Effect of a mindfulness exercise on stress in veterinary students performing surgery

Vet Surg. 2019 Apr;48(3):360-366. doi: 10.1111/vsu.13169. Epub 2019 Jan 29.


Objective: To determine students' stress while performing surgery and evaluate the ability of a mindfulness intervention to reduce this stress.

Study design: Quasi-experimental design.

Sample population: Eighteen fourth-year DVM program students (n = 9 student/group).

Methods: Utilizing a quasi-experimental design, students were randomly assigned to a control or treatment group. The treatment group performed a 5-minute breathing (mindfulness) exercise immediately prior to performing surgery. Each student provided 3 samples of saliva, at time 0, at 10 minutes before surgery, and at 10 minutes after surgery. Students' salivary cortisol and α-amylase levels were compared between groups. Students' self-reported mood measures were also correlated to levels of salivary biomarkers.

Results: Cortisol and α-amylase levels of students in both groups greatly exceeded normative reference groups (>90th percentile) prior to surgery and diminished to average levels (50th-60th percentile) after surgery but did not differ between groups at any time point. Immediately prior to surgery when stress values were likely to peak, salivary α-amylase levels decreased approximately 30 U/L units for students in the treatment group compared with an increase of approximately 10 U/L units for students in the control group. Students in the treatment group reported being more calm (mean [M] 2.67, SD 1.03, d = 0.75) and relaxed (M 2.33, SD 1.51, d = 0.90) than students in the control group (M 3.44, SD 1.01 and M 3.44, SD 0.88, respectively).

Conclusion: This study provides some evidence that the mindfulness intervention temporarily decreased stress levels and improved students' sense of calmness and relaxation immediately before operating on a live animal.

Clinical impact: Students who are experiencing less stress may be less likely to commit a medical error and negatively impact animal health. This study, the first of its kind in veterinary surgery, may serve as a model for related future studies.

MeSH terms

  • Animals
  • Education, Veterinary*
  • Female
  • Humans
  • Hydrocortisone / blood
  • Male
  • Mindfulness*
  • Stress, Psychological / prevention & control*
  • Students*
  • alpha-Amylases / blood


  • alpha-Amylases
  • Hydrocortisone