{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T09:40:29Z","timestamp":1794476429433,"version":"4.9.1"},"reference-count":68,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Stoneygate Trust","award":["Not Applicable."],"award-info":[{"award-number":["Not Applicable."]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,24]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To conduct an overview of systematic reviews that explore the effectiveness of interventions to enhance medical student well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Overview of systematic reviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>The Cochrane Library of Systematic Reviews, MEDLINE, APA PsychInfo, CINAHL and Scopus were searched from database inception until 31 May 2023 to identify systematic reviews of interventions to enhance medical student well-being. Ancestry searching and citation chasing were also conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>The Assessing the Methodological Quality of Systematic Reviews V.2 tool was used to appraise the quality of the included reviews. A narrative synthesis was conducted, and the evidence of effectiveness for each intervention was rated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>13 reviews (with 94 independent studies and 17\u2009616 students) were included. The reviews covered individual-level and curriculum-level interventions. Individual interventions included mindfulness (n=12), hypnosis (n=6), mental health programmes (n=7), yoga (n=4), cognitive and behavioural interventions (n=1), mind-sound technology (n=1), music-based interventions (n=1), omega-3 supplementation (n=1), electroacupuncture (n=1) and osteopathic manipulative treatment (n=1). The curriculum-level interventions included pass\/fail grading (n=4), problem-based curriculum (n=2) and multicomponent curriculum reform (n=2). Most interventions were not supported by sufficient evidence to establish effectiveness. Eleven reviews were rated as having \u2018critically low\u2019 quality, and two reviews were rated as having \u2018low\u2019 quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual-level interventions (mindfulness and mental health programmes) and curriculum-level interventions (pass\/fail grading) can improve medical student well-being. These conclusions should be tempered by the low quality of the evidence. Further high-quality research is required to explore additional effective interventions to enhance medical student well-being and the most efficient ways to implement and combine these for maximum benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082910","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T14:51:20Z","timestamp":1715266280000},"page":"e082910","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Interventions to promote medical student well-being: an overview of systematic 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New York: Basics and beyond Guilford Publication, 2011:19\u201320."},{"key":"2024050911501983000_14.5.e082910.55","doi-asserted-by":"crossref","first-page":"501","DOI":"10.4103\/0019-5359.102122","article-title":"Psychological well-being in medical students during exam stress-influence of short-term practice of mind sound technology","volume":"64","author":"Dayalan","year":"2010","journal-title":"Indian J Med Sci"},{"key":"2024050911501983000_14.5.e082910.56","first-page":"298","article-title":"Short communication study of stress, self-esteem and depression in medical students and effect of music on perceived stress","volume":"58","author":"Baste","year":"2014","journal-title":"Indian J Physiol Pharmacol"},{"key":"2024050911501983000_14.5.e082910.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2011.07.229"},{"key":"2024050911501983000_14.5.e082910.58","doi-asserted-by":"publisher","DOI":"10.1136\/acupmed-2013-010408"},{"key":"2024050911501983000_14.5.e082910.59","doi-asserted-by":"crossref","first-page":"84","DOI":"10.7556\/jaoa.2015.019","article-title":"Osteopathic manipulative treatment for self-reported fatigue, stress, and depression in first-year Osteopathic medical students","volume":"115","author":"Wiegand","year":"2015","journal-title":"J Osteop Med"},{"key":"2024050911501983000_14.5.e082910.60","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1097\/00001888-199410000-00031","article-title":"Does a problem-based learning curriculum affect depression in medical students","volume":"69","author":"Camp","year":"1994","journal-title":"Acad Med"},{"key":"2024050911501983000_14.5.e082910.61","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s40596-014-0197-5","article-title":"Efficacy of burnout interventions in the medical education pipeline","volume":"39","author":"Williams","year":"2015","journal-title":"Acad Psychiatry"},{"key":"2024050911501983000_14.5.e082910.62","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-043525","article-title":"Mindfulness-based programmes to reduce stress and enhance well-being at work: a realist review","volume":"11","author":"Micklitz","year":"2021","journal-title":"BMJ Open"},{"key":"2024050911501983000_14.5.e082910.63","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e31819f6d78"},{"key":"2024050911501983000_14.5.e082910.64","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e3182305d81"},{"key":"2024050911501983000_14.5.e082910.65","doi-asserted-by":"publisher","DOI":"10.4065\/81.11.1443"},{"key":"2024050911501983000_14.5.e082910.66","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1016\/S0140-6736(16)31279-X","article-title":"Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis","volume":"388","author":"West","year":"2016","journal-title":"The Lancet"},{"key":"2024050911501983000_14.5.e082910.67","doi-asserted-by":"crossref","DOI":"10.4103\/ijpvm.IJPVM_255_18","article-title":"Interventions for physician burnout: A systematic review of systematic reviews","volume":"9","author":"Kalani","year":"2018","journal-title":"Int J Prev Med"},{"key":"2024050911501983000_14.5.e082910.68","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/occmed\/kqs179","article-title":"Support for tomorrow\u2019s doctors: getting it right, meeting their needs","volume":"63","author":"Cohen","year":"2013","journal-title":"Occupat Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-082910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T14:51:42Z","timestamp":1715266302000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-082910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":68,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,9]]},"published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1136\/bmjopen-2023-082910"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-082910","relation":{"has-part":[{"id-type":"doi","id":"https:\/\/doi.org\/10.1136\/bmjopen-2023-082910.supp1","asserted-by":"subject"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}