The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response

The objective structured clinical examination (OSCE) is a method for assessment clinical competencies and skills. However, there is a need to improve its design in psychology programs. The aim of this study was to analyze the effect of the different scenario’s presentation order with different compl...

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Autores:: Bellido-Esteban, Alberto
Beltrán Velasco, Ana Isabel
Ruisoto, Pablo
Nikolaidis, Pantelis
Knechtle, Beat
Clemente-Suárez, Vicente Javier

Tipo de recurso:: Article of journal

Fecha de publicación:: 2021

Institución:: Corporación Universidad de la Costa

Repositorio:: REDICUC - Repositorio CUC

Idioma:: eng

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repository_id_str
dc.title.spa.fl_str_mv	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
title	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
spellingShingle	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response OSCE Autonomic stress response Executive functions Complexity Undergraduate
title_short	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
title_full	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
title_fullStr	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
title_full_unstemmed	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
title_sort	The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response
dc.creator.fl_str_mv	Bellido-Esteban, Alberto Beltrán Velasco, Ana Isabel Ruisoto, Pablo Nikolaidis, Pantelis Knechtle, Beat Clemente-Suárez, Vicente Javier
dc.contributor.author.spa.fl_str_mv	Bellido-Esteban, Alberto Beltrán Velasco, Ana Isabel Ruisoto, Pablo Nikolaidis, Pantelis Knechtle, Beat Clemente-Suárez, Vicente Javier
dc.subject.spa.fl_str_mv	OSCE Autonomic stress response Executive functions Complexity Undergraduate
topic	OSCE Autonomic stress response Executive functions Complexity Undergraduate
description	The objective structured clinical examination (OSCE) is a method for assessment clinical competencies and skills. However, there is a need to improve its design in psychology programs. The aim of this study was to analyze the effect of the different scenario’s presentation order with different complexity/difficulty on the autonomic stress response of undergraduate students undergoing a Psychology OSCE. A total of 32 students of Psychology Bachelor’s Degree (23.4 ± 2.5 years) were randomly selected and assigned to two OSCE scenarios of different complexity. While undergoing the scenarios, participants heart rate variability was analyzed as an indicator of participant’s stress autonomic response. Results indicate that the order of presentation of different complexity/difficulty scenarios affects the autonomic stress response of undergraduate Psychology students undergoing an OSCE. Students who underwent the high-complexity scenario (difficult) first, reported significantly higher autonomic stress response than students who began the OSCE with the low-complexity scenario (easy). Highly complex or difficult scenarios require good executive functions or cognitive control, very sensitive to autonomic stress responses. Therefore, OSCE design will benefit from placing easy scenarios first.
publishDate	2021
dc.date.accessioned.none.fl_str_mv	2021-05-27T18:37:22Z
dc.date.available.none.fl_str_mv	2021-05-27T18:37:22Z
dc.date.issued.none.fl_str_mv	2021-03-24
dc.type.spa.fl_str_mv	Artículo de revista
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dc.identifier.issn.spa.fl_str_mv	1664-042X
dc.identifier.uri.spa.fl_str_mv	https://hdl.handle.net/11323/8289
dc.identifier.doi.spa.fl_str_mv	https://doi.org/10.3389/fpsyg.2021.622102
dc.identifier.instname.spa.fl_str_mv	Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv	REDICUC - Repositorio CUC
