Emergency medicine residents and performance under pressure: learning from elite athletes’ experience

The skills of coping with stress and pressure within emergency medicine are conveyed informally and inconsistently throughout residency training. This study aims to identify key psychological competencies used by elite athletes in high-pressure situations, which can be integrated into a formal curriculum to support emergency medicine residents’ performance in high acuity settings.

We conducted a scoping review spanning 20 years to identify the relevant psychological competencies used by elite athletes (Olympic or World level) to perform under pressure. We used controlled vocabulary to search within Medline, PsycInfo and SportDiscuss databases. A standardized charting method was used by the team of four authors to extract relevant data.

The scoping review identified 18 relevant articles, including 707 athletes from 49 different sports and 11 countries, 64 data items were extracted, and 6 main themes were identified. The main psychological competencies included the ability to sustain a high degree of motivation and confidence, to successfully regulate thoughts, emotions and arousal levels, and to maintain resilience in the face of adversity.

We used the main psychological competencies identified from our scoping review to develop a hypothesis generated framework to guide the integration of performance psychology principles into future emergency medicine residency programs.