There is a significant body of evidence to suggest that acute stress impacts concentration, memory, and focus.

This article is the 5th of an 8-part series on crisis stress.

Vicki LeBlanc’s Study on Stress and Learning in Healthcare Settings is a valuable resource. LeBlanc’s research on stress and learning in healthcare suggests that the source of stress significantly impacts memory and learning outcomes. For trainees like surgery residents, experiencing stress from an intimidating staff surgeon can lead to a strong memory of the negative interaction, but not necessarily of the surgery itself or related learning points. Similarly, in simulation settings, stress arising from social evaluation (being observed or judged) can hinder memory of the scenario’s learning objectives.

For effective learning and strong memory of clinical details, the stress response needs to be directly linked to the clinical case or task being learned.

Acute Crisis Stress and Memory

Acute stress, defined as a stressor arising from an immediate perceived threat, has a complex relationship with memory. Some research indicates that acute stress can impair both short-term (STM) and long-term memory (LTM), hindering the ability to recall existing skills and form new memories. For instance, cortisol, a stress hormone, can impair the hippocampus, a brain region crucial for memory encoding.

However, other studies suggest that acute stress can enhance memory, particularly for emotional experiences. This enhancement might be due to the hippocampus increasing connectivity within itself during stressful situations, aided by cortisol. Additionally, post-learning stress can even improve memory formation and retrieval. The timing of the stressor seems to be a crucial factor.

Different Types and Levels of Stress

Stress can be categorized as intrinsic (related to the learning challenge) or extrinsic (unrelated to the task). Research suggests that intrinsic stress may facilitate memory consolidation, while the effects of extrinsic stress on memory consolidation are less consistent.

Individual Differences in Stress Response

It is important to remember that individuals experience and respond to acute stress differently. These individual differences, including coping styles, locus of control, and social supports, can influence how stress affects performance. For instance, individuals with strong task-oriented coping skills may experience reduced anxiety in stressful situations, potentially mitigating negative impacts on performance.

References

Calvo, M.G. and Gutiérrez-García, A. (2016). Chapter 16 – Cognition and Stress, in Editor: George Fink, (2016) Stress: Concepts, Cognition, Emotion, and Behavior, Academic Press, Pages 139-144, ISBN 9780128009512, https://doi.org/10.1016/B978-0-12-800951-2.00016-9.

Dahlgren, A., Keckland, G. and Akerstedt, T. (2005). Different levels of work-related stress and the effects on sleep, fatigue, and cortisol. Scandinavian Journal of Work, Environment & Health, Vol. 31, No. 4 (August 2005), pp. 277-285. https://www.jstor.org/stable/40967503

Johnson, S., Cooper, C., Cartwright, S., Donald, I., Taylor, P. and Millet, C. (2005), “The experience of work‐related stress across occupations”, Journal of Managerial Psychology, Vol. 20 No. 2, pp. 178-187. https://doi.org/10.1108/02683940510579803

LeBlanc, V. R. (2009). The Effects of Acute Stress on Performance: Implications for Health Professions Education. Academic Medicine 84(10):p S25-S33, October 2009. DOI: https://doi.org/10.1097/ACM.0b013e3181b37b8f

Loftus, E.F. (2005). Planting misinformation in the human mind: A 30-year investigation of the malleability of memory, Learning Memory, 12, 361-366. https://learnmem.cshlp.org/content/12/4/361

Loftus, E.F., and Christianson, S. (1989). Chapter 12 Malleability of Memory for Emotional Events in Archer, T. and Nilsson, L. editors (1989) Aversion, Avoidance, and Anxiety: Perspectives on Aversively Motivated Behavior, New York: Psychology Press, DOI https://doi.org/10.4324/9781315808154

Luettgau, L. Schlagenhauf, F. and Sjoerds, Z. (2018). Acute and past subjective stress influence working memory and related neural substrates, Psychoneuroendocrinology, Volume 96, Pages 25-34. ISSN 0306-4530, https://doi.org/10.1016/j.psyneuen.2018.05.036

Riccio, D. C., Rabinowitz, V. C., & Axelrod, S. (1994). Memory: When less is more. American Psychologist, 49(11), 917–926. https://doi.org/10.1037/0003-066X.49.11.917