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identifier_str_mv	1664-042X Corporación Universidad de la Costa REDICUC - Repositorio CUC
url	https://hdl.handle.net/11323/8289 https://doi.org/10.3389/fpsyg.2021.622102 https://repositorio.cuc.edu.co/
dc.language.iso.none.fl_str_mv	eng
language	eng
dc.relation.references.spa.fl_str_mv	Appelhans, B. M., and Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Rev. Gen. Psychol. 10, 229–240. doi: 10.1037/1089-2680.10.3.229 Belinchon-Demiguel, P., and Clemente-Suárez, V. J. (2018). Psychophysiological, body composition, biomechanical and autonomic modulation analysis procedures in an ultraendurance mountain race. J Med Sys. 42:32. doi: 10.1007/s10916-017-0889-y Belinchón-deMiguel, P., Ruisoto-Palomera, P., and Clemente-Suárez, V. J. (2019). Psychophysiological stress response of a paralympic athlete during an ultra-endurance event. A case study. J. Med. Sys. 43:70. doi: 10.1007/s10916-019-1188-6 Beltrán-Velasco, A., Bellido-Esteban, A., Ruisoto-Palomera, P., and ClementeSuárez, V. (2018). Use of portable digital devices to analyze autonomic stress response in psychology objective structured clinical examination. J Med Sys. 42:35. doi: 10.1007/s10916-018-0893-x Beltrán-Velasco, A. I., Mendoza-Castejón, D., Fuentes-García, J. P., and Clemente-Suárez, V. J. (2020). Behavioural, psychological, and physiological stress markers and academic performance in immigrant and nonimmigrant preschool and school students. Physiol. Behav. 225:113081. doi: 10.1016/j.physbeh.2020.113081 Beltrán-Velasco, A. I., Ruisoto-Palomera, P., Bellido-Esteban, A., García-Mateos, M., and Clemente-Suárez, V. J. (2019). Analysis of psychophysiological stress response in higher education students undergoing clinical practice evaluation. J Med Sys. 43:68. doi: 10.1007/s10916-019-1187-7 Beltrán-Velasco, A. I., Sánchez-Conde, P., Ramos-Campo, D. J., and ClementeSuárez, V. J. (2021). Monitorization of autonomic stress response of nurse students in hospital clinical simulation. Biomed Res. Int. 2021, 1–7. doi: 10.1155/2021/6641425 Borggreve, A. S., Meijer, J. M., Schreuder, H. W., and Ten Cate, O. (2017). Simulation-based trauma education for medical students: a review of literature. Med. Teach. 39, 631–638. doi: 10.1080/0142159X.2017.1303135 Bradley, P. (2006). The history of simulation in medical education and possible future directions. Med. Educ. 40, 254–262. doi: 10.1111/j.1365-2929.2006.02394.x Chan, R. C., Shum, D., Toulopoulou, T., and Chen, E. Y. (2008). Assessment of executive functions: review of instruments and identification of critical issues. Arch. Clin. Neuropsychol. 23, 201–216. doi: 10.1016/j.acn.2007.08.010 Clemente-Suárez, V. (2015). Psychophysiological response and energy balance during a 14-h ultraendurance mountain running event. Appl. Physiol. Nutr. Metab. 40, 269–273. doi: 10.1139/apnm-2014-0263 Clemente-Suárez, V., Beltrán-Velasco, A. I., Bellido-Esteban, A., and Ruisoto, P. (2018). Autonomic adaptation to clinical simulation in psychology students: teaching applications. Appl. Psychophysiol. Biofeedback 43, 239–245. doi: 10.1007/s10484-018-9404-6 Clemente-Suárez, V., and Robles-Pérez, J. J. (2013). Mechanical, physical, and physiological analysis of symmetrical and asymmetrical combat. J. Strength Cond. Res. 27, 2420–2426. doi: 10.1519/JSC.0b013e31828055e9 Clemente-Suárez, V., Robles-Pérez, J. J., and Fernández-Lucas, J. (2017). Psychophysiological response in an automatic parachute jump. J. Sports Sci. 35, 1872–1878. doi: 10.1080/02640414.2016.1240878 Clemente-Suarez, V. J., Herrera-Mendoza, K., Montañez-Romero, M., Navarro, M. C., Crespo-Ribera, W., Vargas, C., et al. (2021). Respuesta autonómica de estrés en estudiantes de doctorado. Cult. Educa. Soc. 12, 9–18. doi: 10.17981/cultedusoc.12.1.2021.01 Crego, A., Carrillo-Diaz, M., Armfield, J. M., and Romero, M. (2016). Stress and academic performance in dental students: the role of coping strategies and examination-related self-efficacy. J. Dent. Educ. 80, 165–172. doi: 10.1002/j.0022-0337.2016.80.2.tb06072.x Delgado-Moreno, R., Robles-Pérez, J. J., Aznar-Laín, S., and ClementeSuárez, V. J. (2019). Effect of experience and psychophysiological modification by combat stress in soldier’s memory. J. Med. Sys. 43, 150–159. doi: 10.1007/s10916-019-1261-1 Diamond, A. (2013). Executive functions. Annu. Rev. Psychol. 