Evidence map›Paper›PMID 42577087›Full record

ReviewJMA journal2026

Comparative Efficacy of Interventions for Burnout in Physician Residents: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Yukiyoshi Sumi, Kenshiro Tabata, Yosuke Hatakeyama, Toshio Morizane, Hatoko Sasaki, Fujimi Kawai, Noriko Kojimahara

Abstract readReview
In one paragraph

Review in JMA journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yukiyoshi SumiDepartment of Psychiatry, Shiga University of Medical Science, Shiga, Japan.
Kenshiro TabataDepartment of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
Yosuke HatakeyamaDepartment of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
Toshio MorizaneSection of Epidemiology, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Hatoko SasakiSection of Epidemiology, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Fujimi KawaiSection of Epidemiology, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Noriko KojimaharaSection of Epidemiology, Shizuoka Graduate University of Public Health, Shizuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Burnout during residency is common and is associated with adverse outcomes for clinicians and patients; however, the comparative efficacy of intervention approaches remains unclear. We aimed to compare the efficacy of different categories of interventions aimed at reducing burnout among physician residents. Methods: We conducted a systematic review of randomized controlled trials (RCTs) in physician residents (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42025610352). Searches were conducted from February 19 to 26, 2025 in PubMed, Cochrane CENTRAL, PsycINFO, Web of Science, and Ichushi-Web.Interventions were classified into six categories: coaching, reflective intervention, intensive care unit short shift schedule, mind-body intervention, skills-based stress management, and information provision. Outcomes were emotional exhaustion (EE), depersonalization (DP), reduced efficacy (RE), and global burnout (GB). We performed a Bayesian random-effects network meta-analysis and reported standardized mean differences (SMDs) with 95% credible intervals (CrI); negative SMD values indicate improvement. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA). Uncertainty was assessed using posterior effect estimates with 95% CrI and ranking probabilities. Certainty was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) summary of findings tables. Results: A total of 20 RCTs (n = 2,616) were included; risk of bias was mostly rated as some concerns (5% low, 60% some concerns, and 35% high risk). Effects were generally small, and estimates were imprecise. By SUCRA, reflective interventions ranked highest for EE and DP (EE: SMD -0.515 [95% CrI, -1.068 to 0.041]; DP: SMD -0.432 [-0.988 to 0.133]), whereas coaching ranked highest for RE and GB (RE: SMD -0.142 [-0.538 to 0.262]; GB: SMD -0.451 [-1.180 to 0.195]). Certainty was predominantly low to very low. Conclusions: The comparative superiority of any single intervention category remains unclear. Reflective interventions, which support guided reflection on clinical work, and coaching showed comparatively favorable signals for some burnout domains, but estimates were imprecise and of low certainty. Findings may inform cautious prioritization and highlight the need for pragmatic, adequately powered trials.

Indexed as

burnoutnetwork meta-analysisoccupational healthrandomized controlled trialreflective interventionsresidentsystematic review

Identifiers

PMID42577087
PMCPMC13453605

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.