The following is a summary of “Heart Rate Variability and Perception of Mental Stress among Medical Students and Residents at an Emergency Department,” published in the April 2024 issue of Emergency Medicine by Schubert, et al.

The demanding environment of an Emergency setting often exposes Medical Residents (MR) and Medical Students (MS) to stress. For a study, researchers sought to evaluate short-term heart rate variability (HRV) before and after shifts, assess perceived stress levels, and examine recovery patterns post-shift.

HRV parameters were assessed in MS and MR using the Polar® Verify Sense wristband physiological monitor before and after day shifts (DS) and night shifts (NS). Perceived stress levels were measured using the simplified State-Trait Anxiety Inventory (STAI-S6) and the Subjective Units of Distress Scale.

About 60 participants were included, 55% female and a mean age of 26. MS exhibited a significant reduction in sympathetic nervous system index after DS [0.68 (0.01–2.42) vs. −0.22 (−0.75–1.13), P < 0.01], and NS [0.87 (−0.28–1.45) vs. 0.06 (−0.70–1.04), P < 0.01], whereas MR maintained consistent levels of sympathetic activity [DS: 1.17 (0.04 –2.88) vs. 0.93 (0.50–1.41), P = 0.14; NS: 1.37 (0.76–2.21) vs 1.29 (0.35–2.18), P = 0.40]. Psychological data from STAI-S6 showed significant differences before and after DS in both groups, with higher perceived stress after DS (MS: 12 ± 4 vs. 14 ± 4, P = 0.04; MR: 14 ± 4 vs 16 ± 4, P = 0.04), not observed at NS (MS: 12 ± 3 vs 12 ± 3, P = 0.84; MR: 15 ± 3 vs 15 ± 4, P = 0.40).

Pre-shift HRV recordings revealed heightened sympathetic activity before both DS and NS among MR and MS, with a more sustained increase observed in MR. Furthermore, perceived stress was higher after DS in both groups.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723007295