64, 135–168. doi: 10.1146/annurev-psych-113011-143750 Giles, D. E., Draper, N., and Neil, W. (2015). Validity of the Polar V800 heart rate monitor to measure RR intervals at rest. Eur. J. Appl. Physiol. 116, 563–571. doi: 10.1007/s00421-015-3303-9 Hood, A., Pulvers, K., Spady, T. J., Kliebenstein, A., and Bachand, J. (2015). Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis. Anxiety Stress Coping 28, 545–562. doi: 10.1080/10615806.2014.1000880 Hormeño-Holgado, A. J., and Clemente-Suárez, V. J. (2019a). Psychophysiological monitorization in a special operation selection course. J. Med. Sys. 43:47. doi: 10.1007/s10916-019-1171-2 Hormeño-Holgado, A. J., and Clemente-Suárez, V. J. (2019b). Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 208:112559. doi: 10.1016/j.physbeh.2019.112559 Kane, M., and Engle, R. (2002). The role of prefrontal cortex in workingmemory capacity, executive attention, and general fluid intelligence: an individual-differences perspective. Psychon. Bull. Rev. 9, 637–671. doi: 10.3758/BF03196323 Malik, M., Bigger, J., Camm, A., and Kleiger, R. (1996). Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Task force of the european society of cardiology and the North American society of pacing and electrophysiology. Eur. Heart J. 17, 354–381. Mendoza-Castejón, D., and Clemente-Suárez, V. J. (2020). Psychophysiological stress markers and behavioural differences between rural and city primary school students. Int. J. Environ. Res. Public Health 17:3157. doi: 10.3390/ijerph17093157 Mendoza-Castejon, D., Fraile-García, J., Diaz-Manzano, M., Fuentes-Garcia, J. P., and Clemente-Suárez, V. J. (2020). Differences in the autonomic nervous system stress status of urban and rural school teachers. Physiol. Behav. 222:112925. doi: 10.1016/j.physbeh.2020.112925 Morgan, C. A., Doran, A., Steffian, G., Hazlett, G., and Southwick, S. (2006). Stress-induced deficits in working memory and visuo-constructive abilities in special operations soldiers. Biol. Psychiatry 60, 722–729. doi: 10.1016/j.biopsych.2006.04.021 Munroe, B., Buckley, T., Curtis, K., and Morris, R. (2016). Designing and implementing full immersion simulation as a research tool. Australas. Emerg. Nurs. J. 19, 90–105. doi: 10.1016/j.aenj.2016.01.001 Ramírez-Adrados, A., Beltrán-Velasco, A. I., Gonzalez-de-Ramos, C., FernándezMartínez, S., Martínez-Pascual, B., Fernández-Elías, V. E., et al. (2020a). The effect of final dissertation defense language, native vs. non-native, in the psychophysiological stress response of university students. Physiol. Behav. 224, 1130–1143. doi: 10.1016/j.physbeh.2020.113043 Ramírez-Adrados, A., Fernández-Martínez, S., Martínez-Pascual, B., Gonzalezde-Ramos, C., Fernández-Elías, V. E., and Clemente-Suárez, V. J. (2020b). Psychophysiological stress response of physiotherapy last year students in his final degree dissertation. Physiol. Behav. 222:112928. doi: 10.1016/j.physbeh.2020.112928 Redondo-Flórez, L., Fernández-Lucas, J., and Clemente-Suárez, V. J. (2020). Cultural differences in stress-related psychological, nutrition, physical activity and oral health factors of professors. Nutrients 12:3644. doi: 10.3390/nu12123644 Redondo-Flórez, L., Tornero-Aguilera, J. F., Ramos-Campo, D. J., and Clemente-Suárez, V. J. (2021). Gender differences in stress-and burnoutrelated factors of university professors. Biomed Res. Int. 2020:6687358. doi: 10.1155/2020/6687358 Ruisoto, P., Ramírez, M. R., García, P. A., Paladines-Costa, B., Vaca, S. L., and Clemente-Suárez, V. J. (2021). Social support mediates the effect of burnout on health in health care professionals. Front. Psychol. 