Abstract
The scoping review as part of the article is outlined in the abstract.
Introduction

Rationale:
A recent meta-analysis by the National Societies Committee (NSC) and the National Societies Forum (NSF) revealed that almost half of gastroenterologists and endoscopists experience burnout, with females being disproportionately affected (Shiha et al. 2025). Burnout in gastroenterology is predominantly driven by work-related factors, particularly high workloads, including emergency procedures and extended hours. Burnout not only affects physician well-being, but also diminishes patient safety, and poses a significant challenge to the sustainability of healthcare systems. Despite growing recognition, evidence-based strategies to mitigate burnout and improve well-being are underutilized, particularly organisational interventions.
Objectives:
This review aims to provide evidence-based interventions to prevent burnout, identify research gaps and generate insights to support coordinated systemic responses.
The scoping review aims to address the following research question: What interventions have been identified to reduce burnout among physicians in gastroenterology and related fields (UEG specialties)?
• Population: Physicians working in gastroenterology, hepatology, endoscopy, and related UEG disciplines.
• Interventions: Interventions targeting physician burnout on individual and organizational level
• Comparison: not specified
• Outcomes: Assessment of workplace well-being with validated burnout measurement instruments

Methods
Protocol and registration:
Protocols of scoping reviews are not eligible for registration in PROSPERO.
Eligibility criteria
Systematic reviews, meta-analyses (published from 2020 onwards) and randomized controlled trials (RCTs, from 2020 onwards) were included. Eligible studies must focus on physicians working in gastroenterology and all related UEG specialties, and specialties outside the UEG were excluded. If specialty is reported as “various” or “physicians,” studies were included. Eligible studies evaluate interventions to prevent or reduce burnout measured by validated instruments. Both organisational and individual interventions targeting workplace well-being were considered.

Exclusion criteria: studies in which reducing burnout is not the primary aim; interventions that are proposed but not implemented; and studies lacking a standardised burnout assessment tool. RCTs were included only if they demonstrated a significant reduction in burnout as an outcome.

For organisation-directed interventions, owing to the scarcity of studies, eligibility was broadened to include all designs reporting objective, quantifiable pre- and post-intervention outcomes from 2015 onwards.

Only articles published in English were included.

Information sources
The following databases were searched:
• Ovid MEDLINE (c. 1964 – current)
• Google Scholar

Search
A search strategy aiming at high sensitivity was used for Ovid MEDLINE. Subject headings and free text terms were selected based on known key articles, relevant entry terms from thesauri and previously published systematic reviews on at least one of the search concepts. Published search filters were employed to limit the results by study design. The MEDLINE strategy was translated to be used in other data sources.
Two searches were performed: one for systematic reviews and one for randomised controlled trials. Additional target searches address specific research questions. The included studies of all included systematic reviews were screened to identify additional eligible trials.
The searches are reported according to PRISMA-S, see the separate documentation below.

Selection of sources of evidence & Data charting process
Data management:
Records from the database searches were imported into Endnote for deduplication with the method of Bramer et al. (Bramer WM, Giustini D, Jonge GB de, Holland L, Bekhuis T. De-duplication of database search results for systematic reviews in EndNote. J Med Libr Assoc 2016;104(3):2403. doi: 10.3163/1536-5050.104.3.014. PubMed PMID: 27366130.)
Screening of records was carried out in Endnote reference management software.
Selection process:
Study selection was conducted by two independent reviewers, with disagreements being resolved by discussion.
Data collection process:
Data was extracted using piloted extraction forms. To account for methodological differences, two separate Excel extraction tables were used: one for systematic reviews and one for randomized controlled trials.
Data items
For systematic reviews:
• Study Group
• First Author
• Title
• Publication Date
• Journal
• Study Design
• Number of studies included
• Investigation window
• Interventions
• Specialisation
• Profession
• Level of Education
• Region
• Components including
• Burnout Measurement tools used
• Results

For randomised controlled trials:
• Category of Intervention
• First author
• Title
• Journal
• Year
• Study design
• Number of Participants
• Study group
• Subject Area
• Region
• Intervention
• Duration of intervention
• Burnout measurement tools used
• Outcome regarding burnout

Critical appraisal of individual souces of evidence
Not applicable for scoping reviews.

Synthesis of results
Regarding the broad field, the variety of interventions, and the different levels at which interventions are implemented, a scoping review was conducted to systematically map and describe available evidence. Results were summarised narratively and in tabular format, and the available evidence was mapped by study type (systematic reviews vs. randomized controlled trials) and by level of intervention (individual vs. organisational/systemic). As a scoping review, no quantitative synthesis was conducted.

Results
The selection of sources of evidence, including the number of records screened, assessed for eligibility, and ultimately included in the review, together with reasons for exclusion, is presented in Figure 3.
The characteristics of the included sources of evidence, for which data were charted, are summarized in Table 1 and Table 2, along with the corresponding citations (DOI, first author, title, journal).
A critical appraisal of the included sources of evidence was not performed, as it is not applicable for scoping reviews (see above).
The results of individual sources of evidence, such as the relevant data extracted from each included source of evidence in relation to the review questions and objectives are provided in Table 1 and Table 2.
A synthesis of the results, summarizing the charted data in the context of the review questions and objectives, is presented in the manuscript section on interventions as well as in Table 1 and Table 2.

Discussion
A summary of the evidence, including an overview of key concepts, themes, and types of evidence in relation to the review questions and objectives, is presented in the manuscript.
In addition, the manuscript discusses the limitations of the scoping review process and provides conclusions that highlight the main results, their implications and potential next steps.