Investigating differences in Paramedic trainees’ multimodal interaction during low and high physiological synchrony

Physiological synchrony—the unconscious, dynamic alignment of physiological responses such as heart rate and electrodermal activity (EDA)—is increasingly recognized as a crucial element of effective teamwork and interpersonal dynamics. While synchrony has been studied extensively in romantic partners, friends, and therapeutic contexts, there is limited research on how it operates within high-stress, hands-on environments such as paramedic trainee simulations. In this study, we examine how differences in synchrony relate to multimodal interaction—specifically, verbal and nonverbal—between paramedic trainee dyads during simulation training. Quantitative analysis revealed statistically significant differences in Technical Coordination across synchrony levels during the Consult phase, with higher synchrony associated with more effective coordination. Qualitative analysis further highlighted distinct interactional patterns: high-synchrony teams demonstrated mutual gaze, closer physical proximity, aligned body orientation, and cooperative dialogue, whereas low-synchrony teams often displayed disengagement, spatial misalignment, and minimal interaction. These findings underscore the role of physiological synchrony in shaping the quality and effectiveness of multimodal team interaction, offering practical insights for improving collaboration in emergency medical training environments.