JMIR Publications

ABSTRACT

Background:

High-fidelity simulation (HFS) is commonly used to train anesthesiology residents in how to perform in high-stress situations. Previous studies have shown physiologic stress responses during HFS may enhance performance during subsequent high-intensity scenarios, however this level of stress may hinder focus and knowledge retention during a post-HFS debrief session. Currently, the optimal mindset to maximize learning during the debrief is unknown and the ideal modality to create this mindset after a stress-inducing session has not been determined.

Objective:

This study aims to examine changes in focus and anxiety in anesthesia PGY-2 residents participating in HFS. Participants completed a guided mindfulness exercise session prior to simulation debriefing, either with or without virtual reality (VR) supplementation. We hypothesized that the mindfulness exercise with VR would lead to a larger increase in focus and decrease in anxiety than compared to the mindfulness exercise without VR.

Methods:

26 anesthesiology PGY-2 residents completed twice-weekly HFS sessions over 8 weeks. Immediately after the HFS session and before a standardized debrief, they completed a 5-minute mindfulness exercise guided by a consumer-grade EEG headband. Half of the residents wore a VR headset and meditated in a virtual forest environment, while the other half meditated with their eyes closed. Immediately before and after meditating, they completed a brief anxiety and focus questionnaire, then participated in a standardized debrief on the HFS session. Changes in focus and anxiety after meditating (self-reported) were compared between the two groups, as well as composite EEG scores between the two groups.

Results:

Analysis showed no significant differences between two groups regarding baseline anxiety levels or composite EEG scores prior to investigation. There were no significant differences between the groups’ increase in focus (VR group 4.8, Control 8.1, P = .62) and reduction in anxiety (VR group -16.4, Control -21.1, P = .39) after meditating. However, regardless of VR supplementation, meditation reduced anxiety levels by about 19% (P < .001) across all participants. Focus levels did not change after meditation.

Conclusions:

The addition of VR had no effect on the quality of meditation or on changing the resident’s mental state. Meditation led to reduced anxiety levels across all groups, suggesting that meditation of any form is useful before HFS debrief in reducing stress, but the addition of VR may be unnecessary.