Pre-simulation orientation for medical trainees: An approach to decrease anxiety and improve confidence and performance

Cassidy Bommer, Sarah Sullivan, Krystle Campbell, Zachary Ahola, Suresh Agarwal, Ann O'Rourke, Hee Soo Jung, Angela Gibson, Glen Leverson, Amy E. Liepert*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background: We assessed the effect of basic orientation to the simulation environment on anxiety, confidence, and clinical decision making. Methods: Twenty-four graduating medical students participated in a two-week surgery preparatory curriculum, including three simulations. Baseline anxiety was assessed pre-course. Scenarios were completed on day 2 and day 9. Prior to the first simulation, participants were randomly divided into two groups. Only one group received a pre-simulation orientation. Before the second simulation, all students received the same orientation. Learner anxiety was reported immediately preceding and following each simulation. Confidence was assessed post-simulation. Performance was evaluated by surgical faculty. Results: The oriented group experienced decreased anxiety following the first simulation (p = 0.003); the control group did not. Compared to the control group, the oriented group reported less anxiety and greater confidence and received higher performance scores following all three simulations (all p < 0.05). Conclusions: Pre-simulation orientation reduces anxiety while increasing confidence and improving performance.

Original languageEnglish
Pages (from-to)266-271
Number of pages6
JournalAmerican Journal of Surgery
Issue number2
StatePublished - Feb 2018
Externally publishedYes


  • Anxiety
  • Medical education
  • Simulation
  • Surgery


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