Table 1.
Characteristics of thirty-three eligible studies
| Author (year), country Measurement |
Baseline MBI scores |
N control/ intervention, (specialty) |
Design | Intervention | Control | |
|---|---|---|---|---|---|---|
| Intervention Mean (SD) |
Control Mean (SD) |
|||||
| Individual coaching interventions (16 studies) | ||||||
|
Ares (2019), United States (9-item aMBI) |
EE: 7.6 (3.1) DP: 6.5 (4.4) PA: 15.9 (3.3) |
EE: 7.6 (3.1) DP: 6.5 (4.4) PA: 15.9 (3.3) |
25/21 (Neurosurgery) | Historical-control |
Mode: Bimonthly wellness lecture Duration: NA Frequency: 0.5 times per month Length: 12 months Dropout: 0 (0%) |
Mode: Pre-intervention, previous academic year Dropout: 0 (0%) |
|
Bragard (2008), Belgium (22-item MBI) |
EE: 25.2 (9.2) DP: 9.2 (5.3) PA: 37.2 (5.6) |
EE: 26.7 (8.4) DP: 9.1 (5.1) PA: 35.8 (5.5) |
58/57 (Mixed) | Randomized controlled trial |
Mode: 30-hour communication skills and 10-hour stress management skills Duration: 4 h per week Frequency: 10 times per month Length: 5 months Dropout: 9 (16%) |
Mode: Waitlist control Dropout: 10 (18%) |
|
Fainstad (2022), United States (22-item MBI) |
EE: 26.0 (8.1) DP: 10.9 (5.5) PA: 35.8 (5.7) |
EE: 28.2 (8.9) DP: 11.1 (5.6) PA: 33.7 (6.9) |
50/51 (Mixed) | Randomized controlled trial |
Mode: Online group-coaching program Duration: 1 h per week Frequency: 8 times per month Length: 6 months Dropout: 16 (32%) |
Mode: Waitlist control Dropout: 6 (12%) |
|
Hart (2019), United States (22-item MBI) |
EE: 24.3 (9.8) DP: 14.2 (5.4) PA: 33.1 (5.0) |
EE: 24.3 (9.8) DP: 14.2 (5.4) PA: 33.1 (5.0) |
46/46 (Emergency medicine) | Self-control |
Mode: Corporate wellness lectures Duration: 1 h per week Frequency: 1 times per month Length: 6 months Dropout: 22 (48%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 12 (26%) |
| Individual coaching interventions (16 studies), continued | ||||||
|
Huang (2020), China (22-item MBI) |
EE: 16.4 (4.8) DP: 7.0 (3.4) PA: 28.5 (7.1) |
EE: 15.8 (5.5) DP: 6.9 (2.8) PA: 28.1 (7.7) |
18/18 (Mixed) | Randomized controlled trial |
Mode: Balint group Duration: 1 h per week Frequency: 2 times per month Length: 6 months Dropout: 0 (0%) |
Mode: Waitlist control Dropout: 0 (0%) |
|
Martins (2011), Argentina (22-item MBI) |
EE: 22.8 (7.4) DP: 7.3 (3.4) PA: 36.5 (3.5) |
EE: 22.0 (6.4) DP: 6.7 (3.3) PA: 34.8 (3.7) |
37/37 (Pediatrics) | Randomized controlled trial |
Mode: Brief intervention Duration: 3 h per week Frequency: 2 times per month Length: 1 months Dropout: 0 (0%) |
Mode: Waitlist control Dropout: 0 (0%) |
|
Milstein (2012), United States (22-item MBI) |
EE: 26.0 (6.6) DP: 9.1 (6.3) PA: 34.3 (5.9) |
EE: 21.2 (10.1) DP: 12.0 (5.4) PA: 43.6 (3.5) |
7/8 (Pediatrics) | Randomized controlled trial |
Mode: Individual psychotherapeutic toll (brief intervention - BATHE technique) Duration: 0 h per week Frequency: 12 times per month Length: 3 months Dropout: 0 (0%) |
Mode: Waitlist control Dropout: 0 (0%) |
|
Palamara (2021), United States (22-item MBI) |
EE: NA (8.8) DP: NA (8.4) PA: NA |
EE: NA (8.8) DP: NA (8.4) PA: NA |
235/235 (Internal medicine) | Self-control |
Mode: Professional Development Coaching Program Duration: 1 h per week Frequency: 0.3 times per month Length: 8 months Dropout: 117 (50%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 117 (50%) |
