Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis.
Claudia Cardoso Gomes Da Silva, Cláudia Vicari Bolognani, Fábio Ferreira Amorim, Aline Mizusaki Imoto
Systematic Reviews May 5, 2023 DOI: 10.1186/s13643-023-02244-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 8 |
| Population | Medical students |
| Intervention | mindfulness-based training programs |
| Topics | Meditation |
| Keywords | Medical education Mental health Meta-analysis Mindfulness-based stress reduction Psychological health Stress management Systematic review Undergraduate medical students |
| Citations | 77 |
| Key findings | Mindfulness-based training improved mindfulness and reduced stress in medical students, with delayed benefits for psychological well-being, though heterogeneity and variable evidence quality limit certainty. |
Abstract
Medical schools have used mindfulness meditation as a strategy to assist students in stress management. This study aimed to seek evidence regarding the effectiveness of mindfulness-based training programs in reducing psychological distress and promoting the well-being of medical students. We conducted a systematic review and meta-analysis. Cochrane Library, Embase, PubMed/MEDLINE, PsycINFO/PsycNet, LILACS/BVS, ERIC (ProQuest), Web of Science, OpenGrey, and Google Scholar were searched for randomized clinical trials published until March 2022, without time or language restrictions. Two authors independently screened the articles, extracted data using a standardized extraction form, and assessed the methodological quality of the included studies using the Cochrane's Risk of Bias 2 (ROB 2) tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Of the 848 articles retrieved, 8 met the inclusion criteria. Mindfulness-based training improved the outcomes: mindfulness (small post-intervention effect: SMD = 0.29; 95% CI: 0.03 to 0.54; p = 0.03; I2 = 46%; high evidence quality, and small effect at follow-up: SMD = 0.37; 95% CI: 0.04 to 0.70; p = 0.03; I2 = 53%; low evidence quality), psychological well-being/health (there was no statistically significant difference between the groups in the post-intervention effect: SMD = - 0.27; 95% CI: - 0.67 to 0.13; p = 0.18; I2 = 76%; moderate evidence quality, and a significant difference at follow-up: SMD = - 0.73; 95% CI: - 1.23 to - 0.23; p = 0.004; I2 = 61%; low evidence quality), and stress (small post-intervention effect: SMD = - 0.29; CI of 95%: - 0.56 to - 0.02; p = 0.04; I2 = 57%; moderate evidence quality, and moderate effect at follow-up: SMD = - 0.45, 95% CI: - 0.67 to - 0.22, p = 0.0001, I2 = 0%, moderate evidence quality). The quality of evidence for the anxiety, depression, and resilience outcomes is low and for the empathy outcome, very low. The results indicate that the students who participated in the mindfulness training perceived improvements in the stress and psychological distress symptoms and improved health perception and psychological well-being. However, the significant heterogeneity among studies should be considered when interpreting these findings. PROSPERO CRD42020153169.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 18
- Effectiveness of Mindfulness-Based Stress Reduction on Mental Health and Psychological Quality of Life among University Students: A GRADE-Assessed Systematic Review. Evidence-based Complementary and Alternative Medicine 2024
- The Western Australian medical schools mindfulness project: a randomised controlled trial. BMC Medical Education October 22, 2024
- Breath-Body-Mind Core Techniques to Manage Medical Student Stress. Journal of medical education and curricular development 2023
- Developing a mindfulness program for pre-clinical medical students in Indonesia: a mixed-methods study on suitability and appropriateness. BMC Medical Education July 17, 2025
- Online mindfulness-based vs. cognitive-behavioural stress reduction for medical students: A randomized controlled trial. Psychiatry Research July 11, 2025
and 13 more in the library
Cites 16
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Stress Reduction through Mindfulness Meditation Psychotherapy and Psychosomatics February 18, 2010
- A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial The Lancet Public Health December 18, 2017
- Mindfulness interventions in medical education: A systematic review of their impact on medical student stress, depression, fatigue and burnout Medical Teacher November 7, 2017
- Teaching mindfulness in medical school: where are we now and where are we going? Medical Education July 10, 2013
and 11 more in the library