ED Noise: Mental Activation or Mental Stress?
ED Noise: Mental Activation or Mental Stress?
The use of only two stressors (time limit and noise) in this study may not have placed a high enough demand on participants. In reality, healthcare professionals are exposed to simultaneous stressors, for example, visual distractions, chaotic environments, urgency and noise, which may be cumulative. Larger effects secondary to noise are then more likely to be demonstrated. Additionally, fatigued (ie, postcall) doctors were excluded, which may have removed a vulnerable group thus reducing noise effects.
A further limitation is the study's translation to reality. When healthcare professionals are required to perform in an emergency environment, the stakes are high thereby placing huge demands on them. This will result in heightened arousal which may allow healthcare workers to block out distracting noise in order to focus on the task at hand. In the OSCE scenarios, there was no real pressure apart from the imposed time constraint—which participants may or may not have taken seriously. Participants also had a specified, limited time for noise exposure, with relief after each noise question, allowing a period of 'rest' from the noise. This rest may have provided enough recovery time so that negative effects of prolonged noise exposure were not seen. In addition, this study only tested cognitive tasks. In actual emergency environments, individuals are required to perform both cognitive and physical tasks. Further testing incorporating both cognitive and psychomotor tasks may render different results.
The fact that noise exposure was limited to 85 dBA exposed participants to lower noise levels than they would routinely be exposed to in a hospital environment. It is nevertheless useful to research the effects of noise at 85 dBA as this is a widely used occupational exposure limit.
Limitations
The use of only two stressors (time limit and noise) in this study may not have placed a high enough demand on participants. In reality, healthcare professionals are exposed to simultaneous stressors, for example, visual distractions, chaotic environments, urgency and noise, which may be cumulative. Larger effects secondary to noise are then more likely to be demonstrated. Additionally, fatigued (ie, postcall) doctors were excluded, which may have removed a vulnerable group thus reducing noise effects.
A further limitation is the study's translation to reality. When healthcare professionals are required to perform in an emergency environment, the stakes are high thereby placing huge demands on them. This will result in heightened arousal which may allow healthcare workers to block out distracting noise in order to focus on the task at hand. In the OSCE scenarios, there was no real pressure apart from the imposed time constraint—which participants may or may not have taken seriously. Participants also had a specified, limited time for noise exposure, with relief after each noise question, allowing a period of 'rest' from the noise. This rest may have provided enough recovery time so that negative effects of prolonged noise exposure were not seen. In addition, this study only tested cognitive tasks. In actual emergency environments, individuals are required to perform both cognitive and physical tasks. Further testing incorporating both cognitive and psychomotor tasks may render different results.
The fact that noise exposure was limited to 85 dBA exposed participants to lower noise levels than they would routinely be exposed to in a hospital environment. It is nevertheless useful to research the effects of noise at 85 dBA as this is a widely used occupational exposure limit.