| Individual coaching interventions (16 studies), continued | ||||||
|
Riall (2017), United States (16-item MBI) |
EE: 16.8 (8.4) DP: 10.3 (7.9) PA: 27.8 (6.9) |
EE: 16.8 (8.4) DP: 10.3 (7.9) PA: 27.8 (6.9) |
49/49 (General surgery) | Self-control |
Mode: Energy Leadership executive coaching model Duration: NA Frequency: 1 times per month Length: 12 months Dropout: 10 (20%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 10 (20%) |
|
Sheer (2021), United States (22-item MBI) |
EE: 10.6 (8.3) DP: 10.4 (8.0) PA: 38.5 (6.4) |
EE: 10.6 (8.3) DP: 10.4 (8.0) PA: 38.5 (6.4) |
107/107 (Internal medicine) | Self-control |
Mode: Wellness morning reports by resident and discussion group by senior residents (Grassroot Interventions) Duration: 1 h per week Frequency: 2 times per month Length: 6 months Dropout: 65 (61%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 67 (63%) |
|
Slavin (2016), United States (22-item MBI) |
EE: 29.6 (9.3) DP: 10.2 (4.2) PA: NA |
EE: 29.6 (9.3) DP: 10.2 (4.2) PA: NA |
17/18 (Pediatrics) | Historical-control |
Mode: Small workshop sessions targeted on stress management and life appreciation Duration: 1 h per week Frequency: 0.5 times per month Length: 12 months Dropout: 0 (0%) |
Mode: Pre-intervention, previous academic year Dropout: 0 (0%) |
| Individual coaching interventions (16 studies), continued | ||||||
|
Song (2020), United States (9-item aMBI) |
EE: 7.6 (4.2) DP: 5.2 (4.5) PA: 16.2 (1.8) |
EE: 7.6 (4.2) DP: 5.2 (4.5) PA: 16.2 (1.8) |
25/25 (General surgery) | Self-control |
Mode: Resilience coaching program with workshops Duration: 1 h per week Frequency: 0.7 times per month Length: 8 months Dropout: 0 (0%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
| Seeland (2024), United States (22-item MBI) |
EE: 25.5 (9.6) DP: 9.5 (4.3) PA: 39.7 (5.8) |
EE: 25.5 (9.6) DP: 9.5 (4.3) PA: 39.7 (5.8) |
58/58 (Obstetrics and gynecology) | Historical-control |
Wellness Wednesday, wellness week, wellness workshops Duration: NA Frequency: 0.33 time per month Length: 24 months Dropout: 17 (35%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 20 (42%) |
|
Stephanie (2022), Philippines (22-item MBI) |
EE: 30.2 (10.0) DP: 13.7 (5.6) PA: 33.5 (4.9) |
EE: 30.2 (10.0) DP: 13.7 (5.6) PA: 33.5 (4.9) |
59/59 (Mixed) | Self-control |
Mode: I-CARE program (communication skill workshops) Duration: NA Frequency: 2 times per month Length: 6 months Dropout: 42 (71%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
|
Wild (2018), United States (22-item MBI, average score) |
EE: 2.6 (1.5) DP: 2.4 (1.6) PA: 5.1 (1.1) |
EE: 2.6 (1.5) DP: 2.4 (1.6) PA: 5.1 (1.1) |
31/31 (Mixed) | Historical-control |
Mode: Patient-centered communication training Duration: 1 h per week Frequency: 4 times per month Length: 36 months Dropout: 0 (0%) |
Mode: Pre-intervention, previous academic year Dropout: 0 (0%) |
| Individual coaching interventions (16 studies), continued | ||||||
|
Winer (2019), United States (22-item MBI) |
EE: 20.0 (9.4) DP: 13.0 (4.8) PA: 38.0 (3.4) |
EE: 20.0 (9.4) DP: 13.0 (4.8) PA: 38.0 (3.4) |
36/36 (General surgery) | Self-control |
Mode: Comprehensive resident curriculum (This Week in SCORE) Duration: 1 h per week Frequency: 4 times per month Length: 12 months Dropout: 19 (53%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 19 (53%) |
