The role of emotions, stress, learning stage, and cognitive load on learning in emergency events: a mixed methods study.

Simulation-based education is used to train healthcare providers; however, studies examining how emotional load stress level and cognitive load influence learning during real emergency events remain limited. This gap limits our understanding of how learning occurs which is essential for preparing novice learners for real code blue events as well as inform curriculum development and design. Therefore, the purpose of this study was to evaluate how EL, SL, CL, and learning stages influence novice learners' experiences during real emergency events, code blue, in the Intensive Care Units (ICU). A mixed-methods approach was used utilizing surveys and individual semi structured interviews. Inclusion criteria were learners had to be either a respiratory therapy students or medical residents attended a real critical event in the intensive care unit event. Their mentors evaluated them as well in the event. 50 participants-27 learners and 23 mentors participated in the study. For learners, the average age was 26.48 ± 3.8, with 55.6% being female. A total of 13 (48%) were respiratory therapy students and 14 (51.9%) were residents. The mean CL for learners was 6.67 ± 1.30 Vs 6.39 ± 1.53 for mentor evaluation, respectively. EL from both learner and mentor evaluation was toward positive emotions. Thematic analyses of the qualitative interviews among learners were: (1) Environment presentation has an effect on learning, (2) Team leader presentation in the critical event is a critical factor to team members learning and success, (3) The team function in the event in a singular mindset, (4) Unexpected events are memorable events, and (5) Learning is continuous via reflective practices post event. Learners showed more positive emotions and were in the phase where learning mostly occurs in CL during the emergency events. The themes that evolved in qualitative analysis shed light for future studies on the importance of team debrief on learners learning and emotional state.