Chesak 2015.

Study characteristics
Methods	Study design: RCT Study grouping: parallel group Unit of randomisation: individuals Power (power sample size calculation, level of power achieved): not specified Imputation of missing data: no imputation of missing data; per‐protocol analysis with participants who complied with allocated intervention and for whom outcomes were obtained
Participants	Country: USA Setting: nurse orientation programme at Mayo Clinic Age: mean = 28.16 (SD = 8.29) years Sample size (randomised): 55 Sex: 38 women, 2 men (in analysed sample) Comorbidity (mean (SD) of respective measures in indicated, if available) at baseline: anxiety GAD‐7: IG = 3.11 (2.76), CG = 4.25 (2.77) Population description: nurses who were new to the institution or transitioning to a new unit or new role and who were undergoing new‐nurse orientation Inclusion criteria: 1) registered nurses (RN) who were enrolled in 1 of 2 designated nurse orientation classes; 2) RNs who were willing and able to participate in all aspects of the study; 3) RNs who were provided with, understood, and signed the informed consent Exclusion criteria: 1) if they reported currently or recently (within the past 6 months) experiencing a psychotic episode; 2) if they reported a clinically significant acute psychiatric event, or a physical illness Attrition (withdrawals and exclusions): 4 withdrawals before the intervention (IG = 2, CG = 2); total number of withdrawals: n = 15 (IG = 8/27 (29.6%), CG = 7/28 (25%)); i.e. 40 completed the study (IG = 19, CG = 21) Reasons for missing data: 4 withdrawals before the intervention: declined to participate in allocated group prior to first group session; not exactly specified for further withdrawals (nurse participants who voluntarily dropped out of the study: inability to make time for the programme)
Interventions	Intervention: Stress Management and Resiliency Training (SMART) (n = 27) delivery: face‐to‐face session; handouts on each of the topics via email providers: study investigator; not further specified duration of treatment period and timing: single 90‐minute session; 1‐hour follow‐up session after 4 weeks; bi‐weekly handouts description: presentation of a model of stress and resilience, integrating neuroscience and biology (during single session) based on this model, mind‐body approaches to managing stress were discussed, including developing intentional attention and practising gratitude, compassion, acceptance, forgiveness, and higher meaning compliance: n = 27 randomised; n = 2 declined to participate in intervention (after randomisation); All 25 participants in the intervention group participated in the first group session. Only 4 participants were present at the follow‐up session for the intervention group, mainly because of scheduling issues integrity of delivery: not specified economic information: not specified theoretical basis: SMART programme developed at Mayo Clinic by a physician in the Division of Complementary and Integrative Medicine who has extensive experience in the field of resiliency training; the programme is designed to help participants understand the neuroscience and biology of stress. From that understanding, participants learn skills to develop intentional attention and reframe life experiences using the 5 core principles of gratitude, compassion, acceptance, forgiveness, and higher meaning. economic information: not specified Control: active control (n = 28) delivery: lecture providers: not specified duration of treatment period and timing (frequency, duration of each session): not specified description: lecture associated with the nursing orientation programme that covered topics related to stress, including reality shock and work‐life connectedness compliance: n = 28 randomised; n = 2 declined to participate in control (after randomisation), 26 took part in the control group integrity of delivery: not specified economic information: not specified theoretical basis: not specified
Outcomes	Outcomes collected and reported: Primary outcome perceived stress ‐ Perceived Stress Scale mindfulness ‐ Mindful Attention Awareness Scale anxiety ‐ GAD‐7 resilience ‐ Connor‐Davidson Resilience Scale Time points measured and reported: 1) pre‐intervention; 2) 3‐month follow‐up (3 months after single‐session intervention) Adverse events: not specified
Notes	Contact with authors: no correspondence required Study start/end date: not specified Funding source: not specified Declaration of interest: Dr Sood has a proprietary interest in a company that teaches resiliency programmes. The other authors have no financial or proprietary interest in the subject matter of this article. Ethical approval needed/obtained for study: IRB‐approved trial Comments by authors: not specified Miscellaneous outcomes by the review authors: not relevant Correspondence: Sherry S. Chesak, PhD, Department of Nursing, Mayo Clinic, 200 First St. SW Rochester, Minnesota 55905Tel: (507) 255‐3236; chesak.sherry@mayo.edu
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Participants were randomized into either the intervention or control group through the use of a random number generator." Judgement comment: The investigators describe a random component in the sequence generation process (random‐number generator); no information about comparability of groups at baseline or respective analysis (statistical (non)significance of differences in demographic variables unclear; baseline comparability for outcome variables not specified
Allocation concealment (selection bias)	Unclear risk	Judgement comment: insufficient information about allocation concealment to permit 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 (online questionnaires); however, 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	High risk	Quote: "55 consented and were randomized ‐ 27 into the intervention arm and 28 into the control arm. Prior to the first group session, 2 participants from each group declined to participate." Quote: "Analysis was restricted to participants who completed the study, including all follow‐up assessments." Quote: "Forty subjects (19 intervention, 21 control) completed the baseline and follow‐up assessments. Some subjects did not complete all scales at both time points. Data are presented only for those who completed the given scale at both baseline and follow‐up." Judgement comment: reasons for missing data unlikely to be related to true outcome with relative balance in missing data between groups (IG: n = 8, CG: n = 7); no reasons for missing data stated for each group; per‐protocol analysis with participants who complied with allocated intervention and for whom outcomes were obtained
Selective reporting (reporting bias)	Low risk	Judgement comment: no study protocol available, but it is clear that the published report includes all expected outcomes, including those that were prespecified