11:3867. doi: 10.3389/fpsyg.2020.623587 Sánchez-Conde, P., Beltrán-Velasco, A. I., and Clemente-Suárez, V. (2019). Influence of psychological profile in autonomic response of nursing students in their first hospital clinical stays. Physiol. Behav. 207, 99–103. doi: 10.1016/j.physbeh.2019.05.008 Saravanan, C., and Wilks, R. (2014). Medical students’ experience of and reaction to stress: the role of depression and anxiety. ScientificWorldJournal 2014:737382. doi: 10.1155/2014/737382 Sobh, A. H., Austin, Z., Izham, M. M. I., Diab, M. I., Wilby, K. J. (2017a). Application of a systematic approach to evaluating psychometric properties of a cumulative exit-from-degree objective structured clinical examination (OSCE). Curr Pharm Teach Learn. 9, 1091–1098. doi: 10.1016/j.cptl.2017.07.011 Sobh, A. H., Izham, M., Diab, M., Pawluk, S., Austin, Z., and Wilby, K. (2017b). Qualitative evaluation of a cumulative exit-from-degree objective structured Q22 Q23 clinical examination (OSCE) in a gulf context. Am. J. Pharm. Educ. 17, 73–80. Soliemanifar, O., Soleymanifar, A., and Afrisham, R. (2018). Relationship between personality and biological reactivity to stress: a review. Psychiatry Investig. 15, 1100–1114. doi: 10.30773/pi.2018.10.14.2 Starcke, K., Wiesen, C., Trotzke, P., and Brand, M. (2016). Effects of acute laboratory stress on executive functions. Front. Psychol. 7:461. doi: 10.3389/fpsyg.2016.00461 Tornero-Aguilera, J. F., and Clemente-Suárez, V. J. (2018). Effect of experience, equipment and fire actions in psychophysiological response and memory of soldiers in actual underground operations. Int. J. Psychophysiol. 128, 40–46. doi: 10.1016/j.ijpsycho.2018.03.009 Unsworth, N., Fukuda, K., Awh, E., and Vogel, E. K. (2014). Working memory and fluid intelligence: capacity, attention control, and secondary memory retrieval. Cogn. Psychol. 71, 1–26. doi: 10.1016/j.cogpsych.2014.01.003 Vicente-Rodriguez, M., and Clemente-Suárez, V. (2020). Psychophysiological anxiety response of a rescue helicopter crew in a crane rescue manoeuvre. BMJ Mil Health. doi: 10.1136/bmjmilitary-2019-001345
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spelling	Bellido-Esteban, AlbertoBeltrán Velasco, Ana IsabelRuisoto, PabloNikolaidis, PantelisKnechtle, BeatClemente-Suárez, Vicente Javier2021-05-27T18:37:22Z2021-05-27T18:37:22Z2021-03-241664-042Xhttps://hdl.handle.net/11323/8289https://doi.org/10.3389/fpsyg.2021.622102Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/The objective structured clinical examination (OSCE) is a method for assessment clinical competencies and skills. However, there is a need to improve its design in psychology programs. The aim of this study was to analyze the effect of the different scenario’s presentation order with different complexity/difficulty on the autonomic stress response of undergraduate students undergoing a Psychology OSCE. A total of 32 students of Psychology Bachelor’s Degree (23.4 ± 2.5 years) were randomly selected and assigned to two OSCE scenarios of different complexity. While undergoing the scenarios, participants heart rate variability was analyzed as an indicator of participant’s stress autonomic response. Results indicate that the order of presentation of different complexity/difficulty scenarios affects the autonomic stress response of undergraduate Psychology students undergoing an OSCE. Students who underwent the high-complexity scenario (difficult) first, reported significantly higher autonomic stress response than students who began the OSCE with the low-complexity