Candy Crush over skipping rope? Real-time EEG-based anxiety index reduction via brief gaming interventions breaks in high-stress anesthesia residency shifts

BACKGROUND: Medical trainees in high-stress specialties like anesthesiology face elevated risks of anxiety and burnout, which may impair clinical performance. Traditional psychological assessments relying on questionnaires are limited by recall bias. This exploratory pilot study employed an EEG based Anxiety Index (ANXi) to evaluate anxiety levels among anesthesiology resident physicians in standardized training (ARPST) under varying shift duration. METHODS: Twenty ARPSTs received ANXi monitoring during five shift periods: morning shift (P0), post-8-h (P1), post-24-h (P2), post-36-h (P3), and weekends (P4). Anxiety was assessed during clinical tasks (drug preparation, examination) and interventions (rest, music, TikTok browsing, Candy Crush gameplay, 200 rope skips). RESULTS: All participants exhibited moderate-to-severe anxiety (ANXi > 45) during clinical tasks. While P3 showed the highest mean ANXi (58.1 vs. P0-P2: 49.8–55.7), inter-shift differences were non-significant (P > 0.05). Five minutes Candy Crush gameplay significantly reduced ANXi to sub-clinical levels (< 45) across all shifts (P < 0.001 vs. baseline). Conversely, 200 rope skips significantly increased anxiety (P < 0.001 vs. other interventions). CONCLUSIONS: This pilot study suggests that five minutes Candy Crush offered immediate anxiety relief in high-stress clinical settings, whereas rope skipping increased anxiety. These preliminary findings still need further verification. CLINICAL TRIAL NUMBER: Not applicable. Data generated in this study are available upon reasonable request to the corresponding author.