Assessing the psychobiological demands of high-fidelity training in pre-hospital emergency medicine.

Project Description & Objectives

The ‘Pre-Hospital Emergency Medicine Crew Course’ (PHEMCC) is a world-leading training experience run by the Great North Air Ambulance Service (GNAAS). The PHEMCC provides high-fidelity, scenario-based training for medics to develop skills and knowledge in complex, high-stress pre-hospital emergency environments and comprises life-saving medical care alongside leadership, communication strategy, stress management, and decision making. The PHEMCC runs consecutively for 2 weeks with different activities each day, apart from Days 6 and 7 (weekend). The activities include immersive experiences and high-fidelity simulations in a range of environments with contributions from other emergency services (e.g., police, fire service, mountain rescue), and actors. Week 1 largely comprises the learning and acquisition of skills, while the second week Involves the application of those skills in complex scenarios. The requirements of each day therefore vary depending on their planned activities which differ in terms of their anticipated learning, cognitive, and physical loads.

This project assessed psychobiological functioning during the 2-week, high-fidelity training course, including rest days. Specifically, we assessed the Sympathetic Adrenal Medullary (SAM) axis (heart rate, HRV-derived stress index) and Hypothalamic Pituitary Adrenal (HPA) axis (diurnal cortisol and Cortisol Awakening Response) axes, self-reported anxiety, and anticipated and experienced demands.