scenario (easy). Highly complex or difficult scenarios require good executive functions or cognitive control, very sensitive to autonomic stress responses. Therefore, OSCE design will benefit from placing easy scenarios first.Bellido-Esteban, AlbertoBeltrán Velasco, Ana Isabel-will be generated-orcid-0000-0002-9893-0227-600Ruisoto, Pablo-will be generated-orcid-0000-0003-1252-0479-600Nikolaidis, Pantelis-will be generated-orcid-0000-0001-8030-7122-600Knechtle, BeatClemente-Suárez, Vicente Javier-will be generated-orcid-0000-0002-2397-2801-600application/pdfengCorporación Universidad de la CostaCC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Frontiers in Physiologyhttps://www.frontiersin.org/articles/10.3389/fpsyg.2021.622102/fullOSCEAutonomic stress responseExecutive functionsComplexityUndergraduateThe effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress responseArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersionAppelhans, B. M., and Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Rev. Gen. Psychol. 10, 229–240. doi: 10.1037/1089-2680.10.3.229Belinchon-Demiguel, P., and Clemente-Suárez, V. J. (2018). Psychophysiological, body composition, biomechanical and autonomic modulation analysis procedures in an ultraendurance mountain race. J Med Sys. 42:32. doi: 10.1007/s10916-017-0889-yBelinchón-deMiguel, P., Ruisoto-Palomera, P., and Clemente-Suárez, V. J. (2019). Psychophysiological stress response of a paralympic athlete during an ultra-endurance event. A case study. J. Med. Sys. 43:70. doi: 10.1007/s10916-019-1188-6Beltrán-Velasco, A., Bellido-Esteban, A., Ruisoto-Palomera, P., and ClementeSuárez, V. (2018). Use of portable digital devices to analyze autonomic stress response in psychology objective structured clinical examination. J Med Sys. 42:35. doi: 10.1007/s10916-018-0893-xBeltrán-Velasco, A. I., Mendoza-Castejón, D., Fuentes-García, J. P., and Clemente-Suárez, V. J. (2020). Behavioural, psychological, and physiological stress markers and academic performance in immigrant and nonimmigrant preschool and school students. Physiol. Behav. 225:113081. doi: 10.1016/j.physbeh.2020.113081Beltrán-Velasco, A. I., Ruisoto-Palomera, P., Bellido-Esteban, A., García-Mateos, M., and Clemente-Suárez, V. J. (2019). Analysis of psychophysiological stress response in higher education students undergoing clinical practice evaluation. J Med Sys. 43:68. doi: 10.1007/s10916-019-1187-7Beltrán-Velasco, A. I., Sánchez-Conde, P., Ramos-Campo, D. J., and ClementeSuárez, V. J. (2021). Monitorization of autonomic stress response of nurse students in hospital clinical simulation. Biomed Res. Int. 2021, 1–7. doi: 10.1155/2021/6641425Borggreve, A. S., Meijer, J. M., Schreuder, H. W., and Ten Cate, O. (2017). Simulation-based trauma education for medical students: a review of literature. Med. Teach. 39, 631–638. doi: 10.1080/0142159X.2017.1303135Bradley, P. (2006). The history of simulation in medical education and possible future directions. Med. Educ. 40, 254–262. doi: 10.1111/j.1365-2929.2006.02394.xChan, R. C., Shum, D., Toulopoulou, T., and Chen, E. Y. (2008). Assessment of executive functions: review of instruments and identification of critical issues. Arch. Clin. Neuropsychol. 23, 201–216. doi: 10.1016/j.acn.2007.08.010Clemente-Suárez, V. (2015). Psychophysiological response and energy balance during a 14-h ultraendurance mountain running event. Appl. Physiol. Nutr. Metab. 