The impact of brief mindfulness meditation on anxiety, cognitive load, and teamwork in emergency simulation training: A randomized controlled trial

Abstract

BackgroundEmergency simulation training may impose a heavy psychological burden on health professions students (HPS), evoking anxiety, and overwhelming their cognitive load. Mindfulness may have a positive impact on HPS’ anxiety, cognitive load, and teamwork during simulation training. The effects of integration of a brief pre-briefing mindfulness meditation (MM) practice into emergency simulation training, on anxiety, cognitive load, and teamwork remain understudied. MethodsFrom November 2021 to June 2022, 70 undergraduate HPS participated in this pilot randomized controlled study. Participants were randomly assigned to the experimental group (EG, n = 24) that completed a brief in-person mindfulness meditation training program (MMTP) (2 h/week during 4 weeks) or a control group (CG, n = 46). Each group was comprised of teams (2 medical students and 1–2 nursing students). Measures of anxiety, mindfulness, cognitive load, and teamwork were collected at 4-time points: baseline, after the completion of the brief MMTP (for the EG only), at the first simulation assessment within one month later, and the second (6-month follow-up) simulation assessment. Student's t and Wilcoxon Mann-Whiney tests were used to compare the groups' measures and changes over time. A one-way repeated measures ANOVA was conducted to assess anxiety and mindfulness scores' changes over time among EG participants. Results52 participants completed all time-point assessments. EG participants recorded better state-anxiety, cognitive load, and teamwork scores than the CG participants in both simulation assessments. However, no statistically significant differences were recorded between the EG and the CG in trait-anxiety and mindfulness at the 6-month follow-up assessment. ConclusionBrief pre-briefing MM practice mitigates HPS' state-anxiety, and promotes cognitive load, and teamwork during emergency simulation training. Simulation instructors should consider MM practice in the emergency healthcare simulation instructional design.