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Mindfulness Meditation and Interprofessional Cardiopulmonary Resuscitation: A Mixed-Methods Pilot Study.

Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo

Teaching and Learning in Medicine 2018 DOI: 10.1080/10401334.2018.1462186 (opens in new tab)

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Characteristics Single-group pretest-posttest convergent mixed-methods study Pilot study Qualitative Peer reviewed
Sample size 24
Population Healthcare providers comprising 4 interprofessional code teams, including physicians, nurses, respiratory therapists, and pharmacists
Interventions Mindfulness meditation Muse™ headband
Dose 7 min twice a day or 14 min daily
Duration 4-week training period
Measures critical positivity ratio, time to epinephrine, time to defibrillation, teamwork, task management, overall performance, skin conductance
Topics Meditation
Keywords Cardiopulmonary resuscitation
Key points Mindfulness meditation training was associated with significantly improved emotional balance, faster time to epinephrine in Scenario 1 and time to defibrillation in Scenario 2, and better teamwork, task management, and overall team performance in simulated cardiopulmonary arrest scenarios. Physiologic stress (skin conductance) improved but did not reach statistical significance. The authors suggest these results may serve as a foundation for larger confirmatory studies.

Abstract

Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress. A better understanding of this process could lead to more effective training approaches, improved team performance, and better patient outcomes. All participants were instructed to use a mindfulness meditation device (Muse™ headband) at home for 7 min twice a day or 14 min daily over the 4-week training period. This device uses brainwave sensors to monitor active versus relaxing brain activity and provides real-time feedback. We conducted a single-group pretest-posttest convergent mixed-methods study. We enrolled 24 healthcare providers, comprising 4 interprofessional code teams, including physicians, nurses, respiratory therapists, and pharmacists. Each team participated in a simulation session immediately before and after the mindfulness training period. Each session consisted of two simulated cardiopulmonary arrest scenarios. Both quantitative and qualitative outcomes were assessed. The median proportion of participants who used the device as prescribed was 85%. Emotional balance, as measured by the critical positivity ratio, improved significantly from pretraining to posttraining (p = .02). Qualitative findings showed that mindfulness meditation changed how participants responded to work-related stress, including stress in real-code situations. Participants described the value of time for self-guided practice with feedback from the device, which then helped them develop individual approaches to meditation not reliant on the technology. Time measures during the simulated scenarios improved, specifically, time to epinephrine in Scenario 1 (p = .03) and time to defibrillation in Scenario 2 (p = .02), improved. In addition, team performance, such as teamwork (p = .04), task management (p = .01), and overall performance (p = .04), improved significantly after mindfulness meditation training. Physiologic stress (skin conductance) improved but did not reach statistical significance (p = .11). Mindfulness meditation practice may improve individual well-being and team function in high-stress clinical environments. Our results may represent a foundation to design larger confirmatory studies.

Comparable studies

Other qualitative studies on meditation, most cited first.

Study Year Design Participants
The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan... 2017 Qualitative study with mixed-methods
The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout Nurses in a hospital system 2004 Implementation study with mixed methods
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators' self-report Meditators 2013 Qualitative study using grounded theory methodology

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