Assessment of burnout in medical undergraduate students in Riyadh, Saudi Arabia

Pathologist workload, burnout, and wellness: connecting the dots

No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired, distributing the workload fairly among pathologists, and assessing the overall cost of pathology consults. Initially, simple tools such as counting cases or slides were used to give an estimate of the workload. More recently, multiple workload models, including relative value units (RVUs), the Royal College of Pathologists (RCP) point system, Level 4 Equivalent (L4E), Work2Quality (W2Q), and the University of Washington, Seattle (UW) slide count method, have been developed. There is no "ideal" model that is universally accepted. The main differences among the models come from the weights assigned to different specimen types, differential calculations for organs, and the capture of additional tasks needed for safe and timely patient care. Academic centers tend to see more complex cases that require extensive sampling and additional testing, while community-based and private laboratories deal more with biopsies. Additionally, some systems do not account for teaching, participation in multidisciplinary rounds, quality assurance activities, and medical oversight. A successful workload model needs to be continually updated to reflect the current state of practice.Awareness about physician burnout has gained attention in recent years and has been added to the World Health Organization's International Classification of Diseases (World Health Organization, WHO) as an occupational phenomenon. However, the extent to which this affects pathologists is not well understood. According to the WHO, burnout syndrome is diagnosed by the presence of three components: emotional exhaustion, depersonalization from one's work (cynicism related to one's job), and a low sense of personal achievement or accomplishment. Three drivers of burnout are the demand for productivity, lack of recognition, and electronic health records. Prominent consequences of physician burnout are economic and personal costs to the public and to the providers.Wellness is physical and mental well-being that allows individuals to manage stress effectively and to thrive in both their professional and personal lives. To achieve wellness, it is necessary to understand the root causes of burnout, including over-work and working under stressful conditions. Wellness is more than the absence of stress or burnout, and the responsibility of wellness should be shared by pathologists themselves, their healthcare organization, and governing bodies. Each pathologist needs to take their own path to achieve wellness.

A study on measure of resilience and impact of demanding clinical training on young medical professional's burnout in a tertiary care hospital, Andhra Pradesh

BACKGROUND

The psychological state of medical students gaining concern on the part of medical institutions in several countries. Numerous studies are being conducted to study stress, burnout, and depression in medical students in India and globally. However, little is known about medical student resilience, particularly in India. The objectives of this study were to study the resilience, self-perceptions of stress coping skills, and burnout among medical students in clinical training in a tertiary care health center, to study factors associated with resilience among medical students in clinical training in a tertiary care health center and to study the relationship between resilience and self-perceptions of stress coping skills and symptoms of burnout.

MATERIALS AND METHODS

This cross-sectional study was conducted in a tertiary healthcare hospital in district Guntur, Andhra Pradesh from November 2020 to December 2020, among 186 adult male and female medical students, aged more than 20 years, enrolled in the regular degree course and part of patient care or at least last three months. Participants were randomly selected and a structured questionnaire with Connor Davidson Resilience Scale 10 was used for interviewing. Descriptive and inferential statistics were conducted to measure associations between outcome and explanatory variables. We used multiple linear regression to examine the association between dependent and independent variables. A P value less than. 05 was considered significant.

RESULTS

In the present study, 109 (58.0%) were females. The mean age of the study participants was 25.4 years (standard deviation 2.78). The mean score resilience score of the study participants using Connor Davidson Resilience Scale 10 was 25.1 (standard deviation 7.97). Of the total 44 (23.7%) of the study, participants reported the presence of burnout. A significant positive correlation was between resilience and self-perceptions of stress-coping skills with a Pearson Correlation coefficient of 0.393. Among the study participants, the mean resilience score was higher among those not having any symptoms of burnout. In the hierarchical stepwise multiple linear regression analysis, male gender (P value = .014), financial independence (P value = .044), and absence of burnout symptoms (P value = .004) were significantly associated with higher resilience scores. Psychiatric medicine usage was significantly associated with a lower resilience score with P < .05.

CONCLUSION

Our study samples had higher resilience and lower burnout prevalence compared to the West. The stressful clinical event experienced by medical students demands training and innovative strategies to foster communication and teamwork skills among medical teams.