| Individual meditation interventions (9 studies) | ||||||
|
Carullo (2021), United States (9-item aMBI) |
EE: 9.9 (3.9) DP: 7.3 (4.3) PA: 13.4 (2.0) |
EE: 9.9 (3.9) DP: 7.3 (4.3) PA: 13.4 (2.0) |
53/53 (Anesthesiology) | Self-control |
Mode: Smartphone meditation application Duration: 1 h per week Frequency: 30 times per month Length: 4 months Dropout: 22 (42%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 22 (42%) |
|
Dunne (2019), United States (22-item MBI) |
EE: 26.0 (4.0) DP: 9.4 (1.7) PA: 36.7 (7.0) |
EE: 26.5 (5.2) DP: 8.8 (1.0) PA: 35.8 (8.8) |
29/29 (Emergency medicine) | Randomized controlled trial |
Mode: Attention-based training program (mantra meditation) Duration: 4 h per week Frequency: 2 times per month Length: 2 months Dropout: 12 (41%) |
Mode: Waitlist control Dropout: 4 (14%) |
|
Loewenthal (2021), United States (22-item MBI) |
EE: 3.4 (1.2) DP: 2.8 (1.5) PA: NA |
EE: 3.2 (1.9) DP: 3.1 (2.1) PA: NA |
38/18 (Mixed) | Randomized controlled trial |
Mode: RISE program (Mindfulness-Based Stress Reduction by Yoga) Duration: 1 h per week Frequency: 4 times per month Length: 2 months Dropout: 12 (32%) |
Mode: Waitlist control Dropout: 2 (11%) |
| Individual meditation interventions (9 studies), continued | ||||||
|
Pandit (2022), United Kingdom (9-item aMBI) |
EE: 7.5 (4.8) DP: 5.0 (1.2) PA: 15.0 (6.0) |
EE: 7.5 (4.8) DP: 5.0 (1.2) PA: 15.0 (6.0) |
21/21 (Neurosurgery) | Self-control |
Mode: Mindfulness course Duration: 2 h per week Frequency: 4 times per month Length: 2 months Dropout: 0 (0%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
|
Peterson (2021), United States (22-item MBI) |
EE: 21.1 (12.2) DP: 8.3 (6.2) PA: 42.2 (3.4) |
EE: 21.1 (12.2) DP: 8.3 (6.2) PA: 42.2 (3.4) |
14/14 (Obstetrics and gynecology) | Self-control |
Mode: Mindfulness course Duration: 2 h per week Frequency: 2 times per month Length: 3 months Dropout: 2 (14%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
|
Purdie (2023), United States (9-item aMBI) |
EE: 10.7 (4.8) DP: 6.0 (4.8) PA: 13.8 (3.9) |
EE: 10.6 (4.0) DP: 5.9 (4.0) PA: 13.9 (3.1) |
27/39 (Pediatrics) | Randomized controlled trial |
Mode: Mindfulness Awareness Practices (MAPs) Duration: 2 h per week Frequency: 3 times per month Length: 1 months Dropout: 0 (0%) |
Mode: Waitlist control Dropout: 0 (0%) |
|
Schmeusser (2023), United States (22-item MBI) |
EE: 14.5 (5.2) DP: 14.2 (7.2) PA: 37.7 (5.7) |
EE: 14.5 (5.2) DP: 14.2 (7.2) PA: 37.7 (5.7) |
24/24 (Obstetrics and gynecology) | Historical-control |
Mode: Wellness program (meditation, guided reflection, and yoga) Duration and frequency: NA Length: 12 months Dropout: 6 (25%) |
Mode: Pre-intervention, previous academic year Dropout: 5 (21%) |
| Individual meditation interventions (9 studies), continued | ||||||
|
Verweij (2017), Netherlands (20-item MBI) |
EE: 16.5 (7.8) DP: 4.8 (3.0) PA: 32.8 (5.1) |
EE: 14.5 (7.1) DP: 5.5 (3.9) PA: 32.9 (5.0) |
80/68 (Mixed) | Randomized controlled trial |
Mode: Mindfulness-Based Stress Reduction (MBSR) Duration: 3 h per week Frequency: 4 times per month Length: 2 months Dropout: 9 (11%) |
Mode: Waitlist control Dropout: 1 (1%) |
|
Weitzman (2021), United States (22-item MBI) |
EE: NA (0.3) DP: NA (0.3) PA: NA (0.4) |
EE: NA (0.3) DP: NA (0.3) PA: NA (0.4) |
18/18 (Otolaryngology) | Self-control |
