Stress, Emotion and Learning: Considerations for the EMS Educator

Educators charged with teaching the next generation of EMS providers must prepare their students with an expansive repertoire of knowledge and skills and often must do so in a short period of time.

To further complicate this challenge, they must ensure their students are capable of proficiently functioning in a highly dynamic environment. They know these students will be frequently exposed to a multitude of stressors (e.g., loud noises, poor lighting and chaotic events), and in the face of such stressful

environments they will be expected to make decisions affecting life or death. This presents a fairly unique challenge for EMS educators: How do we prepare individuals to function capably in such an environment when similar exposure during the educational process can compromise learning?

Neuroeducation and Learning

Educational best practices have previously relied on anecdotal observations. Luckily, the field of education is slowly being informed by the study of neuroeducation. Neuroeducation is one of several names referring to “an interdisciplinary field that combines neuroscience, psychology and education to create improved teaching methods and curricula.”¹ When properly interpreted and applied, this newfound knowledge can provide educators with insight into the process of learning.

Neuroeducation shows us learning is more than simple memorization; it is a process resulting in being able to make sense of things.² Evidence from the field of neuroscience shows learning is the result of chemical changes in our brain known as neural or synaptic plasticity.³ These changes involve the structuring and restructuring of connections between neurons (i.e., synapses). With repeated exposure, these connections are strengthened and learning occurs. Researchers have described how these connections are not permanent once established, but rather can strengthen (a.k.a. potentiation) or weaken (a.k.a. depression) over time.4

The Stress-Emotion Connection

From a conceptual perspective, stress has been described as an increased demand for mental or physical productivity; however, from a physiological perspective, stress refers to a heightened state of arousal.⁵ We refer to those factors that induce stress (i.e., challenges and conflicts) as stressors. Similarly, emotions are those feelings (e.g., fear, anger, sadness) that characterize our state of mind. Together, stress and emotion induce protective mechanisms within our bodies that are regulated by the nervous system. While these mechanisms help us avert perceived threats, they can also compromise higher-level cognition.⁶

The reaction that an individual experiences in response to stressors is driven by the activation of our autonomic nervous system. Exposure to stress and emotion results in the release of stress hormones (cortisol, adrenaline and noradrenaline).⁵ These hormones are then responsible for the fight-or-flight response.⁷

While it might be tempting to focus singularly on stress or emotion as a factor affecting learning, such a task is complicated by the similar characteristics of stress and emotion. Emotions are often prompted by stressful events (e.g., fear or joy), yet the experience of a particular emotion can itself trigger a stress response.⁷ From this perspective we can see the shared properties between emotion and stressors: both have an identifiable source, involve an intense experience of short duration and create physiologic changes in our bodies. Canadian neuroscientist Sonia Lupien et al., suggest this interconnected relationship as the reason most literature on stress, emotion and learning fails to distinguish between the two.

Effects on Memory

A great deal of literature addresses the effects of emotion and stress on memory. Some sources report the detrimental effects of stress, while others suggest memory and learning can be enhanced by stress. Researchers have attributed such variations to the source of the stress (e.g., physical, cognitive or emotional), as well as the stage of learning at which the stress is introduced.⁵