Yes, we can improve performance in 60 minutes!

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Yes, we can improve performance in 60
minutes! Sport Psychology principles and its
application to performance in the OCSE
Dr. Kirsty Forrest Ian Maynard, Ph.D Joanne Butt,
Ph.D Dr. Brian Nicholson
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Overview of the Research Project

• Project initiation
• Getting started .
• Aims of the project
• Funding
• For medical students

KF
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Objectives of the Session

• Sport psychology
• Performing under pressure
• Elite sport and preparing for OSCE
• Overview of the 6-week intervention
• Cognitive and somatic anxiety intervention
• Activity 1
• Develop awareness of our own responses to stress
• Activity 2
• (a) Cognitive restructuring
• (b) Cue controlled relaxation

JB
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Performing Under Pressure

• Mentally and physically prepared
• Manage emotions
• Do not let uncontrollable factors affect their
  performance
• Able to focus and refocus
• Have high levels of self belief

JB
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Psychological Skills Training for OSCE

• Intervention Overview
• Completing the CSAI-2
• Cognitive and somatic anxiety, and self
  confidence
• Develop awareness
• Responses to stress

IM
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Psychological Skills Training for OSCE

• Cognitive anxiety self confidence
• Controlling the controllable factors
• Cognitive restructuring
• Building confidence
• Planning and focusing

• Somatic anxiety
• 6-stage process of applied relaxation
• Systematic desensitisation
• Coping responses

IM
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IM
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Intervention Examples

• Activity 1 Developing awareness of our own
  responses to stress
• Activity 2
• (a) Cognitive restructuring
• (b) Cue controlled relaxation

IM
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Developing Awareness

• What characteristics do elite sport and OSCE/your
  world share?

JB
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The mirror of sport and preparing for the OSCE

• What characteristics do elite sport and OSCE/your
  world share?

• High pressure situations
• Demand for results
• Performance is critically evaluated
• Continuous need for improvement
• Performance edges are critical
• Personal accountability for performance
• Good communication

JB
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Recognising when you are under stress

• Common Early Warning Signs
• Mental (e.g., inability to concentrate,
  difficulty in making rational judgements)
• Emotional (e.g., state of anxiety, increased
  moodiness, angry outbursts)
• Physical (e.g., tense muscles, erratic breathing,
  cough/colds)
• Behavioural (e.g., increased or decreased sleep,
  social withdrawal)

Activity 1 see Booklet p. 7
JB
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Activity 2a Cognitive Restructuring

• Countering
• Identifying negative thoughts
• Thought stopping cue
• Reframing

Activity 2 see Booklet p. 10-13
IM
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Identifying Negative Thoughts and Expectations

• Examples OSCE Negative Self-Talk
• I don't know what to expect
• Its so difficult getting through so many stations
• I hope I say the correct things
• I shouldn't have asked that question

IM
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Thought Stopping

• Involves briefly focusing on the undesired
  thought and then using a cue or trigger to stop
  the thought and clear it from your mind.
• Cues or triggers can be mental or physical (e.g.,
  saying the word 'stop' to yourself, clenching
  your fist)

IM
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COUNTERING OSCE SpecificReframing Negative
Self-Talk to Positive Self-Talk
Negative Self-Talk Positive Self-Talk
I don't know what to expect I'm well prepared, I've been through this before. I have the skills to perform at each station.
Its so difficult getting through so many stations Just take one station at a time, and stick to my routine
I hope I say the correct things I'll perform well because I have the knowledge
I shouldn't have asked that question Its Ok, its just one question, I will accrue points from asking questions at each station
IM
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Activity 2b Progressive Relaxation

• Stage 3 Cue Controlled Relaxation
• Focus on breathing
• Use of 'cue' words e.g., 'relax', 'loose' etc

IM
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Changes in CSAI-2 Scores Pre and Post
Intervention
Pre-OSCE CSAI-2 (M) Post-OSCE CSAI-2 (M) T-Test Results
Cognitive Intensity (decreased) 25.39 20.83 t3.57df17 plt.01
Cognitive Direction (less debilitating) -10.06 -2.89 t-3.66df17 plt.01
Somatic Intensity (decreased) 22.78 17.94 t3.09df17 plt.01
Somatic Direction (facilitative) -10.11 1.44 t-4.49df17 plt.001
Self-confidence Intensity (increased) 14.22 21.50 t-5.19df17plt.001
Self-confidence Direction (facilitative) -5.06 9.59 t-5.18df16 plt.001
Intensity Range 9-36 Direction Range -27 to
27 - Understanding your own scores
JB
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Summary

• Psychological skills intervention Successful
  transition from sport to medicine OSCE
• Multi-modal Stress Management Training Programme
  (6 weeks)
• Focus on managing cognitive and somatic anxiety,
  and improving self confidence
• Provided examples of cognitive restructuring and
  cue-controlled relaxation

JB
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Final Comments

• Summary of the project
• Benefits for the medical students
• Future work
• Thank You for Listening

KF