Mindfulness-Based Interventions as a Tool to Combat Resident Physician Burnout: A Systematic Review
Poster #: 018
Session/Time: A
Author:
Julianne Ghiorzi, BS
Mentor:
Rehan Qayyum, MD, MHS, SFHM, FAHA
Research Type: Educational
Abstract
INTRODUCTION:
Burnout among physicians is a pervasive and growing concern, with implications for clinician well-being, patient care, and healthcare system performance. Resident physicians may be particularly vulnerable due to unique stressors encountered during training, including relocation, extended work hours, escalating clinical responsibilities, and the administrative burden of documentation. In response, residency programs have increasingly implemented mindfulness-based interventions (MBIs) as a strategy to mitigate burnout and promote resilience. While prior studies suggest potential benefits of MBIs, the evidence specific to resident populations remains fragmented. This systematic review synthesizes published literature between July 2016 and September 2024 to evaluate the effectiveness of MBIs in reducing burnout among resident physicians.
METHODS:
A systematic review was conducted in accordance with updated PRISMA guidelines. Comprehensive searches of three electronic databases (PubMed, Embase, and Web of Science) were performed using the terms: ("resident" OR "residency" OR "intern") AND "burnout." The search yielded 12,550 records. References were imported into Covidence for screening and duplicate removal. Eligible studies met the following criteria: (1) published in English; (2) original research (excluding reviews, commentaries, or abstracts); (3) incorporated MBI; and (4) reported burnout outcomes. Two independent reviewers screened titles/abstracts, conducted full-text reviews, extracted data, and assessed the risk of bias, with a third reviewer resolving disagreements at all stages. Where appropriate, results were synthesized quantitatively using inverse variance-weighted random-effects models. The certainty of evidence across studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
RESULTS:
We identified 19 eligible studies, comprising 11 randomized controlled trials and 8 observational pre-post designs. A range of MBIs were evaluated, including meditation, journaling, silent retreats, relaxation techniques, and breathing exercises, delivered in both virtual and in-person formats. Across 13 studies, MBIs were associated with significant reductions in emotional exhaustion (pooled mean difference [PMD] = -0.61; 95%CI: -0.72 to -0.50; p<0.001) and in depersonalization (12 studies; PMD= -0.55; 95%CI: -0.65 to -0.44; p<0.001). Eleven studies reported a modest but significant improvement in personal accomplishment (PMD= 0.12; 95%CI: 0.01 to 0.22; p=0.02). In contrast, eight studies that assessed overall burnout demonstrated no significant effect of MBIs (PMD= -0.15; 95%CI: -0.32 to 0.02; p=0.08). Substantial heterogeneity was observed among studies reporting emotional exhaustion (I²=88%), depersonalization (I²=95%), and personal accomplishment (I²=80%), whereas studies reporting overall burnout showed low heterogeneity (I²=19%). Visual inspection of funnel plots suggested potential publication bias for emotional exhaustion, depersonalization, and personal accomplishment outcomes. Based on GRADE, the certainty of evidence was rated as moderate for reductions in emotional exhaustion and depersonalization, low for improvement in personal accomplishment due to inconsistency and possible publication bias, and low for overall burnout given the null effect and imprecision.
CONCLUSION:
MBIs are associated with meaningful reductions in emotional exhaustion and depersonalization and modest improvements in personal accomplishment among resident physicians, although effects on overall burnout appear limited. These findings suggest that MBIs may be a valuable, though not comprehensive, strategy to address specific components of resident burnout, underscoring the need for larger, rigorously designed trials to clarify their role.
Burnout among physicians is a pervasive and growing concern, with implications for clinician well-being, patient care, and healthcare system performance. Resident physicians may be particularly vulnerable due to unique stressors encountered during training, including relocation, extended work hours, escalating clinical responsibilities, and the administrative burden of documentation. In response, residency programs have increasingly implemented mindfulness-based interventions (MBIs) as a strategy to mitigate burnout and promote resilience. While prior studies suggest potential benefits of MBIs, the evidence specific to resident populations remains fragmented. This systematic review synthesizes published literature between July 2016 and September 2024 to evaluate the effectiveness of MBIs in reducing burnout among resident physicians.
METHODS:
A systematic review was conducted in accordance with updated PRISMA guidelines. Comprehensive searches of three electronic databases (PubMed, Embase, and Web of Science) were performed using the terms: ("resident" OR "residency" OR "intern") AND "burnout." The search yielded 12,550 records. References were imported into Covidence for screening and duplicate removal. Eligible studies met the following criteria: (1) published in English; (2) original research (excluding reviews, commentaries, or abstracts); (3) incorporated MBI; and (4) reported burnout outcomes. Two independent reviewers screened titles/abstracts, conducted full-text reviews, extracted data, and assessed the risk of bias, with a third reviewer resolving disagreements at all stages. Where appropriate, results were synthesized quantitatively using inverse variance-weighted random-effects models. The certainty of evidence across studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
RESULTS:
We identified 19 eligible studies, comprising 11 randomized controlled trials and 8 observational pre-post designs. A range of MBIs were evaluated, including meditation, journaling, silent retreats, relaxation techniques, and breathing exercises, delivered in both virtual and in-person formats. Across 13 studies, MBIs were associated with significant reductions in emotional exhaustion (pooled mean difference [PMD] = -0.61; 95%CI: -0.72 to -0.50; p<0.001) and in depersonalization (12 studies; PMD= -0.55; 95%CI: -0.65 to -0.44; p<0.001). Eleven studies reported a modest but significant improvement in personal accomplishment (PMD= 0.12; 95%CI: 0.01 to 0.22; p=0.02). In contrast, eight studies that assessed overall burnout demonstrated no significant effect of MBIs (PMD= -0.15; 95%CI: -0.32 to 0.02; p=0.08). Substantial heterogeneity was observed among studies reporting emotional exhaustion (I²=88%), depersonalization (I²=95%), and personal accomplishment (I²=80%), whereas studies reporting overall burnout showed low heterogeneity (I²=19%). Visual inspection of funnel plots suggested potential publication bias for emotional exhaustion, depersonalization, and personal accomplishment outcomes. Based on GRADE, the certainty of evidence was rated as moderate for reductions in emotional exhaustion and depersonalization, low for improvement in personal accomplishment due to inconsistency and possible publication bias, and low for overall burnout given the null effect and imprecision.
CONCLUSION:
MBIs are associated with meaningful reductions in emotional exhaustion and depersonalization and modest improvements in personal accomplishment among resident physicians, although effects on overall burnout appear limited. These findings suggest that MBIs may be a valuable, though not comprehensive, strategy to address specific components of resident burnout, underscoring the need for larger, rigorously designed trials to clarify their role.