Prevalence of burnout and its associated factors among medical students during COVID-19 pandemic in Indonesia: A cross-sectional study

Shifting learning process due to COVID-19 has led to increased burnout prevalence among medical students. Thus, this study aimed to assess burnout prevalence and its associated factors among Indonesian medical students during the COVID-19 pandemic. An online cross-sectional study was carried out among medical students in Malang, Indonesia. Burnout was assessed using the Maslach Burnout Inventory-Student Survey tool. Pearson's Chi-square was used to assess significant associations, and binary logistic regression was conducted to evaluate the relationships between the predictor variables and burnout. The difference of each subscale score was evaluated using an independent sample t test. This study analyzed 413 medical students with a mean age of 21.1 ± 1.4 years old. About 29.5% and 32.9% of students reported a high level of emotional exhaustion and depersonalization, respectively, resulting in 17.9% of burnout prevalence. Stage of study was the only sociodemographic factor independently associated with burnout prevalence (odds ratio = 0.180, 95% confidence interval = 0.079-0.410, p-values = 0.000). Preclinical students had significantly higher levels of emotional exhaustion (p-value = 0.004, d = 0.3) and depersonalization (p-value = 0.000, d = 1.1), and lower levels of personal accomplishment (p-value = 0.000, d = -0.5). Around one-sixth of the medical students experienced burnout during the COVID-19 pandemic, with preclinical students being more prone to have burnout. Future study with other adjusted confounding factors is needed to completely understand the issue and obtain immediate interventional strategies to reduce burnout among medical students.

Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review

BACKGROUND

Evidence suggests physicians have higher rates of mental distress than other professionals. Although multiple studies have been conducted among Saudi medical trainees to address this issue, no reviews assessed multiple psychological problems simultaneously. We aimed to examine the prevalence and trends of depression, anxiety, burnout and stress among Saudi medical trainees.

METHODS

A systematic review was conducted searching PubMed/Medline, OVID, Scopus, PsychInfo, EBSCOhost and the Directory of Open Access Journals (DOAJ) for studies addressing depression, burnout, stress and anxiety among Saudi medical trainees, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Joanna Briggs Critical Appraisal Checklist was used to evaluate quality. The main findings were summarised in tables.

RESULTS

We identified 57 records from 2001 to 2020. Overall (mild, moderate or severe) depression ranged from 28% to 70.6%, while stress ranged from 30.5% to 90.7%. Burnout was primarily assessed among residents with an overall prevalence reaching 85.5%. Overall anxiety ranged from 52.7% to 67%, and was only assessed among undergraduates. Higher levels of all four mental conditions were reported among females.

CONCLUSION

This review suggests high prevalence of depression, stress, burnout and anxiety among medical trainees, with higher estimates for females compared to males.

Experiences of burnout, anxiety, and empathy among health profession students in Qatar University during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

The prevalence of burnout and anxiety is constantly increasing among health profession students worldwide. This study evaluates the prevalence of burnout and its relationship to anxiety and empathy during the COVID-19 pandemic among health profession students in the main governmental institution in Doha, Qatar using validated instruments.

METHODS

A cross-sectional survey of health profession students using validated instruments was employed. The Maslach Burnout Inventory-General Students Survey (MBI-GS(S)) to measure burnout; The Generalized Anxiety Disorder (GAD-7) to measure anxiety; and Interpersonal Reactivity Index (IRI) to measure empathy were utilized. Descriptive statistics and multivariable linear regression were used.

RESULTS

Of the 1268 eligible students, 272 (21.5%) completed the online survey. Burnout was found to be prevalent amongst the students. The mean scores for the MBI-GS(S) subscales of emotional exhaustion, cynicism, and professional efficacy were 4.07, 2.63, and 3.97, respectively. Anxiety was found to be a strong predictor for burnout and burnout was positively associated with empathy.

CONCLUSIONS

Findings from this study demonstrated relationships between health profession students' burnout, anxiety, and empathy. These findings might have an impact on the development of curriculum interventions to enhance student well-being. More burnout awareness and management programs that cater to the specific needs of health profession students are needed. Furthermore, findings of this study may have implications for future educational interventions during times of crisis or how this can be used to improve student experiences in normal times.

Assessment of Medical Students Burnout during COVID-19 Pandemic

This study estimated the prevalence of burnout and its determinants among medical students at Jazan University during the COVID-19 pandemic. A total of 444 medical students completed an online survey containing the Maslach burnout inventory. The prevalence of burnout was 54.5%. Burnout reached its peak during the fourth year whereas it was the lowest in the internship year. Being a resident in mountain areas, being delayed in college-level, being divorced, and having divorced parents were all associated with an increased risk of burnout. During their time at medical school, students generally showed a trend of consistently high scores in the personal accomplishment subscale, a decreasing trend in the emotional exhaustion subscale, and an increasing trend in the depersonalization subscale. The most important predictive factor was having separated parents. Perceived study satisfaction appeared to be a significant protective factor in a dose-response manner. These findings suggest that burnout among medical students during the COVID-19 pandemic is a concern that should be monitored and prevented.

