Assessing the Impact of a Shinrin-Yoku (Forest Bathing) Intervention on Physician/Healthcare Professional Burnout: A Randomized, Controlled Trial.

The short version

This randomized controlled trial with 34 physicians and healthcare workers (24 in the forest-bathing group, 10 in a waitlist control group who took a day off instead) explored whether Shinrin-Yoku, Japanese for "forest bathing," a guided practice of mindfully sensing a forest environment rather than exercising through it, could ease professional burnout. Burnout was tracked with two validated tools: the Oldenburg Burnout Inventory (OLBI), which scores exhaustion and disengagement from work, and the Mini-Z, a shorter survey of job satisfaction and burnout risk. Physician burnout affects an estimated 33-50% of doctors and was worsened by the COVID-19 pandemic. Participants, health sciences faculty and medical residents at a New Mexico teaching hospital, were randomized through REDCap. The intervention group completed a 3-hour guided walk of under half a mile through a pinon-juniper forest, led by certified Association of Nature and Forest Therapy guides: a 15-minute grounding exercise, several sensory "invitations" to notice their surroundings, a 20-minute solo "sit spot," and a closing gratitude circle with shared tea. Both groups completed the OLBI and Mini-Z before and after their respective activity. Burnout scores stayed high in both groups throughout: median OLBI and Mini-Z scores never dropped below established burnout thresholds, before or after the walk. On the OLBI, there was no significant difference between the forest-bathing group's before-and-after scores, or between the two groups afterward (meaning the walk did not measurably shift standardized burnout scores). The Mini-Z initially showed a significant post-walk improvement in the intervention group versus control, but after adjusting for multiple comparisons (a standard statistical correction to avoid false positives), that difference was no longer significant. Separately, 34% of all participants said they had some burnout symptoms and 12% said those symptoms never let up. Yet the subjective side told a different story: of 20 participants who wrote in after their walk, 19 described feeling calmer, more relaxed, more appreciative, or less anxious; only one felt no different. This gap, unchanged scores next to strongly positive accounts, suggests one forest-bathing session may ease momentary stress without touching the deeper, cumulative syndrome burnout scales measure. The study was small (34 completers of 56 enrolled, notable dropout) and unblinded, testing only a one-time session; the authors and Shinrin-Yoku's founders note the practice is meant to be ongoing, not a single dose. Larger trials of repeated forest-bathing over months are needed before it can be recommended as a standalone burnout treatment, though it may help as a short-term stress reliever alongside other care.

Key findings

• In this randomized controlled trial of 34 physicians and healthcare workers, a single 3-hour guided Shinrin-Yoku (forest bathing, a Japanese nature-immersion practice) session did not significantly improve standardized burnout scores compared to a control group that simply took a day off.
• Burnout was measured with the Oldenburg Burnout Inventory (OLBI, a 16-item exhaustion and disengagement scale) and the Mini-Z (a 10-item work-satisfaction survey); both groups' scores stayed above established burnout thresholds before and after the study.
• Despite the lack of measurable change on these burnout scales, 19 of 20 participants who gave written feedback after the walk described feeling calmer, more relaxed, and less anxious, showing the intervention may ease momentary stress even without shifting chronic burnout.
• The study was small and had substantial dropout (only 34 of 56 enrolled participants completed both assessments), so its findings are preliminary rather than conclusive.
• Because burnout builds up over months or years, the researchers suggest an ongoing forest-bathing practice, not a single session, may be needed to produce a measurable reduction, and larger long-term trials are needed to test this.

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