Mode: Virtual reality meditation program Duration: 0 h per week Frequency: 1 times per month Length: 4 months Dropout: 0 (0%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
| Organizational work-hour interventions (6 studies) | ||||||
|
Burgos (2014), Argentina (22-item MBI) |
EE: 29.0 (11.6) DP: 19.0 (12.3) PA: 31.0 (5.8) |
EE: 29.0 (11.6) DP: 19.0 (12.3) PA: 31.0 (5.8) |
25/25 (Cardiology) | Historical-control |
Mode: Day of rest after shift Duration: NA Frequency: NA Length: 12 months Dropout: 2 (8%) |
Mode: Pre-intervention, previous academic year Dropout: 6 (24%) |
|
Parshuram (a) (2015), Canada (22-item MBI) |
EE: 26.2 (11.0) DP: 13.0 (4.8) PA: 37.3 (4.9) |
EE: 23.7 (10.2) DP: 9.8 (4.9) PA: 36.9 (7.4) |
17/15 (Mixed) | Randomized controlled trial |
Mode: Shift length modification from 24 to 12 h Duration: NA Frequency: NA Length: 2 months Dropout: 3 (18%) |
Mode: 24-hour shift Length: 2 months Dropout: 2 (13%) |
| Organizational work-hour interventions (6 studies), continued | ||||||
|
Parshuram (b) (2015), Canada (22-item MBI) |
EE: 26.4 (9.6) DP: 11.4 (7.4) PA: 35.3 (5.4) |
EE: 23.7 (10.2) DP: 9.8 (4.9) PA: 36.9 (7.4) |
15/15 (Mixed) | Randomized controlled trial |
Mode: Shift length modification from 24 to 16 h Duration: NA Frequency: NA Length: 2 months Dropout: 1 (7%) |
Mode: 24-hour shift Length: 2 months Dropout: 2 (13%) |
| Heppe (2024), United States (22-item MBI) |
EE: 25 (IQR, 19–30) DP: 11 (IQR, 8–15) PA 38 (IQR, 33–41) |
EE: 25 (IQR, 19–30) DP: 11 (IQR, 8–15) PA 38 (IQR, 33–41) |
313/313 (Internal Medicine) | Historical-control |
Mode: Alternate 4 + 4 block schedule (4 inpatient on-call weeks plus 4 outpatient off-call weeks) Duration: 24 months Frequency: NA Dropout: 97 (31%) |
Mode: No alternate on-call and off-call schedule Duration: 24 months Frequency: NA Dropout: 97 (31%) |
|
Schuh (2011), United States (22-item MBI) |
EE: 23.3 (12.4) DP: 8.7 (6.6) PA: 35.6 (8.1) |
EE: 23.3 (12.4) DP: 8.7 (6.6) PA: 35.6 (8.1) |
34/34 (Neurology) | Self-control |
Mode: Work hour limitation Duration: NA Frequency: NA Length: 1 months Dropout: 11 (32%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 10 (29%) |
|
Stevens (2020), United States (22-item MBI) |
EE: 2.7 (1.2) DP: 1.7 (0.9) PA: 4.6 (0.9) |
EE: 2.7 (1.2) DP: 1.7 (0.9) PA: 4.6 (0.9) |
19/19 (Otolaryngology) | Self-control |
Mode: 2-hour protected nonclinical time Duration: 2 h per week Frequency: 4 times per month Length: 4 months Dropout: 0 (0%) |
Mode: Pre-intervention baseline characteristics of the participants Dropout: 0 (0%) |
| Organizational improved learning environment interventions (2 studies) | ||||||
|
Bisgaard (2021), United States (22-item MBI) |
EE: 23.5 (11.2) DP: 9.6 (4.4) PA: 32.8 (6.4) |
EE: 23.5 (11.2) DP: 9.6 (4.4) PA: 32.8 (6.4) |
59/59 (General surgery) | Historical-control |
Mode: Healthy snacks delivery Duration: NA Frequency: 4 times per month Length: 24 months Dropout: 32 (54%) |
Mode: Pre-intervention, previous academic year Dropout: 28 (47%) |
|
Ogunyemi (2021), United States (22-item MBI) |
EE: 28.1 (10.6) DP: 12.5 (6.6) PA: 38.5 (6.3) |
EE: 28.1 (10.6) DP: 12.5 (6.6) PA: 38.5 (6.3) |
130/130 (Mixed) | Historical-control |
Mode: Learning environment and workflow streamlining Duration: NA Frequency: NA Length: 24 months Dropout: 9 (7%) |
Mode: Pre-intervention, previous academic year Dropout: 0 (0%) |