Burnout, Stress, and Stimulant Abuse among Medical and Dental Students in the Western Region of Saudi Arabia: An Analytical Study

Background

High levels of burnout, stress, and stimulant abuse have been reported among medical and dental students worldwide, with country-specific factors being contributors. The association, risk factors, and predictors of these three variables have not sufficiently been reported from Saudi Arabia, especially from the Western region.

Objective

To determine the prevalence, association, and predictors of burnout, stress, and stimulant abuse among medical and dental students in the Western region of Saudi Arabia.

Methods

This cross-sectional study included all second to sixth year medical and dental students enrolled at Taibah University, Madinah, Saudi Arabia, during the 2019-2020 academic year. A self-administered, closed online questionnaire was administered. Data regarding stress were elicited using Cohen's 10-item Self-Perceived Stress Scale and regarding burnout using the Oldenburg Burnout Inventory Student Version questionnaire. Multiple logistic regression model to identify the risk of burnout was conducted, and univariate and multiple linear regression models were carried out to identify the predictors of stress.

Results

Of 1016 eligible students, 732 responded (medical: 511; dental: 221). About half of the students experienced burnout (51.5%), with both high disengagement (49%) and exhaustion (45%). Most participants (90.3%) experienced moderate levels of stress. Eight (1.1%) respondents had experienced stimulant abuse; there was a no significant association between stimulant abuse and burnout in the multivariate analysis. Stress, age, gender, body mass index, GPA, study field, smoking, family income, and birth order were significant predictors of burnout, while burnout, age, gender, GPA, and physical exercise were significant predictors of stress.

Conclusion

The findings in this study highlight the need for policymakers to devise strategies that target early identification as well as reduction of the high levels of burnout and stress.

Burnout rates among Lebanese pre-final and final year medical students during the COVID-19 pandemic: A multi-centered survey-based study

BACKGROUND

Burnout among medical students has always been a major concern.

OBJECTIVE

To evaluate changes in the prevalence rates of burnout among Lebanese pre-final and final year medical students while taking into consideration the impact of coronavirus 2019 (COVID-19) on both the academical and clinical experiences.

METHODS

This is a multi-centered, survey-based, cross-sectional study conducted in October 2021. The Copenhagen Burnout Inventory questionnaire was used on 120 medical students from three different medical schools in Lebanon.

RESULTS

The overall burnout prevalence was 40.01%. When further dividing it into domains, 39.36% of students had personal burnout, 41.52% had work-related burnout, and 39.16% had pandemic-related burnout. Theoretical learning and clinical training were reported to be affected in respectively 66.70% and 71.70%. However, only 10.00% of the students have regretted choosing medicine and 67.50% felt comfortable to get to the next academic level.

CONCLUSION

High levels of burnout were reported among pre-final and final year medical students with a subsequent negative impact on their academic life and clinical training. Medical schools should start adopting a conscious view of how to guide medical students in finding adequate coping mechanisms during these times of crisis.

Academic burnout, self-esteem, coping with stress and gratitude among Polish medical students – a cross sectional study

Introduction: Academic burnout is emerging as an essential obstacle in education process. Students of the most challenging fields of study with high degrees of stress are thought to be at the highest risk. Medical studies are considered one of them. The aim of the study was to measure the levels of academic burnout, stress and gratitude among Polish medical students of Medical University of Lublin, and determine their styles of coping with stress.

Materials and methods: A cross-sectional study was conducted using a questionnaire comprised of the following: Maslach Burnout Inventory – Student Survey (MBI-SS), Rosenberg Self-Esteem Scale (SES), a Coping Inventory for Stressful Situations (CISS) and a Gratitude Questionnaire Six-Item form (GQ-6). The data was obtained from 773 medical students.

Results: Total number of 169 students (21.86%) met criteria for academic burnout. When it comes to 354 participants, they displayed signs of low self-esteem (45.8%). The number of 18 students showed low level of gratitude, while gratitude level of the majority of them – 496 (64.17%) was high. The most common style of coping with stress was emotions-oriented style – 354 students (48.29%), followed by task-oriented style – 345 students (47.07%). Burnout subscales turned out to be associated with age, year of study, self-esteem, gratitude and different styles of coping with stress to the various extent.

Conclusions: The prevalence of academic burnout among Polish medical students is high compared with general population across various occupations. Utilisation of protective characteristics of high self-esteem, gratitude and healthy coping methods can result in development of efficient anti-burnout prevention strategies and intervention tools.

