Is the Advanced Trauma Life Support simulation exam more stressful for the surgeon than emergency department trauma care?

Background: Stress affects surgeons both during training and during professional activity.

Objective: To compare stress levels affecting surgical residents during the simulated initial assessment and management in the Advanced Trauma Life Support practical exam vs initial assessment and management of trauma patients in the emergency room.

Method: Eighteen surgical residents were evaluated under basal conditions, during the Advanced Trauma Life Support simulation, and during emergency room initial care.