Investigating stress in surgical simulation education: markers, devices, and implications

Abstract Research on stress in surgical simulation education (SSE) is growing, driven by recognition of its impact on learning. Measuring stress is complex, given the range of wearable devices and biomarkers. Effective investigation of the human stress response (HSR) requires careful tool selection. This commentary reviews key device-based markers, their strengths and limitations, and advocates a triangulated, multi-modal approach to stress evaluation.