Table 3 General characteristics of the included studies
Study ID | Participants | Intervention | Comparator | Outcome | Time frame measurement | Notes |
|---|---|---|---|---|---|---|
Warneck et al. (2011) [46] Australia | Medical students in the final 2 years of their degree course Location: distributed across three clinical schools attached to the University of Tasmania, Hobart, Tasmania, Australia Number of students randomized = 65 Intervention group = 31 Control group = 34 | 8-week mindfulness-based intervention program (adapted from Kabat-Zinn, 1982), 28 h of practice In addition: - 30 min audio, CD of guided mindfulness practice, followed independently every day - Adherence diary - No face-to-face meetings nor interaction between the instructors and students | The mindfulness intervention CD after the 8-week trial period as an incentive to remain in the trial | - Perception of stress: PSS - Depression, Anxiety and Stress: DASS | T1: before intervention T2: following the intervention (8 weeks) T3: 16 weeks (4 months) following the intervention | Funding source: the Australian and New Zealand Association for Health Professional Educators (ANZAHPE) Declarations of interest: no conflicts |
Erogul, et al. (2014) [47] USA | First-year class of students Location: SUNY Downstate School of Medicine in Brooklyn, New York, USA Number of students randomized = 57 Intervention group = 28 Control group = 29 | 8-week mindfulness-based intervention program Group (adapted from Kabat-Zinn, 1982), 10 h of practice In addition: - Between the 7th and 8th weekly meeting, full-day retreat - Home practice: individual sessions of daily meditation for 20 min for the 8-week intervention | The control group did not receive any intervention during the 8-week study period | - Perceived stress: PSS - Resilience: RS | T1: before the intervention T2: after the intervention T3: 6 months after the intervention | Funding source: Arnold P. Gold Foundation Declarations of interest: none reported |
Phang et al. (2015) [48] Malaysia | Medical students in year 1 to 3 of studies in Universiti Putra Malaysia (UPM), Malaysia Number of students randomized = 75 Intervention group = 37 Control group = 38 | “Mindful-Gym”: 5-week mindfulness-based intervention program Group (adapted from Kabat-Zinn, 1982), 10 h of practice In addition: - Shorter in duration with more emphasis on informal practice, includes sessions on gratitude and cultivation of loving-kindness, and contains instructions tailored for medical students - Home practice: daily self-help exercises audio-guided instructions on a CD | They were informed that they would receive the program in a DVD 6 months later (after the follow-up period) | - Level of awareness and mindful attention: MAAS - Perceived stress: PSS - Mental distress: GHQ | T1: 1 week before intervention T2: 1 week after the interventions T3: 6 months after the interventions | Funding source: The Department of Psychiatry, Faculty of Medicine & Health Sciences, UPM, and a research grant from UPM Declarations of interest: none reported |
van Dijk et al. (2017) [49] | Medical students in first-year clinical neurology clerkship, in Radboudumc University in Nijmegen, Netherlands Number of students randomized = 167 Intervention group = 83 Control group = 84 | 8-week mindfulness-based intervention program Group (adapted from Kabat-Zinn, 1982), 16 h of practice In addition: - Addition of 10 min of interactive presentation each week related to the session - No silent retreat - Adaptation of the folder material for use in clinical clerkship students instead of patients - Home practice: online questionnaire that asked how much time, on average, they had spent each week on home practice | Clinical clerkships as usual in first-year clinical clerkship students | - Psychological distress: BSI - Positive mental health: MHC-SF - Physician empathy: JSPE - Mindfulness skills: FFMQ | T1: before intervention T2: 3 months after T1 T3: 7 months after T1 T4: 12 months afterT1 T5: 15 months after T1 T6: 20 months after T1 | Funding source: The Department of Psychiatry and Department of Primary and Community Care of the Radboudumc and by a grant of the Department of Evaluation, Quality and Development of Education of the Radboudumc Declarations of interest: none reported |
Yang et al. (2018) [50] USA | Medical students at Keck School of Medicine at the University of Southern California (USC), USA Number of students randomized = 88 Intervention group = 45 Control group = 43 | 4-week mindfulness-based intervention program (adapted from Kabat-Zinn, 1982), 7.08 h of practice In addition: - Smartphone application "Headspace", an audio-guided mindfulness meditation program, structured such that each session lasts 10 min for the first ten days, 15 min for the next 15 days, and 20 min for all subsequent sessions - No face-to-face meetings nor interaction between the instructors and students | Waiting list | - Stress: PSS - Mindfulness: FFMQ - Well-being: GWBS | T1: before intervention T2: 30-day (1 month) time point T3: 60-day (2 months) time point | Funding source: none reported Declarations of interest: none reported |
Damião Neto et al. (2020) [51] Brazil | First-year incoming medical students at the School of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora – Minas Gerais – Brazil Number of students randomized = 141 Intervention group = 70 Control group = 71 | 6-week mindfulness-based intervention program Group (adapted from Kabat-Zinn, 1982), 12 h of practice In addition: - Students stayed in a conventional classroom with school chairs - Home practice: four audios in MP3 format via email for guided home practice and practice daily for at least 10 min and bring a meditation diary including information of how many days students had practiced at home | The control group was given theoretical content in which they were shown organizational aspects of medical school | - Depression, Anxiety, and Stress: Depression, Anxiety, and Stress Scale (DASS) - Quality of Life: WHOQOL-BREF - Mindfulness: FFMQ-BR | T1: before intervention T2: after intervention | Funding source: none reported Declarations of interest: no conflict of interest |
Astin (1997) [52] USA | Undergraduate students in an upper-division Behavioral Medicine class Location: University of California, Irvine, USA Number of students randomized = 28 Intervention group = 14 Control group = 14 | 8-week mindfulness-based intervention program group (adapted from Kabat-Zinn, 1982), 16 h of practice In addition: - No all-day meeting - Home practice (cassette tapes) for 45 min/ day, 5 days/ week | Waiting list | - Psychological distress: Hopkins SC-90-R and subscales | T1: before intervention T2: following the intervention (8-weeks) T3: 6–9 months following the intervention | Funding source: none reported Declarations of interest: none reported |
Shapiro et al. (1998) [53] USA | Premedical and medical students Inclusion criteria: students willing to be randomly assigned to either the intervention Location: The University of Arizona College of Medicine – Tucson, USA Number of students randomized = 73 Intervention group = 36 Control group = 37 | 7-week mindfulness-based intervention program group (adapted from Kabat-Zinn, 1982), 17.5 h of practice In addition: a “loving-kindness” and a “forgiveness” meditation were introduced and a weekly home practice assignments as well as daily journals | waiting list | - Empathy: ECRS - Psychological distress: SCL-90-R - Depression:subscale 4 of the SCL-90 - State and trait Anxiety: STAI Form Y | T1: before intervention T2: following the intervention (7 weeks) | Funding source: none reported Declarations of interest: none reported |