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Royal College/Associated Medical Services CanMEDS Research Development Grant — Recipients


Melissa Duffy, PhD

Managing Emotionally-charged Events: The Impact of Stress Inoculation Training on Empathy in Simulation

Melissa Duffy, PhD
Melissa Duffy, PhD
Assistant Professor, Department of Innovation in Medical Education
Faculty of Medicine, University of Ottawa


Emotional competencies have received relatively little attention within postgraduate training. However, given the ubiquity of emotionally-charged events in medical practice, there is a need to develop training that helps residents to effectively manage emotions. In particular, it is important to ensure trainees are equipped to provide compassionate care during crisis events, as previous research has demonstrated that acute stress can reduce empathy.

Thus, the purpose of this research is to examine the impact of an emotion regulation training intervention (stress inoculation training) on empathic communication. Using an experimental design, obstetrics and gynecology residents and anesthesia residents (N=30) will be randomly assigned to an intervention condition (stress inoculation training) or control condition (traditional crisis resource management training) within the context of team-based simulation training. The intervention will involve an educational session and feedback on the use of emotion regulation strategies (e.g., cognitive restructuring, muscle relaxation). Participants will be exposed to simulation scenarios involving emotionally-charged events (e.g., patient distress during high-stakes case) followed by debriefing sessions and a focus group interview. Outcome measures will include audio, video, self-report, and physiological data. Primary outcome measures will include state emotions (empathy and anxiety) and empathic communication. Quantitative analyses will be conducted to test for differences in emotions and empathic communication between the two groups. Qualitative analyses will be conducted to examine factors that facilitate or hinder emotion regulation.

The proposed study moves beyond research that has relied on self-reported emotional competencies by examining real-time emotion regulation. In addition, by leveraging multi-source feedback and multiple measures of emotion, this research is better equipped to detect changes in emotional experience and expression than previous research.

The findings from this research have implications for competency-based training designed to promote more compassionate care and will offer insights into the role of emotion regulation within the CanMEDS framework.

How this work will inform research in medical education
This work is important because it helps to address the need for emotional competency training in postgraduate medical education. Proficiency in regulating one’s emotions is a key component of emotional competency. However, little attention in medical training has been devoted to helping residents manage affective factors, such as emotions. This research will test an educational intervention designed to augment traditional crisis resource management training in simulation environments by helping trainees to apply strategies to manage emotionally charged events. We anticipate that this type of intervention will not only lead to reductions in stress but also promote better clinical performance and compassionate care. This work will provide insights into the link between anxiety and empathy, as well as factors that impact the use of emotion regulation strategies in simulation training.


Kori A. LaDonna, PhD

Maria Hubinette, MD, CCFP, MMEd

Ryan Snelgrove, MD, FRCSC

Sarah Wright, MBA, PhD