This new review sought to assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions distinct from medical care (e.g. psychology, physical therapy or social work students).
The review authors included 30 randomised controlled trials (RCTs); 24 of which were conducted in high-income countries. Participants were mainly women aged between, on average, 19.35 to 38.14 years.
The included studies were mainly conducted in a university or school setting, including nursing/midwifery students or medical students (15/30 studies). Twenty-two studies focused solely on healthcare students (total of 1315 participants, not specified in two studies). Eight studies investigated mixed samples (1365 participants) of healthcare and non-healthcare students.
About half of the studies investigated group interventions (17 studies) of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The overall risk of bias was high with main flaws in performance, detection, attrition and reporting bias.
The included studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources (four studies). Seven studies did not specify a potential funder, three studies received no funding support.
The review authors found evidence that, compared to control, resilience training may increase resilience (9 studies, n = 561), and lower levels of anxiety (7 studies, n = 362) and stress or stress perception (7 studies, n = 420) at post-intervention. They found little to no evidence of any effect of resilience training on depression (6 studies, n = 332), and well-being or quality of life (4 studies, n = 251) at post-intervention, compared to control. All very-low certainty evidence.
Four studies measured adverse effects but only three reported data; none reported adverse effects (very-low certainty evidence).
The authors concluded that there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience and lower levels of anxiety and stress or stress perception, but that it may have little to no effect on depressive symptoms and well-being at post-intervention. The uncertainty of the evidence means that future research could change the findings. More research of greater methodological quality is needed.
The evidence is current to June 2019.
Read the full review here on the Cochrane Library.