Evaluation of a Yoga-Based Mind-Body Intervention for Resident Physicians: A Randomized Clinical Trial
Open accessAbstract
Background and Objective: Mind-body interventions (MBIs) have been shown to be effective individual-level interventions for mitigating physician burnout, but there are no controlled studies of yoga-based MBIs in resident physicians. We assessed the feasibility of a yoga-based MBI called RISE (resilience, integration, self-awareness, engagement) for residents among multiple specialties and academic medical centers. Methods: We conducted a waitlist controlled randomized clinical trial of the RISE program with residents from multiple specialty departments at three academic medical centers. The RISE program consisted of six weekly sessions with suggested home practice. Feasibility was assessed across six domains: demand, implementation, practicality, acceptability, adaptation, and integration. Self-reported measures of psychological health were collected at baseline, post-program, and two-month follow-up. Results: Among 2,000 residents contacted, 75 were assessed for eligibility and 56 were enrolled. Forty-four participants completed the study and were included in analysis. On average, participants attended two of six sessions. Feasibility of in-person attendance was rated as 28.9 (SD 25.6) on a 100-point visual analogue scale. Participants rated feasibility as 69.2 (SD 26.0) if the program was offered virtually. Those who received RISE reported improvements in mindfulness, stress, burnout, and physician well-being from baseline to post-program, which were sustained at two-month follow-up. Conclusion: This is the first controlled study of a yoga-based MBI in residents. While the program was not feasible as delivered in this pilot study, initial analyses showed improvement in multiple measures of psychological health. Residents reported that virtual delivery would increase feasibility.
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Outcome measurements were conducted using various versions of the validated Maslach Burnout Inventory (MBI): 26 studies used the 22-item MBI, 5 used the 9-item MBI, 1 used the 20-item Dutch version, and 1 used the 16-item MBI.
“Outcome measurements were conducted using various versions of the validated MBI. Specifically, 26 studies (78.7%) used the 22-item MBI [44, 45, 47–49, 51, 52, 54, 56, 58, 60–65, 67, 68, 70–76], 5 studies (15.2%) employed the 9-item MBI [50, 53, 55, 59, 69], 1 study (3.0%) used the 20-item Dutch version of the MBI [57], and 1 study (3.0%) utilized the 16-item MBI [66].”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [52]
The citation to this trial is attached to the claim that one study used a 16-item MBI. The Methods > Outcome Measures passage says this trial used a 2-item Maslach Burnout Inventory; the 16-item measure was the Professional Fulfillment Index. No page number is available in our copy. (LLM, conf=0.92)
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Experimental — accuracy not yet measuredEight studies (72.7%) were categorized as high risk of bias in the second or third domain due to naive per protocol analysis from complete cases at the end of the studies.
“Also, 8 studies [45, 51, 52, 57, 63, 64, 74], comprising 72.7% of the total, were categorized as high risk of bias in the second or third domain due to naive per protocol analysis from complete cases at the end of the studies.”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [52]
The Results > Participants section says the trial included only participants who completed baseline and at least one follow-up assessment, supporting the concern about analysis limited to participants with follow-up data. It does not say that participants had to be complete cases at the end of the study; some could qualify with only one follow-up. The high-risk-of-bias classification and the eight-study percentage are the citing authors’ assessment, not findings reported by this trial. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn the meditation intervention subgroup, emotional exhaustion (EE) was not significantly reduced: Cohen's d SMD -0.30 (95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%).
“In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [52]
In the meditation intervention subgroup, depersonalization (DP) was not significantly reduced: Cohen's d SMD -0.10 (95% CI -0.28 to 0.07, p = 0.25, I2 = 0%).
“In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [52]
In the meditation intervention subgroup, personal accomplishment (PA) was significantly improved: Cohen's d SMD 0.22 (95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).
“In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [52]
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Building a data-driven evaluation framework of physician wellness initiatives: a rapid review
Khairi, I., Kundurthi, S., Lo, B., Tajirian, T., Rodak, T., Sockalingam, S., & Wilkie, T. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-106432
- Authors
- Loewenthal, J., Dyer, N. L., Lipsyc-Sharf, M., Borden, S., Mehta, D. H., Dusek, J. A., & Khalsa, S. B. S.
- Affiliations
- Brigham and Women's Hospital (US)
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
- Corresponding author
- Loewenthal, Julia
- ORCID
- Venue
- Global Advances in Health and Medicine
- Publisher
- SAGE Publications
- Published
- 2021-01
- Volume
- 10
- Pages
- 21649561211001038-21649561211001038
- ISSN
- 2164-9561 (ISSN-L)
- 2164-957X
- PMC
- PMC7961714
- OpenAlex
- W3133769782
- Cited by
- 20
- References
- 59
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Advances in Health and Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Funders
- Partners HealthCare Graduate Medical Education (Partners Centers of Expertise in Medical Education)
- Osher Center for Integrative Medicine, Brigham and Women's Hospital (Osher Pilot Research Award)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- yoga, mind-body interventions, physician burnout, medical residents, RISE program, feasibility, virtual delivery, mindfulness, stress, psychological well-being, physician well-being
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