Monitoring stress using a wearable device and measuring satisfaction during high-fidelity perinatal simulation: A randomized controlled study

Aim: To continuously monitor midwifery students' physiological stress during high-fidelity perinatal simulation using a wearable device (Empatica (c) E4 wristband) and assess the impact of a stress-focused debriefing on their physiological and psychological stress and satisfaction. Background: High-fidelity simulation is an innovative training method that improves satisfaction and learning in healthcare, including midwifery. However, students might experience pressure and this can result in stress during simulations. Design: A two-group randomized controlled. Methods: The study was conducted at a University College's High-Fidelity Perinatal Simulation Centre in Belgium. Participants included fifty-six second- and third-year midwifery students. The intervention group received a stress-focused debriefing in addition to a standard debriefing, while the control group received routine standard debriefing. Physiological stress was continuously monitored using the E4 wristband, which measures electrodermal activity, heart rate, blood pressure and temperature. Measurements were divided into time periods: pre-simulation (T-0), scenario-running (T-1), debriefing (T-2) and post-simulation (T-3). Psychological stress was assessed at T-0 and T-3 using the Short Stress State Questionnaire and satisfaction was evaluated the Satisfaction with Simulation Experience Scale at T-3. Results: The intervention group showed a significant reduction in psychological stress and higher satisfaction than the control group (p < 0.001). Electrodermal activity at T-2 and heart rate at T-3 were significantly lower in the intervention group than the control group (p < 0.05). Conclusions: A stress-focused debriefing effectively reduces midwifery students' psychological and physiological stress while enhancing satisfaction. Electrodermal activity and heart rate parameters offered valuable insights into the students' physiological responses during perinatal simulation.