The effects of job-specific work stress on emotional and physiological responses and performance in pre-registration house officers

Background: In order to understand how work stress can affect emotional and physiological responses and performance it is necessary to assess individuals whilst they are experiencing work stress. Ideally, this would involve assessments during the course of the working day, however, whilst such assessments have high external validity, they are often lacking in control. An alternative, therefore, is to simulate everyday tasks in a more controlled environment. Methods: As part of a larger study assessing the effects of individual and situational factors on psychobiological stress responses, job-specific work stress was assessed in a group of pre-registration house officers (PRHOs). PRHOs were presented with simultaneous job-specific tasks (calculation of drug dosages, processing of test results, monitoring heart rate and prioritising time spent with patients) on a standardised computerised framework for 10 minutes. PRHOs were told that it was a performance test and they were to be as fast and accurate on all of the tasks as possible. Mood was recorded immediately before and after the testing session and heart rate and blood pressure were recorded throughout. Results: The tasks elicited increases in blood pressure and heart rate (t = 6.7, P <0.01) and feelings of alertness (t = 2.8, P <0.01), but decreased feelings of contentment (t = 2.7, P <0.01) and calm (t = 3.1, P <0.01). Differences were also observed between individuals reporting higher and lower levels of background stress. High stress PRHOs demonstrated degraded task performance and perceived the tasks to be more demanding, e.g., increased reports of physical demand (t = 2.4, P <0.05) and frustration (t = 4.1, P <0.01) when compared to low stress PRHOs. Conclusions: The combination of tasks elicited physiological (blood pressure and heart rate) and psychological (decreases in feelings of calm and contentment) stress responses. In addition, PRHOs engaged in the task, as evidenced by increases in feeling of alertness. However, facets of perceived task demands and performance were altered in PRHOs reporting higher levels of background stress. The framework provides a standardised platform for the presentation of performance-based tasks and can, therefore, be used in a controlled environment to assess the demands of jobs characterised by the need to attend and respond to several stimuli simultaneously.