Mindfulness in the OR: A Pilot Study Investigating the Efficacy of an Abbreviated Mindfulness Intervention on Improving Performance in the Operating Room

Abstract

Surgery requires operating room physicians to succumb to unpredictable schedules, long hours, and involved operations, which have led many to acquire maladaptive habits to attain focus in the OR. Research on mindfulness in the medical community has shown positive results on stress, burnout, and quality of life. However, due to the seemingly subjective nature of the benefits of mindfulness as well as the lengthy time requirement by participants, researchers have had difficulty conducting experiments with adequate sample sizes and controls in operating room specialties. We assessed the hypotheses that a brief mindfulness intervention on physicians, residents, and anesthesiologists can improve mindfulness, focus, and perceived stress in the operating room. Additionally, we hypothesized that the improvement in scores are independent of level of training and physician type. As part of a 3 (Physician Type) X 3 (Case) X 2(Timing) factorial design, 33 surgeons, anesthesiologists, and surgical residents completed a pre- and postintervention Mindfulness Awareness and Attention Scales (MAAS) survey. Three categories of surgery cases, routine-elective, complex-elective, and add-on, were completed pre- and postintervention, along with measures addressing focus and perceived stress. The intervention included a 25-minute mindfulness training on the benefits of mindfulness and how to utilize a brief, 4-minute mindfulness skill employed prior to each postintervention surgery. The mindfulness intervention was associated with a significant increase in mindfulness (p = 0.006) and flow state (p = 0.009) and a significant decrease in perceived stress (p = 0.033), particularly during the complex routine cases (p = 0.024). We have developed a brief mindfulness intervention that is compatible with the busy workflow of operating room physicians and can increase the mindful state of participants as well as improve factors that are associated with burnout and distractions.