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Table 17 Summary of evidence for this systematic review

From: Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis

Outcomes

Assessment time

Study

Effect

Studies (participants)

Certainty of evidence

Mean score for control groups

Effect estimation

Mindfulness

At the end of the intervention

Phang et al. (2015) [48]

van Dijk et al. (2017) [49]

Yang et al. (2018) [50]

Damião Neto et al. (2020) [51]

-a

The mean scores for intervention groups were significantly higher than the mean scores for control groups (SMD: 0.29, 95% CI: 0.03 to 0.54)

4 (462)

High

6-month to 1-year follow-up

Phang et al. (2015) [48]

van Dijk et al. (2017) [49]

Yang et al. (2018) [50]

-a

The mean scores for intervention groups were significantly higher than the mean scores for control groups (SMD: 0.37, 95% CI: 0.04 to 0.7)

3 (321)

Low b,i

Well-being/Psychological Health

At the end of the intervention

Erogul et al. (2014) [47]

van Dijk et al. (2017) [49]

Yang et al. (2018) [50]

Damião Neto et al. (2020) [51]

-a

The mean scores for intervention groups showed no significant difference compared to the mean scores for control groups

(SMD: − 0.27, 95% CI: − 0.67 to 0.13)

4 (446)

Moderatec

6-month to 1-year follow-up

Erogul et al. (2014) [47]

van Dijk et al. (2017) [49]

-a

The mean scores for intervention groups were significantly lower than the mean scores for control groups (SMD: − 0.73, 95% CI: − 1.23 to − 0.23)

2 (224)

Lowd,i

Stress

At the end of the intervention

Erogul et al. (2014) [47]

Phang et al. (2015) [48]

van Dijk et al. (2017) [49]

Yang et al. (2018) [50]

Damião Neto et al. (2020) [51]

-a

The mean scores for intervention groups were significantly lower than the mean scores for control groups (SMD: − 0.29, 95% CI: − 0.56 to − 0.02)

5 (520)

Moderatee

6-month to 1-year follow-up

Erogul et al. (2014) [47]

Phang et al. (2015) [48]

van Dijk et al. (2017) [49]

-a

The mean scores for intervention groups were significantly lower than the mean scores for control groups (SMD: − 0.45, 95% CI: − 0.67 to − 0.22)

3 (290)

Moderatei

Anxietyf

At the end of the intervention

Damião Neto et al. (2020) [51]

Warnecke et al. (2011) [46] g

Astin (1997) [52] g

Shapiro et al. (1998) [53] g

The mean score in control group was 3.57 ± 3.45 h

The estimated mean difference between the two groups (MD: − 0.17, 95% CI: − 1.32 to 0.98) h

4 (307)

Low i, j

Depressionf

At the end of the intervention

Damião Neto et al. (2020) [51]

Warnecke et al. (2011) [46] g

Astin (1997) [52] g

Shapiro et al. (1998) [53] g

The mean score in control group was 3.97 ± 3.28 h

The estimated mean difference between the two groups (MD: 0.06, 95% CI: − 1.04 to 1.16) h

4 (307)

Low i, j

Empathy

At the end of the intervention

van Dijk et al. (2017) [49]

Shapiro (1998) [53] g

The mean score in control group was 108.4 ± 10.0 k

The estimated mean difference between the two groups (MD: − 3.5, 95% CI: − 6.51 to − 0.49) k

2 (240)

Very low i, l

6-month to 1-year follow-up

van Dijk et al. (2017) [49]

The mean score in control group was 109.8 ± 8.6

The mean score for the intervention group showed no significant difference compared to the mean score for the control group (MD: − 1.10, 95% CI: − 4.20 to 2.00)

1 (167)

Low i, m

Resilience

At the end of the intervention

Erogul et al. (2014) [47]

The mean score in control group was 77.1 ± 14.1

The mean score for the intervention group showed no significant difference compared to the mean score for the control group (MD: − 3.40, 95% CI: − 9.91 to 3.11)

1 (57)

Low i, m

6-month to 1-year follow-up

Erogul et al. (2014) [47]

The mean score in control group was 77.3 ± 12.5

The mean score for the intervention group was significantly higher than the mean score for the control group (MD: − 5.10, 95% CI: − 11.08 to 0.88)

1 (57)

Low i, m

  1. 95% CI 95% confidence interval, MD mean difference, SMD standardized mean difference
  2. a The outcome was measured on a variety of scales
  3. bI2: 53%—Substantial heterogeneity among trials (I2 equal or more than 50%, equal or less than 90%). Therefore, the certainty of the evidence was downgraded by one level (inconsistency)
  4. cI2: 76%—Substantial heterogeneity among trials (I2 equal or more than 50%, equal or less than 90%). Therefore, the certainty of the evidence was downgraded by one level (inconsistency)
  5. dI2: 61%—Substantial heterogeneity among trials (I2 equal or more than 50%, equal or less than 90%). Therefore, the certainty of the evidence was downgraded by one level (inconsistency)
  6. eI2: 57%—Substantial heterogeneity among trials (I2 equal or more than 50%, equal or less than 90%). Therefore, the certainty of the evidence was downgraded by one level (inconsistency)
  7. fThere was no analyzable data on the outcome from 6-month to 1-year follow-up
  8. gNot reported data (mean and standard deviation)
  9. hThe result is based on the Damião Neto et al. (2020) [51] that reported no significant difference. Warnecke et al. (2011) [46], Astin (1997) [52], and Shapiro et al. (1998) [53] reported improvement with intervention, but they did not show data (mean and standard deviation)
  10. iThe number of patients is less than 400 (< 400). Therefore, the certainty of the evidence was downgraded by one level (imprecision)
  11. jThere was a significant heterogeneity considering this study. The certainty of the evidence was downgraded by one level. (inconsistency)
  12. kThe result is based on van Dijk et al. (2017) [49] which reported no significant difference. Shapiro et al. (1998) [53] reported improvement with intervention, but they did not show data (mean and standard deviation)
  13. lThe result is based on just one study that showed data (mean and standard deviation). There was heterogeneity considering this study and another study that reported improvement with intervention but did not show data (mean and standard deviation. Therefore, the certainty of the evidence was downgraded by two levels (inconsistency)
  14. mThe confidence intervals cross the line of no effect, i.e., wide confidence intervals. Therefore, the certainty of the evidence was downgraded by one level (imprecision)