The effects of stress on the driving abilities of paramedic students - a pilot, simulator-based study.

BackgroundPrevious research has suggested that stress may have a negative effect on the clinical performance of paramedics. In addition, stress has been demonstrated to have a negative impact the driving abilities of the general population, increasing the number of driving errors. However, to date no studies have explored stress and its potential impact on non-clinical performance of paramedics, particularly their driving abilities. MethodsParamedic students underwent emergency driving assessment in a driving simulator before and after exposure to a stressful medical scenario. Number and type of errors were documented before and after by both driving simulator software and observation by two observers from the research team. The NASA Task Load Index (TLX) was utilised to record self-reported stress levels. Results36 students participated in the study. Following exposure to a stressful medical scenario, paramedic students demonstrated no increase in overall error rate, but demonstrated an increase in three critical driving errors, namely failure to wear a seatbelt (3 baseline v 10 post stress), failing to stop for red lights or stop signs (7 v 35), and losing control of the vehicle (2 v 11). Self-reported stress levels also increased after the clinical scenario, particularly in the area of mental (cognitive) demand. ConclusionParamedics are routinely exposed to acute stress in their everyday work, and this stress could affect their non-clinical performance. The critical errors committed by participants in this study closely matched those considered to be contributory factors in many ambulance collisions. These results stimulate the need for further research into the effects of stress on non-clinical performance in general, and highlight the potential need to consider additional driver training and stress management education in order to mitigate the frequency and severity of driving errors. Key pointsO_LIParamedics are exposed to stressful clinical scenarios during the course of their work C_LIO_LIMany critical and serious clinical calls require transport to hospital C_LIO_LIAmbulance crashes occur regularly and pose a significant risk to the safety and wellbeing of both patients and paramedics C_LIO_LIThis simulated clinical scenario followed by a simulated driving scenario has highlighted that stress appears to affect driving abilities in paramedic students C_LIO_LIThe findings of this study, although conducted in paramedic students in simulated environments, highlight the need to further investigate the effects of stress on driving abilities among paramedics C_LI