ArticleBMJ open2017
Examining self-reported and biological stress and near misses among Emergency Medicine residents: a single-centre cross-sectional assessment in the USA.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Thriving in Nursing Work: The Association Between Self-Reports and Biomarkers of Stress, Inflammation and Neuroplasticity.Journal of advanced nursing · 2026Article
- Cluster analysis of participants' self-reported emotional and organizational responses during a large-scale disaster simulation exercise at a level 1 trauma center.International journal of emergency medicine · 2026Article
- Effort-reward imbalance, subjective sleep quality, and inflammation in female nurses at a tertiary hospital: a pilot study.Scientific reports · 2025Article
- Article
- Surgeon reported measures of stress and anxiety prior to and after elective gynecological surgery.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Applying machine learning to explore the association between biological stress and near misses in emergency medicine residents.PloS one · 2022Article
- Workplace Cognitive Failure among Nurses during the COVID-19 Pandemic.International journal of environmental research and public health · 2021Article
- Emergency Medicine Residents Experience Acute Stress While Working in the Emergency Department.The western journal of emergency medicine · 2020Observational
- Lifestyle and psychosocial factors associated with maintenance of normal body mass index in college students: a cross sectional study.BMC research notes · 2020Article
- The association between attendings' feedback and residents' reporting of near-misses.BMC research notes · 2019Article
- The Impact of Choice Architecture on Sepsis Fluid Resuscitation Decisions: An Exploratory Survey-Based Study.MDM policy & practiceArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents.
designSelf-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses.
settingThe study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA.
participantsResidents in Emergency Medicine volunteered to participate. The sample consisted of 32 residents, with complete data on 28 subjects. Residents' supervising physicians assessed the clinical performance of each resident. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants' preshift and postshift stress, biological stress (salivary cortisol, plasma interleukin-6, tumour necrosis factor-alpha (TNF-α) and high-sensitivity C-reactive protein), residents' and supervisors' reports of near misses, number of critically ill and patients with trauma seen during the shift.
resultsResidents' self-reported stress increased from an average preshift level of 2.79 of 10 (SD 1.81) to a postshift level of 5.82 (2.13) (p<0.001). Residents cared for an average of 2.32 (1.52) critically ill patients and 0.68 (1.06) patients with trauma. Residents reported a total of 7 near misses, compared with 11 reported by the supervising physicians. After controlling for baseline work-related exhaustion, residents that cared for more patients with trauma and had higher levels of TNF-α reported a higher frequency of near misses (R
conclusionResidents' own ratings of near misses were associated with residents' TNF-α, a biomarker of systemic inflammation and the number of patients with trauma seen during the shift. In contrast, supervisor reports on residents' near misses were related only to the residents' preshift expectations of how stressful the shift would be.
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