The effect of occupational physical activity on paramedic student neurocognitive response in high-fidelity simulation: a pilot randomized cross-over trial

Objective This study investigated how occupational physical activity (OPA) affects cognition and self-reported physical exertion in paramedicine students in simulation. Methods Eleven paramedic final-year paramedicine students or recent graduates: seven regional male and four regional female students completed two randomized crossover simulations: one preceded by OPA, another by rest (REST). Neurocognitive tests: Paced Auditory Serial Addition Test (PASAT) and Repeatable Episodic Memory Test (REMT) were administered pre-simulation, immediately post-simulation, and 60-minute post-simulation. Participants self-reported Rate of Perceived Exertion (RPE) before and after each simulation. Activity levels (g-force) and physiological parameters were monitored throughout. Results PASAT performance demonstrated time-dependent effects independent of physical exertion, while REMT showed no significant differences between OPA and REST. RPE was significantly higher pre-simulation in the OPA arm but showed no significant differences between conditions by simulation end. The OPA simulation produced a significantly higher level of physical activity (g-force) and physiological responses compared to REST at the beginning but no significant differences by the end of simulation. Conclusions OPA significantly affects initial perceived exertion in paramedic students, while cognitive performance shows nuanced responses. The timing of cognitive assessments appears more influential than physical exertion. Further research is needed to better understand these relationships.