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

OBJECTIVE: 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. DESIGN: 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. RESULTS: 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. CONCLUSION: 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.

Impact of BDNF Val66Met polymorphism on olfactory functions of female concussed athletes.

BACKGROUND: Concussions exert persistent effects on asymptomatic athletes, especially women. Among chief mechanisms of concussion recovery are alterations of neuronal plasticity. Olfactory function, often impaired following a concussion, greatly involves plasticity and, therefore, appears as a good candidate to study the deleterious effects of concussions. The BDNF Val66Met polymorphism (BDNFMet), which reduces availability of BDNF in the brain, has surprisingly been associated with better recovery following concussion. OBJECTIVE: This study examines the mediating effect of BDNFMet on olfactory functions in asymptomatic concussed female athletes. METHODS: Participants, 105 female university athletes, were divided into four groups based on their history of concussion (Concussion/No concussion) and BDNF polymorphism (BDNF Val66Val/Val66Met). Odour threshold, discrimination and identification were measured using the Sniffin' Sticks Inventory Test. RESULTS: Concussed female BDNFMet athletes performed significantly better than BDNFVal counterparts on threshold (F(1, 34) = 4.73, p < 0.05), discrimination (F(1, 52) = 5.36, p < 0.05), identification tests (F(1, 52) = 5.65, p < 0.05) and total olfactory scores (F(1, 34) = 9.54, p < 0.05). CONCLUSION: These results support a genotypic effect of the BDNF Val66Met polymorphism on long-term olfactory function following a concussion in young female athletes.