Brief mindfulness intervention prior to simulated central venous access device insertion: A pilot randomised feasibility study.
Denis O'Dwyer, Ashwin Subramaniam, Dean McKenzie, Tony King, Laven Padayachee
Critical Care and Resuscitation July 9, 2026 DOI: 10.1016/j.ccrj.2026.100198 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized pilot feasibility study Peer reviewed |
|---|---|
| Sample size | 12 |
| Population | ICU registrars with prior CVAD experience |
| Intervention | Mindfulness meditation |
| Topics | Meditation |
| Keywords | Cognitive workload Physiological arousal Procedural performance Randomised pilot study |
| Key points | A brief mindfulness intervention was feasible and reduced physiological arousal and state anxiety, but procedural performance was numerically lower and critical errors more frequent in the mindfulness group, though chance imbalance cannot be excluded. |
Abstract
Acute stress impairs attention and procedural performance in high-acuity environments. Whether brief mindfulness-based interventions are feasible and affect performance in intensive care unit (ICU) simulation training is unknown. To evaluate the feasibility of a brief mindfulness-based intervention before simulated ultrasound-guided central venous access device (CVAD) insertion. Single-centre pilot randomised feasibility study at a tertiary ICU simulation centre. Twelve of thirteen ICU registrars with prior CVAD experience were randomised 1:1 to mindfulness or an active control. A 3-min recorded mindfulness meditation focused on breath awareness and attentional regulation, or a time-matched active control (standardised observation chart review), delivered immediately prior to simulation. Feasibility thresholds: recruitment ≥80%, adherence ≥90%, data completeness ≥95%, and assessor blinding. Exploratory outcomes included procedural performance (checklist, global rating scale, and total score), physiological arousal (heart rate and blood pressure), psychological state anxiety (STAI-State), confidence, and cognitive workload (NASA-TLX). All feasibility thresholds were met (recruitment [92%], adherence, and data completeness [100%, respectively]; blinding maintained). Mindfulness produced greater transient reductions in heart rate (-12.4 vs -5.3 beats/min) and systolic blood pressure (-13.5 vs -3.7 mmHg). STAI-State decreased in the mindfulness group but was unchanged in controls. Postsimulation confidence was higher in the mindfulness group (mean 13.7 vs 11.8). Procedural performance was numerically lower in the mindfulness group across all domains (total score 41.3 vs 52.0), and critical procedural errors were more frequent (4/6 vs 1/6). Confidence intervals were wide throughout, reflecting the small sample. A brief preprocedural mindfulness intervention was feasible and transiently reduced physiological arousal and state anxiety, but did not improve procedural performance; scores were numerically lower in the mindfulness group and critical errors were more frequent, though chance imbalance cannot be excluded given the small sample. These findings support progression to a larger, multicentre, adequately powered trial.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 5
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- A systematic review of the impact of mindfulness on the well-being of healthcare professionals. Journal of Clinical Psychology March 2018
- Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience June 2007