Impact of Mental Training on the stress of anaesthesiology residents before performing obstetrical epidural analgesia: A prospective randomised educational trial

BACKGROUND: Anaesthetists are trained from the beginning of their residency to perform high-risk procedures, often in high-stress environments, that can adversely affect both their technical and non-technical performance. Effective stress management is therefore essential, particularly before executing technical procedures. Recently, mental training has been introduced in the education of surgical residents to enhance performance under pressure. This study aimed to assess, using simulation, the impact of mental preparation on stress levels among anaesthesia residents before performing obstetric epidural analgesia. METHODS: A prospective, randomised, double-blind controlled trial was conducted at the Medical Training Center in Rouen in 2024. Second and third-year anaesthesia residents were randomly assigned to either a Mental Training group or a control group. The primary objective was to measure stress levels before performing obstetric epidural analgesia using the STAI-6 score. Secondary objectives included assessing technical and non-technical performance as well as mental imagery skills. The simulation took place in an immersive environment designed to replicate a realistic delivery room. RESULTS: A total of 31 residents participated (16 in the Mental Training group and 15 in the control group). There was a lower stress level among the Mental Training group compared to the control group (STAI-6: 10 [8-12] vs. 13 [12-14] respectively, p = 0.007). We observed a higher score in mental imagery abilities in the Mental Training group compared to the control group (MIQ at 46 50 [48-53] vs. [43-50] respectively, p = 0.039). No significant difference was observed between the two groups regarding technical and non-technical skills. CONCLUSION: Mental training before performing technical procedures significantly reduces stress levels in anaesthesia residents. Integrating mental training into anaesthesia residency programs could serve as a valuable educational strategy to enhance performance and resilience in high-pressure clinical situations. REGISTRATION: ClinicalTrials.gov (NCT07183618), registered 2025-09-18.