Slides for a talk by Chris Nickson on how acute stressors affect performance and the techniques we can use to maintain performance despite them. Targeted at critical care trainees. Show notes available at: http://intensiveblog.com/training-for-stress
3. Objectives
1. Discuss acute stress and the effects on
performance
2. Discuss strategies and techniques for
maintaining performance in stressful
situations
10. In a lake there is a patch of lily pads
Every day, the patch doubles in size
If it takes 48 days for the patch
to cover the lake…
How long would it take for the patch to
cover half the lake?
This is Mr T saying “Beat The Stress, Fool!”
If you only remember one thing from this talk, remember this…
We will come back to it at the end, but it might make more sense and be more memorable if you know who Mr T is - here he is playing “Clubber Lang’ - Rocky Balboa’s nemesis in Rocky 3:
physiological effects:
“fight or flight or freeze”
result from activation of the limbic system and hypothalamus
- anterior hypothalmus stimulates the ANS resulting in adrenaline release from the adrenal medulla
- ACTH release from the pituitary gland stimulates glucocorticoid release from the adrenal cortex
manifestions:
tachycardia
perspiration and clammy skin
tachypnea
dry mouth
urination
and even defecation - “scared shitless”
the physical effects may compound the psychological effects, in particular they tend to optimise gross motor function at the expense of fine motor control (e.g. tremor may worsen performance of technical skills)
In Grossman’s cult book, ‘On Combat’ he popularises the idea of degrees of stress - condition white, yellow, red, grey, black - correlates with the stress reaction and that there are certain thresholds for degree of impairment
I think this should be taken with a grain of salt, the correlation with heart-rate is imperfect and how stress manifests differs in different people and in different circumstances
However, the take home is that excessive arousal from an acute stress response can have catastrophic effects on performance. This is important because doctors are notorious for under-estimating the effects of stress on our performance
