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Managing student workload in clinical simulation: a mindfulness-based intervention
  1. Cheryl Pollard,
  2. Lisa Anne McKendrick-Calder,
  3. Christine Shumka,
  4. Mandy McDonald,
  5. Susan Carlson
  1. Nursing, MacEwan University, Edmonton, Alberta, Canada
  1. Correspondence to Lisa Anne McKendrick-Calder, Nursing, MacEwan University, Edmonton, AB T5J 4S2, Canada; mckendrickl{at}


Background Simulation places multiple simultaneous demands on participants. It is well documented in the literature that many participants feel performance stress, anxiety or other emotions while participating in simulation activities. These feelings and other stressors or distractions may impact participant ability to engage in simulation. The use of mindfulness has been proven to enhance performance in other contexts and we wondered if including a mindful moments activity in the traditional prebrief would change the participants perceived workload demands.

Method Using a fourth-year undergraduate nursing course with an intense simulation requirement we were able to compare a control group to an intervention group who was exposed to this mindful moment activity. All participants completed the same simulations. Postsimulation event, all participants completed the National Aeronautics and Space Administration Task Learning Index which measures mental demands, physical demands, temporal demands, effort, performance and frustration. Our convenience sample consisted of 107 nursing students (86 treatment group, 21 control group) who participated in 411 simulations for this study.

Results The control group experienced significantly different perceived workload demands in two domains (temporal and effort).

Conclusion It is possible to manipulate participants’ perceived workload in simulation learning experiences. More research is needed to determine optimal participant demand levels. We continue in our practices to use this technique and are currently expanding it to use in other high stress situations such as before examinations.

  • cognitive load
  • debriefing/facilitating
  • deliberate practice
  • nursing education
  • simulation

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  • Contributors All five authors have significantly contributed to the development of this manuscript according to the ICMJE guidelines for authorship. The guarantors of the work are CP and LM-C. All authors have been involved in the research including conception, REB approval, data collection, data analysis, drafting of the manuscript and editing the manuscript. All authors have seen this final manuscript in this final form and have given approval for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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