Role of emotional competence in residents' simulated emergency care performance: a mixed-methods study

BMJ Qual Saf. 2016 May;25(5):364-71. doi: 10.1136/bmjqs-2015-004032. Epub 2015 Oct 5.

Abstract

Objective: Emergency situations can generate negative affect in medical personnel, which can negatively impact on the quality of care. Several studies have demonstrated a positive influence of emotional competence (EC) on negative affect. The goal of this study was to test the effect of EC level on simulated emergency care situation in medical residents.

Methods: The sample included 21 medical residents caring for a simulated seriously wounded person whose condition suddenly deteriorated. Medical performance was scored by expert medical doctors (MDs). EC level and affective states were evaluated with self-assessment questionnaires. Finally, the origin of the negative affect experienced by the residents was identified through individual interviews.

Results: Higher EC levels were found to be associated with better medical performance and a lower intensity of negative affect. The latter two variables were found to correlate negatively. The main source of negative affect for residents was the inability to establish a diagnosis, regardless of their EC level and their medical performance.

Conclusions: The results suggest that residents who have a high EC level are better able to manage negative affect, so that they are better able to put their medical knowledge to work and explore alternative diagnoses. Emotional-management training for residents who, as new MDs, have limited experience may be beneficial to complement simulation exercises. Additional studies should be considered to better define the links between the affect experienced by MDs and their thought processes during establishment of a diagnosis.

Keywords: Critical care; Medical education; Patient safety.

MeSH terms

  • Clinical Competence*
  • Education, Medical, Graduate / methods
  • Emergency Medical Services / methods
  • Emergency Medicine / education*
  • Emotions
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Patient Simulation*
  • Surveys and Questionnaires