The effect of assessor presence on stress and anxiety experienced during clinical simulation-based assessment

Abstract: Background: Emergency medical care (EMC) has been recognised as an important sector within public health care by the World Health Organisation. Emergency medical care refers to the provision of initial resuscitation, stabilisation, and treatment to acutely ill and injured patients and delivering those patients to the best available definitive care (AFEM Consensus Conference, 2013). As part of teaching and learning methods for emergency care education, clinical simulation-based learning has traditionally been used to train and assess EMC students. Clinical simulation has proven to be a valuable tool for EMC students to prepare them for the real pre-hospital work environment. Many EMC programmes use clinical simulations to assist EMC students in learning the roles and responsibilities of the pre-hospital emergency care providers. These teaching tools include the use of a simulated clinical environment in which students practise with manikins or actors as patients, and may include being observed by assessors, cameras, moderators and their peers, especially during simulation-based assessments. Clinical simulation-based assessment is now acknowledged as an effective strategy to improve and support the development of confidence and competence, yet it also presents challenges for EMC students, such as anxiety and stress (Taylor, 2017; Burke & Mancuso, 2012) as with all forms of assessment (Childs & Sepples, 2006; Stecz et al.,2021; Muldoon, Biesty & Smith, 2014). The presence of assessors in the clinical simulation assessment venue has been reported as one of the possible sources of stress and anxiety among students during clinical simulation-based assessment (Mills et al., 2016). Despite some evidence that students are stressed and anxious in the presence of assessors in the simulation venue, which may, in turn, have a negative effect on students’ performance, the experiences of students enrolled in the BHSc EMC (Bachelor of Health Science in Emergency Medical Care) programme in South Africa remains unknown.M.A. (Emergency Medical Care