Peng 2014.

Study characteristics
Methods	Study design: RCT Study grouping: parallel group Unit of randomisation: individualsPower (power & sample size calculation, level of power achieved): not specifiedImputation of missing data: not specified
Participants	Country: ChinaSetting: medical students of Third Military Medical University; training setting not specifiedAge: mean = 19.78 (SD = 0.77); range = 18 ‐ 22 yearsSample size (randomised): 60; 30 divided into high‐resilience group (SD above average score of CD‐RISC (CD‐RISC)); n = 30, divided into low‐resilience group (SD below average score of CD‐RISC)Sex: 18 women, 42 menComorbidity (mean (SD) of respective measures in indicated, if available) at baseline: not specifiedPopulation description: medical students Inclusion criteria: not specified Exclusion criteria: not specified Attrition (withdrawals and exclusions): not specified Reasons for missing data: not specified
Interventions	Intervention: Penn Resilience Program (PRP) (in total: n = 30; n = 15 of high‐resilience group, n = 15 of low‐resilience group) delivery: face‐to‐face group setting; emphasised discussion and experiences sharing among the participants; includes theme games, role‐playing, case analysis, brainstorming, and other activities to enable students to increase their participation in the training providers: group leaders (not further specified) duration of treatment period and timing: 10 weekly 90‐ to 120‐minute sessions description: based on the PRP course contents and the characteristics of the medical students consists of following steps: connecting thoughts and emotions, challenging irrational thinking and beliefs, cognitive training, a review of lessons 1 – 3, self‐confidence and interpersonal contact, coping strategies, behaviour modification exercises, a review of lessons 5 – 7, problem‐solving exercises, and a review of the entire PRP curriculum LESSON 1: thoughts and emotion connection; content: group leaders and members get to know each other; course contents all around Ellis’s ABC (Activating event, Belief, Consequence) theory are also introduced; students need to recount recent difficult experiences in a sequential manner, and to recall their thoughts and their feelings LESSON 2: challenging irrational thoughts and beliefs; content: identify involuntary negative thoughts, and recognise these ideas often appear correct; learn to analyse cases from a positive view LESSON 3: cognitive training; content: learn how to deal with negative events and think flexibly to prevent catastrophising; the members ascertain the worst‐case scenario, the best‐case scenario, the probable scenarios, respectively by analysing the events; the members describe accidents and frustrations that occur in their daily life, and discuss feasible solutions to these events LESSON 4: review lessons 1 – 3; content: review the knowledge and cognition skills in lessons 1 – 3; the trainer provided additional cases to the members to complete the exercises LESSON 5: interpersonal communication; content: the members present 3 common types of social communication patterns (impulsive, passive and confident) through role‐play; the members develop interpersonal communication skills by improving confidence LESSON 6: coping strategy; content: learn stress‐coping methods (e.g. deep breathing and muscle relaxation), practise positive meditation through organising positive and optimistic images LESSON 7: behaviour modification exercises; content: adjust their maladaptive behaviour and recognise all‐or‐nothing thinking; learn to divide complex tasks into several more controllable sections and finish the entire mission step by step LESSON 8: review lessons 5 – 7; content: review the relaxation and social skills to solve problems in daily life LESSON 9: problem‐solving exercises; content: discuss and analyse events in their daily lives; problem‐solving exercises are repeatedly made to consolidate skills and knowledge LESSON 10: review entire course; content: summarise PRP training course; end the course with a party compliance: not specified integrity of delivery: not specified economic information: not specified theoretical basis: based on the PRP course contents and the characteristics of the medical students PRP designed by Seligman and colleagues in Pennsylvania University in 1999 based on cognitive behavioural theory, which focuses on improving students’ cognitive behaviour and skills (Kumpfer 1999) Control: wait‐list control (in total: n = 30; 15 of high‐resilience group, 15 of low‐resilience group)
Outcomes	Outcomes collected and reported: resilience ‐ CD‐RISC positive emotion ‐ PANAS negative emotion ‐ PANAS emotion regulation, cognitive appraisal ‐ ERS emotion regulation, expression inhibition ‐ ERS Time points measured and reported: 1) pre‐intervention; 2) post‐intervention Adverse events: not specified
Notes	Contact with authors: We contacted the authors for the second full text, but received no response to 2 inquiries. Study start/end date: not specifiedFunding source: This study was financially supported by National Natural Science Foundation of China Granted to Min Li (No. 31170994) and Project of Military Research Foundation of PLA of China to Min Li (Grants 12XLZ212 and CWS11J049).Declaration of interest: not specifiedEthical approval needed/obtained for study: approved by the Ethics Committee of the Third Military Medical UniversityComments by study authors: not relevantMiscellaneous outcomes by the review authors: 2 reports; full text for 2. report not availableCorrespondence: Li Peng; corresponding author: Min Li; Department of Military Psychology, School of Psychology, The Third Military Medical University, No. 30, Gaotanyan Road, Shapingba District, Chongqing 400038, China, Tel.: +86 23 68752267; fax: +86 23 68752360; limin52267@tmmu.edu.cn (M. Li)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "the students were divided into high‐resilience and low‐resilience groups, with each group consisting of 30 students. Half of the students from each group were then divided into the experimental group and received PRP training. The remaining students were divided into the control group and were told to wait for resilience training." Quote: "From them, 30 students with high resilience and 30 with low resilience were obtained. These students were further randomly assigned into experimental group to receive resilience training (n = 15), and control group without training (n = 15)." Quote: "No significant differences in resilience, positive emotion, negative emotion, cognitive appraisal, and expression inhibition scores were found between the control and experimental groups (P > .05) (see Table 2)." Judgement comment: insufficient information about random‐sequence generation to permit judgement of ‘Low risk’ or ‘High risk’; verified baseline comparability of groups for outcome variables on the basis of analysis (see Table 2; all Ps > 0.28 in high‐resilience participants or all Ps > 0.30 in low‐resilience individuals), baseline comparability for sociodemographic characteristics (e.g. age, gender) not specified
Allocation concealment (selection bias)	Unclear risk	Judgement comment: insufficient information about allocation concealment to permit a judgement of low risk or high risk
Blinding of participants and personnel (performance bias) Subjective outcomes	High risk	Judgement comment: blinding of participants and personnel probably not done (face‐to‐face intervention) and the outcome is likely to be influenced by lack of blinding
Blinding of outcome assessment (detection bias) Subjective outcomes	High risk	Judgement comment: insufficient information about blinding of outcome assessment; but due to potential performance bias (no blinding of participants), the review authors judge that the participants' responses to questionnaires may be affected by the lack of blinding (i.e. knowledge and beliefs about intervention they received)
Incomplete outcome data (attrition bias) All outcomes	Low risk	Judgement: insufficient reporting of attrition/exclusions to permit judgement of 'Low risk' or 'High risk' (probably 30 randomised in each group were also analysed; but unclear if there were any missing data and if missing data were imputed)
Selective reporting (reporting bias)	Low risk	Judgement comment: no study protocol or trial registration available but it is clear that the published reports include all expected outcomes, including those that were prespecified