40, 269–273. doi: 10.1139/apnm-2014-0263Clemente-Suárez, V., Beltrán-Velasco, A. I., Bellido-Esteban, A., and Ruisoto, P. (2018). Autonomic adaptation to clinical simulation in psychology students: teaching applications. Appl. Psychophysiol. Biofeedback 43, 239–245. doi: 10.1007/s10484-018-9404-6Clemente-Suárez, V., and Robles-Pérez, J. J. (2013). Mechanical, physical, and physiological analysis of symmetrical and asymmetrical combat. J. Strength Cond. Res. 27, 2420–2426. doi: 10.1519/JSC.0b013e31828055e9Clemente-Suárez, V., Robles-Pérez, J. J., and Fernández-Lucas, J. (2017). Psychophysiological response in an automatic parachute jump. J. Sports Sci. 35, 1872–1878. doi: 10.1080/02640414.2016.1240878Clemente-Suarez, V. J., Herrera-Mendoza, K., Montañez-Romero, M., Navarro, M. C., Crespo-Ribera, W., Vargas, C., et al. (2021). Respuesta autonómica de estrés en estudiantes de doctorado. Cult. Educa. Soc. 12, 9–18. doi: 10.17981/cultedusoc.12.1.2021.01Crego, A., Carrillo-Diaz, M., Armfield, J. M., and Romero, M. (2016). Stress and academic performance in dental students: the role of coping strategies and examination-related self-efficacy. J. Dent. Educ. 80, 165–172. doi: 10.1002/j.0022-0337.2016.80.2.tb06072.xDelgado-Moreno, R., Robles-Pérez, J. J., Aznar-Laín, S., and ClementeSuárez, V. J. (2019). Effect of experience and psychophysiological modification by combat stress in soldier’s memory. J. Med. Sys. 43, 150–159. doi: 10.1007/s10916-019-1261-1Diamond, A. (2013). Executive functions. Annu. Rev. Psychol. 64, 135–168. doi: 10.1146/annurev-psych-113011-143750Giles, D. E., Draper, N., and Neil, W. (2015). Validity of the Polar V800 heart rate monitor to measure RR intervals at rest. Eur. J. Appl. Physiol. 116, 563–571. doi: 10.1007/s00421-015-3303-9Hood, A., Pulvers, K., Spady, T. J., Kliebenstein, A., and Bachand, J. (2015). Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis. Anxiety Stress Coping 28, 545–562. doi: 10.1080/10615806.2014.1000880Hormeño-Holgado, A. J., and Clemente-Suárez, V. J. (2019a). Psychophysiological monitorization in a special operation selection course. J. Med. Sys. 43:47. doi: 10.1007/s10916-019-1171-2Hormeño-Holgado, A. J., and Clemente-Suárez, V. J. (2019b). Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 208:112559. doi: 10.1016/j.physbeh.2019.112559Kane, M., and Engle, R. (2002). The role of prefrontal cortex in workingmemory capacity, executive attention, and general fluid intelligence: an individual-differences perspective. Psychon. Bull. Rev. 9, 637–671. doi: 10.3758/BF03196323Malik, M., Bigger, J., Camm, A., and Kleiger, R. (1996). Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Task force of the european society of cardiology and the North American society of pacing and electrophysiology. Eur. Heart J. 17, 354–381.Mendoza-Castejón, D., and Clemente-Suárez, V. J. (2020). Psychophysiological stress markers and behavioural differences between rural and city primary school students. Int. J. Environ. Res. 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BMJ Mil Health. doi: 10.1136/bmjmilitary-2019-001345PublicationORIGINALThe Effect of Psychology Objective Structured Clinical Examination Scenarios Presentation Order on Students Autonomic Stress Response.pdfThe Effect of Psychology Objective Structured Clinical Examination Scenarios Presentation Order on Students Autonomic Stress Response.pdfapplication/pdf499453https://repositorio.cuc.edu.co/bitstreams/3464d030-09b8-4d03-8a47-7f58ea3a858d/download5d2a51126cb5f4210bddc82b7a7651e2MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8701https://repositorio.cuc.edu.co/bitstreams/d35cfbc5-7a2a-4bff-8a72-049d838cf18e/download42fd4ad1e89814f5e4a476b409eb708cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83196https://repositorio.cuc.edu.co/bitstreams/de298298-2bc0-40b4-aa91-f74de001b1c9/downloade30e9215131d99561d40d6b0abbe9badMD53THUMBNAILThe Effect of Psychology Objective Structured Clinical Examination Scenarios Presentation Order on Students Autonomic Stress 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The effect of psychology objective structured clinical examination scenarios presentation order on students autonomic stress response

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