Recovery periods are important to maintaining the health and well-being of physicians

One study assessed the psychobiological functioning of 27 prehospital emergency physicians and paramedics over a two-week period. Results indicated that increases in psychological and biological stress in response to times of emergency are adaptive and substantial. However, when professionals often face emergency situations, the body has to respond too often and for too long, which can affect well-being and can lead to burnout. The research highlights the importance of recovery periods in maintaining the health and well-being of physicians.

Situations where the perceived demands of an event exceed our perceived ability to cope are interpreted as challenging or threatening and can lead to anxiety. To deal with these challenging events or stressors, biological mechanisms are activated, which through the secretion of the hormones adrenaline and cortisol, facilitate the release and mobilization of energy resources to deal with threats.

Experiencing acute challenge events is a ubiquitous feature of those who provide critical emergency care and adapt by mounting rapid physiological responses to provide the resources needed to address the emerging situation. The nature of this professional occupation, however, means that these responses are likely to be frequent with limited opportunities for recovery. Since the repeated activation of physiological stress responses often leads to burnout, these professionals are at particular risk to their health and well-being.

Following individuals in real emergency situations would provide an understanding of stress responses during critical care, but presents logistical challenges. A viable alternative is to assess individuals during high-fidelity training scenarios, that is, highly realistic representations of equivalent real-world scenarios. In this context Mark A. Wetherell and colleagues conducted the first and most comprehensive assessment of psychobiological response during high-fidelity training in prehospital emergency medicine.

With support from the BIAL Foundation, researchers from Northumbria University and James Cook University Hospital (UK) used a sample of doctors and paramedics (N = 27) and assessed their psychobiological functioning over ten training days and an activity-free weekend. The training was high-fidelity and based on real-life scenarios (eg car accidents, firearms incidents and rapid water rescue operations) so that professionals developed the skills and knowledge to work in complex and stressful pre-hospital settings environments.

Different psychobiological response patterns were identified between training days and weekends, with higher levels of anxiety, stress, worry, heart rate and cortisol on training days and lower levels on the weekend. Additionally, it was observed that on training days with greater physical and psychological workload, practitioners reported lower levels of coping and control resources and showed higher levels of psychobiological responsiveness.

The results were presented in the article “Assessing the psychobiological demands of high-fidelity training in prehospital emergency medicine,” published in October in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, where the authors investigate how emergency situations (with different workloads) and recovery affect physicians’ emotional, behavioral, and physiological responses. Although the study was conducted in a training setting, it was high-fidelity and based on real-life situations, and therefore representative of the everyday experiences of critical care providers.

Considering recent reports showing that “more than 50% of emergency medical care providers experience moderate to high levels of burnout, this study reinforces the importance of the opportunity for recovery to avoid the negative consequences of repeated and prolonged physiological activation of biological mechanisms to cope with difficult events for the health and well-being of these professionals”points out Mark A. Wetherell.