Just Breathe: Enhancing Student Performance Through Mindfulness Training

Mindfulness training offers techniques to help students manage stress and enhance focus in demanding environments.

Third-year military medical students evacuate a simulated patient during a prolonged casualty

care scenario at Operation Gunpowder, spring 2024. (Photo credit: Tom Balfour, USU)

August 21, 2025 by Vivian Mason

The brain is remarkably efficient, often shifting into “autopilot” mode for nearly half of our waking hours. This mind-wandering state isn’t always a drawback—it allows us to problem-solve, imagine possibilities, and make mental connections. Yet when drifting thoughts pull us away from what truly matters in the moment, mindfulness provides a way to return, helping us stay grounded and intentional.

Rebekah Cole, Ph.D., associate professor and director of Research in the Department of Military and Emergency Medicine (MEM) at the Uniformed Services University (USU), describes mindfulness as the practice of being fully present in the moment. She explains that it requires paying attention to one’s thoughts, emotions, and overall state of being—even in the midst of distractions.

With a background in mental health counseling, Cole focuses her work on exploring how mindfulness training influences military medical students’ performance in operational settings, while also teaching practical mindfulness techniques. She underscores the value of self-reflection and developing awareness of the mind, body, and environment. By practicing mindfulness, individuals can cultivate calm, reduce stress, and respond to their thoughts and emotions with greater intention.

Mindfulness is a skill that develops through consistent practice. Techniques can range from simple breathing exercises to more structured meditation. These practices help individuals observe the flow of their thoughts, tune into physical sensations, and cultivate a healthy sense of detachment from their mental activity. By becoming more aware of thoughts and emotions in challenging moments, individuals are better able to make intentional choices in how they respond. Over time, mindfulness can become a natural part of daily life, promoting greater patience, compassion, and overall well-being, while strengthening the ability to manage thoughts and emotions.

Dr. Cole’s mindfulness “classroom” for third-year military medical students attending

Operation Gunpowder, spring 2024 at Fort Indiantown Gap, PA. (Photo credit: Courtesy of

Rebekah Cole, USU)

For healthcare professionals, especially in high-pressure environments like deployments, mindfulness training can be an invaluable resource. USU field practicums such as Operation Bushmaster and Operation Gunpowder give students in the MEM department unique opportunities to apply mindfulness techniques in realistic scenarios. Cole emphasizes that these practices not only help students manage stress but also enhance their performance in demanding situations.

In simulated training environments, mindfulness has been shown to help students experiencing stress regain focus and remain present. Students are introduced to foundational practices such as box breathing—inhale and exhale while visualizing the shape of a square—and mindful breathing, which emphasizes focusing solely on the breath. These simple techniques are often reported as particularly effective.

Cole explains: “When your mind wanders, you can redirect your thoughts back to your breathing. By consistently training your mind in this way, you begin to develop the ability to manage your thoughts under highly stressful conditions. This process has significant value, though it requires considerable effort.”

She adds that mindful breathing can have a calming effect on the body under stress. By consciously remembering to breathe and focusing attention on that rhythm, students can engage both body and mind in a steadying practice.

Drawing on her background in mental health counseling and resiliency, Cole emphasizes preparing students for the demands of wartime, ensuring they are ready to lead healthcare teams from their very first deployment. “When our students lead teams during future conflicts, they will encounter significant stress and numerous distractions, yet they will remain responsible for the health and well-being of their teams. Therefore, it is essential that they can concentrate on providing effective medical care and ensuring the welfare of their personnel,” Cole states.

To cultivate presence, students are encouraged to focus intentionally on their actions, surroundings, thoughts, and feelings. Like any skill, mindfulness strengthens with practice. Even a few minutes a day can make a difference, particularly when incorporated into routine activities—such as pausing to notice the taste and texture of food while eating. Over time, consistent practice can yield wide-ranging benefits, including reduced stress, improved mental health, greater self-compassion, lower anxiety, enhanced performance, stronger self-awareness, better emotional regulation, and more effective management of negative thoughts.

Sustained practice and applying mindfulness across varied experiences are essential. Students report using mindfulness techniques during exams, clerkship rotations, and field exercises such as Operation Bushmaster and Operation Gunpowder. After a recent Operation Bushmaster, several students shared that mindfulness training improved their leadership skills, sharpened their focus, enhanced sleep, supported problem-solving, and helped them navigate the emotional demands of the exercise.

Fourth-year medical students care for simulated patients during a high-stress simulated mass

casualty scenario at Operation Bushmaster, fall 2024. (Photo credit: Tom Balfour, USU)

Preliminary findings suggest that students who complete mindfulness training show marked gains in both mindfulness and resilience, along with reduced levels of perceived stress. Cole emphasizes, “The more students incorporate mindfulness into their lives, the greater the benefits they will experience throughout their careers.”

When fully integrated, mindfulness practice can positively influence both professional and personal aspects of life. Cole emphasizes that developing greater awareness of one’s thoughts and actions can enhance academic performance and foster more meaningful relationships. “It offers comprehensive benefits,” she notes.

Student testimonials and feedback further highlight the effectiveness of mindfulness training. By offering these practices, USU demonstrates a strong commitment to the long-term health and well-being of its students, benefiting them as both physicians and individuals. Plans are underway to permanently incorporate mindfulness into the four-year medical school curriculum and to extend the training across the Military Health System (MHS).

Reflecting on the program, Cole shares, “Knowing that we are making a difference and enhancing student readiness is incredibly rewarding and motivates me to continue this work.”