Meditation consists of a set of mental exercises used to develop a cognitively and emotionally balanced mind, and its development and practice date back 4000 years ^[1][6]. Over the past 50 years, there has been increasing interest in meditation, largely because of its effectiveness in improving emotional regulation ^[2][7]. Meditation is often conceptualized as a series of attentional and emotional regulation exercises ^[3][8]. There are many ways to practice meditation, and a common way to classify this large family of practices is based on what meditators do from their first-person perspective: focused-attention meditation (FAM) and open-monitoring meditation (OMM) ^[4][9]. While FAM has a clear focus on objects such as breathing, OMM practice (e.g., mindfulness meditation) has no clear focus, and the task is to be constantly aware of what is happening and to return to this monitoring state when drawn to something else ^[5][10]. The purpose of FAM is to resist the outside world and no longer receive external information, while that of OMM is to be inside, to treat and restore the current self-state ^[4][9]. FAM emphasizes attention maintenance and aims to consciously induce a state of relaxation, while OMM focuses on monitoring attention and emphasizes acceptance without judgment ^[4][6][9,11]. In this study, FAM was chosen as the intervention method because FAM simply focuses on the improvement of attention, while OMM maintains the awareness and monitoring of internal and external stimuli while maintaining attention.

During FAM, the meditator brings her/his attention to an object, such as breathing, and then uses this attention to monitor whether the attention is still there; once the meditator realizes that attention has strayed, he or she returns to the object in focus, minimizing any further mental elaboration ^[7][12].

Moye and van Vugt ^[8][16] found that the ability to maintain attention was significantly improved after FAM practice than before, and speculated that the improvement in mood regulation observed after meditation was due to the ability to maintain focus. A series of studies by Chan et al. has confirmed that FAM affects a series of attention-related learning and cognitive processes. FAM establishes a state of enhanced cognitive control, and enhances the effect of top-down control on sequence-learning based on the control characteristics of attention ^[7][12]. FAM may be associated with enhanced cognitive control to facilitate the development of a more efficient stimulus–response process compared to other forms of attentional task induction ^[3][5][8,10]. Many studies have explained the mechanism through which FAM enhances attention from a neurological perspective. Irrmischer et al. ^[9][17] found that the effect of FAM on attention was associated with greater control, and FAM strongly suppressed the long-range temporal correlations (LRTC) of neuronal oscillations relative to eyes-closed rest. The ability to reduce LRTC during meditation increased, which was associated with maintaining focus ^[9][17]. Manna et al. ^[10][18] found that the functional reorganization of brain activity patterns for attention and cognitive monitoring occurred during FAM practice. In a study by Yoshida et al. ^[11][14], the FAM group showed significantly higher P3 amplitude and shorter response time to target T stimulus during the task; by contrast, no such correlations were observed in the control group. These findings provide direct evidence of the effectiveness of FAM training.

Surgeons need to maintain a high level of concentration while performing surgery, and they also need channels to relieve the intense stress and negative emotions involved in such a high-intensity job; therefore, FAM practice may help them.

Flow refers to a mental state experienced by being fully engaged and deeply immersed in the task or activity at hand, in which people are fully engaged in the activity and gain many positive experiences ^[12][19]. Csikszentmihalyi ^[13][20] believed that flow is a positive emotion and experience related to a task. Flow refers to the mental state in which an individual uses his or her skills to complete a series of challenges and achieve a goal. In this process, individuals constantly receive positive feedback and adjust their behavior according to this feedback ^[14][21]. Flow can prompt an individual to show a strong interest in an activity or thing and motivate them to participate in it ^[15][22]. What FAM and flow have in common is a high degree of concentration. FAM is an effective training method for concentration. Individuals with higher levels of concentration are more likely to enter the flow state ^[16][23].

Bakker ^[17][24] applies flow to work situations. According to flow’s attribute description, flow is most likely to occur when the challenge of a situation is balanced with a person’s ability to cope with this challenge ^[13][20]. Analogously, in work situations, employees experience work-related flow when their work needs are matched with their skills ^[18][25]. Work-related flow is a peak experience generated by individuals at work, characterized by clear goals, focus, and matching of skills with challenges ^[17][24]. The nature of surgeons’ work makes it easier for them to experience flow. First, the goal of the surgeon’s job is clear: to treat patients and remove and repair diseased tissue. Secondly, surgeons need to maintain a high degree of concentration in their work. Thirdly, the complexity of surgery poses significant challenges, requiring surgeons to constantly improve their skills.

Communication and teamwork can be complex skills to apply in the operating room, as the members of operating-room teams vary by type of surgery ^[19][26]. Communication is the process of information exchange between people. Surgery is an important means of eradicating or effectively treating some diseases, and it is the embodiment of medical technology and medical skill ^[20][27]. Effective communication between surgeons and other medical workers and between surgeons and patients is the basis for improving medical quality and achieving the expected results of surgery ^[21][22][28,29]. Therefore, surgeons need to have good communication skills. Surgery requires the surgeon to work with nurses and anesthesiologists. Different medical specialties have different working styles, and surgeons must have a high degree of responsibility, respect, and understanding of the nature and characteristics of the work of other medical staff ^[23][30]. Surgeons should establish a harmonious working environment, in which all colleagues display a positive working attitude, support and cooperate with each other, do not shirk responsibility, and analyze and solve problems directly, so as to ensure smooth operation and better embody the idea of patient-centered medicine ^[24][31].

When people communicate, they mobilize an ability to coordinate their attention with that of others, which is called joint attention ^[25][32]. Joint attention is usually based on visual attention to define social coordination following another person’s gaze, adopting common reference points to operate, and on using the direction of one’s own gaze or position to determine, with another person, the potential of common reference points ^[26][33]. According to the theory of joint attention, as visual attention ability improves, visual attention develops into the ability to coordinate mental attention with others ^[25][32]. Increased focus helps to promote joint attention, which, in turn, helps to improve communication ^[27][34]. Many previous studies have also confirmed the effect of attention on communication skills. Karnieli-Miller et al. ^[28][35] found that the higher the concentration levels of medical students, the better their clinical communication skills.