The Fringe Abstract

Examining Autonomic Arousal in a Web-based CME Simulation Activity (F001)

Tristan Gorrindo, MD (Division of Postgraduate Medical Education, Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School); Elizabeth Goldfarb, BA (Division of Postgraduate Medical Education, Massachusetts General Hospital); Robert Birnbaum, MD, PhD (Division of Postgraduate Medical Education, Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School)


Stress, anxiety, and excitement are key components of learning in simulation activities. Here we examine heart rate variability and galvanic skin conduction as measures of autonomic arousal and affective engagement in a web-based CME activity focused on violence assessment in a veteran recently returning from Afghanistan. Data presented will focus on the correlations between autonomic arousal, performance in the simulation, and retention of knowledge.


Education is moving in the direction of not only assessing knowledge, but also competence and performance. This has led to increased interest in simulation and the components within simulation learning which make it an effective educational tool. Emotional engagement within high-fidelity (or mannequin-based) learning has been linked to enhanced learning, but it is unclear if affective learning translates to web-based simulation.

Our study uses galvanic skin conduction and heart rate variability as two peripheral indices of autonomic arousal to measure (in a more objective manner than self-report) levels of affective engagement in a web-based CME simulation activity.

Participants are randomized to either “high affective valence” or “low affective valence” conditions. Both groups interact with a Computer Simulation Assessment Tool. The high valence participants interact with a rich version of the simulation which contains well-acted audio and video components. Low valence participants interact with the same content, but rather than viewing multimedia videos, they only view a still image, and the audio is affectively flat. After using the simulation, participants in both groups meet with an investigator and undergo a structured debriefing, which includes self-reports of affective engagement and assessments of knowledge acquisition/retention.

Although data collection is ongoing, results will focus on correlations between autonomic arousal and performance in the simulation, as well as between autonomic arousal and retention in the debriefing. We will also examine differences in autonomic arousal between the low valence and high valence conditions.

These data begin to explore the connection between emotional engagement and web-based CME learning.


Nothing to disclose.