organs, however kidney morphology and function after stress conditions are not well-known. To evaluate the effects o...

Medical and Biotech [MESH] Definitions

A class of traumatic stress disorders that is characterized by the significant dissociative states seen immediately after overwhelming trauma. By definition it cannot last longer than 1 month, if it persists, a diagnosis of post-traumatic stress disorder (STRESS DISORDERS, POST-TRAUMATIC) is more appropriate.

A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi).

Stress wherein emotional factors predominate.

Treatment to improve one's health condition by using techniques that can reduce PHYSIOLOGICAL STRESS; PSYCHOLOGICAL STRESS; or both.

A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.

More From BioPortfolio on "Stress and Clinical Reasoning in Medical Students"

Advertisement
Quick Search
Advertisement
Advertisement

 

Relevant Topics

Stress
Stress is caused by your perception of situations around you and then the reaction of your body to them. The automatic stress response to unexpected events is known as 'fight or flight'. Discovered by Walter Cannon in 1932, it is the release of h...

Anxiety Disorders
Anxiety is caused by stress. It is a natural reaction, and is beneficial in helping us deal with tense situations and pressure. It is deterimental when is becomes an excessive, irrational dread of everyday situations. The most common types of anxiety di...


Searches Linking to this Trial