Interns' anticipatory anxiety about cardiopulmonary resuscitation: reducing it while bolstering confidence with psychological skills training

Introduction: Dealing with emergencies is a critical responsibility of physicians-in-training. Residents typically lead cardio-pulmonary resuscitation efforts in a teaching hospital. A 'Code Blue' is a situation that is highly challenging, time sensitive and very often highly anxiety-provoking. Recently, there is greater recognition of the need and value of integrating specific psychological performance skills training to better manage the stress of critical situations. In this study, we sought to evaluate the impact of including a psychological skills training program with BLS/ACLS training for performance and confidence optimization and mitigation of anxiety in 1 year residents related to participating in and leading emergency resuscitations.

Materials and methods: First-year residents across six specialties underwent traditional BLS/ACLS training with the addition of a 3 h psychological skills training component (Code Calm) as part of their residency orientation. Anxiety and confidence-based questionnaires were used to evaluate the residents' perceptions of code-related stress and confidence to lead resuscitation efforts.

Results: Code-related anxiety scores demonstrated a statistically significant decrease post training (p < 0.0001); general confidence scores showed a statistically significant increase post-training (p < 0.001); confidence in leading resuscitation showed a statistically significant increase (p < 0.0001).

Discussion: The results of this study demonstrate that BLS/ACLS training can positively influence anxiety and confidence in residents related to their resuscitation skills, especially if combined with psychological skills training. Future studies should evaluate the incremental value of including psychological skills training with BLS/ACLS and its impact on enhancing physical performance skills.