Abstract
BACKGROUND: Medical and nursing students experience high stress that can impair well-being and training. Immersive technologies may offer brief, scalable relaxation. MK360 combines short guided mindfulness with immersive 360° projection in a shared multisensory room environment without wearables. OBJECTIVE: To assess feasibility and explore short-term changes in perceived stress and immediate autonomic arousal following a brief, predominantly group-based immersive 360° mindfulness program in medical and nursing students. METHODS: Single-site pre-post pilot at the University of Lleida. Students attended four ~20-min MK360 sessions over 4 weeks. Heart rate (HR) and blood pressure (SBP/DBP) were recorded immediately before and after each session. The Perceived Stress Scale (PSS-14), the Goldberg Anxiety and Depression Scale-anxiety subscale (GADS/EADG), and the Maslach Burnout Inventory-Student Survey (MBI-SS) were administered at baseline and endline. Pre-post changes were tested using Wilcoxon signed-rank tests (α = 0.05); a one-tailed test was pre-specified for PSS (direction: decrease). RESULTS: Twenty-six students initiated the study (mean age 21.0 years; 88.9% female; 83.3% medical students), and 18 completed all assessments (completion 69.2%). Perceived stress decreased from baseline to endline (PSS-14 median [IQR] 29.5 [26.0-33.5] to 26.5 [19.5-33.8]; Δ - 3), but did not reach statistical significance in the pre-specified one-tailed Wilcoxon test (p ≈ 0.07; two-tailed sensitivity p ≈ 0.15; r ≈ -0.35). Burnout subscales showed non-significant directional changes (exhaustion and cynicism decreased; academic efficacy increased). Anxiety scores showed no material change. Immediate pre- to post-session reductions were observed for HR (mean Δ - 1.8 to -5.5 bpm) and SBP (Δ - 2.7 to -8.4 mmHg) across sessions; DBP decreased in sessions 2 and 4 but not in sessions 1 and 3. Among completers, 50.0% reported feeling somewhat better emotionally and 38.9% no change. No serious adverse events were reported. CONCLUSION: MK360 was feasible and well tolerated, with signals consistent with reduced perceived stress over 4 weeks and transient reductions in cardiovascular arousal within sessions. Given the uncontrolled design and small sample, causal inference is not warranted; controlled studies should confirm effectiveness, examine dose-response, and compare delivery formats.