Design and Preliminary Evaluation of a Stress Reflection System for High-Stress Training Environments

Stress is a leading cause of errors and mental health issues for medical personnel in high-stress environments. Formal training on stress awareness at an early stage through interaction with systems that provide trainees with multimodal contextualized simulation training information may improve resilience. To this end, we designed the Stress Reflection system as a proof-of-concept educational tool to foster and promote stress reflection and awareness by presenting trainees with both internal and external behavioral information, i.e., electrodermal activity (EDA) and corresponding situated simulation videos. The system supports individual and team reflection, which is crucial for stress comprehension and mitigation. We conducted two initial studies within paramedic simulation training to assess the usability of the system and how trainees envisioned using the system as a post-simulation debrief. Our findings revealed that most trainees understood the system and believed it could be beneficial in promoting reflection on their performance. However, trainees emphasized the importance of allowing time for mental and emotional processing to enhance the effectiveness and constructive use of stress systems and physiological data. Our contribution lies in developing a multimodal educational and collaborative tool for individual and team stress reflection on shared stress data.