Mindfulness for stress and anxiety management in nursing students in a clinical simulation: A quasi-experimental study

Aim: To determine the efficacy of an online mindfulness intervention in reducing anxiety and stress levels in nursing students during clinical simulations.Background: Clinical simulation as a learning strategy has many benefits but the high levels of stress and anxiety it produces in participants can compromise learning, motivation or performance.Design: A quasi-experimental study with a non-equivalent control group design is presented. Forty-two under-graduate nursing students from a natural group were divided into: an experimental group (n = 21) and a control group (n = 21).Methods: Before conducting a clinical simulation, the experimental group followed a 10-day intensive online mindfulness intervention. All students received the same information and training. Instruments used were: Self-administered Analogue Stress Scale, State-Trait Anxiety Inventory and Five Facet Mindfulness Questionnaire. In addition, physiological data (blood pressure and heart rate) were collected at baseline, pre-briefing and debriefing.Results: Physiological variables increased in the prebriefing phase but remained statistically significantly lower in the experimental group (diastolic blood pressure p = .032 and heart rate p = .048). Levels of stress (p = .029) and anxiety (p = .016) were also managed better. Both groups in the debriefing session showed a statistically significant decrease in the different physiological variables, stress and anxiety. No changes in mindfulness were observed.Conclusions: The clinical simulation is indicated to generate stress and anxiety in nursing students. Therefore, measures must be adopted to control it. The intensive online mindfulness intervention proposed in this study reduced physiological parameters, stress and anxiety in the clinical simulation.