The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students

The purpose of the study was to evaluate the relationship between school burnout, sense of school belonging, and academic achievement in medical students. This cross-sectional study was performed with students at the Ondokuz Mayıs University Medical Faculty (Samsun, Turkey) between 1 and 31 May 2019. Six hundred one (71.0%) first, second, and third-year students were included in the study. A questionnaire was employed as the data collection method. The questionnaire consisted of two parts. The first part consisted of questions investigating sociodemographic information produced by the authors by scanning the literature. The second part consisted of the School Burnout Inventory and the Psychological Sense of School Membership Scale. The relationship between the sense of school belonging, school burnout, and academic achievement was evaluated using structural equation modeling. The structural equation modeling analysis determined that school burnout played a mediating role in the relationship between the sense of school belonging and academic achievement in preclinical medical students. As the sense of belonging to the school increases in preclinical medical students, academic achievement increases. School burnout in preclinical medical students increases as a sense of school belonging decreases. Academic achievement among preclinical medical students decreases as school burnout levels increase. Increasing the sense of school belonging can be effective in preventing school burnout and increasing academic achievement.

Prevalence of burnout in medical students: A systematic review and meta-analysis

BACKGROUND

Medical students are at a significant risk of experiencing psychological issues, such as burnout. Over the past few years, more studies have been conducted on this topic, producing different results.

AIMS

The purpose of this review was to determine the global pooled prevalence rate and risk factors associated with burnout and its components among undergraduate (pre-intern) medical students.

METHOD

From inception until 30 November 2021, nine electronic databases were used for an electronic search. Using random-effects meta-analysis, we pooled the estimates using the DerSimonian-Laird method. The prevalence of burnout in medical students was the primary outcome of interest. Data were analyzed globally, by country, by research measure. Age and sex were examined as confounders using meta-regression analysis.

RESULTS

A random-effects meta-analysis of 42 studies involving 26,824 evaluating the prevalence of burnout in medical students showed an overall prevalence rate 37.23% [32.66%; 42.05%], Q = 2,267.15(41), p < .0001, τ² = .42, τ = .65, I² = 98.2%; H = 7.5. Prevalence of emotional exhaustion, depersonalization, and personal accomplishment were 38.08% [30.67%; 46.10%], 35.07% [26.74%; 44.41%], and 37.23% [32.66%; 42.05%], respectively. Variations were observed between countries and research measures. Age (older) and sex (female) were both significant predictors of burnout.

CONCLUSION

The prevalence of burnout in medical students was estimated to be 37.23%. It is urgent that future studies serve as a basis for the development of prevention and treatment programs to prevent and treat burnout in students.

Prevalence and associated risk factors of burnout amongst veterinary students in Ghana

This study was designed as a cross-sectional study to find out the prevalence and associated risk factors of burnout among veterinary students at Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi—Ghana. A total of 74 veterinary students served as the respondents and were given online questionnaires which comprised questions on emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (RPA). Data obtained were analysed using descriptive statistics, Chi-square test and regression analysis. Results indicated that on average, the EE and RPA were low with mean score of 12.72 ± 4.46 and 27.96 ± 7.94 whilst DP was high with a mean score of 20.72 ± 6.5 among veterinary students. The year of study had a significant effect (p = 0.000) on burnout with levels of high RPA (80%) and DP (70%) being more in the preclinical students as compared to the clinical students (RPA = 20%, DP = 30%). There was also a significant effect (p = 0.028) of the year of study and type of residence of the students on the high level of DP and RPA. Daily sleep hours of students had Daily sleep hours of the veterinary students were also indicated as a significant associated risk factor of burnout among veterinary students in this study as more less sleep hours (<6hours), causes high levels of DP and RPA. Age, gender and marital status, working status, exercise hours and weekly study hours of students did not count as significant predictive factors (p>0.05) of burnout.

Burnout Among University Students During Distance Learning Period due to the COVID-19 Pandemic: A Cross Sectional Study at the University of Jordan

OBJECTIVE

The COVID-19 pandemic led to a deviation from classical face-to-face learning to distance learning. Few studies examined burnout among university students during the distance learning period due to the COVID-19 pandemic. This study that aims to investigate the prevalence of burnout among university students during distance learning and the factors associated with it.

METHOD

A cross-sectional study was conducted among undergraduate students at the University of Jordan. The modified version of the Maslach Burnout Inventory for students (MBI-SS) was used to assess burnout.

RESULTS

The total number of participants was 587 and the mean total of MBI-SS score was 63.34 ± 8.85. Based on the MBI-SS definition, 6.6% of the study participants were found to have symptoms of burnout. Practicing hobbies, level of satisfaction with distance learning, and thoughts about quitting courses were significant predictors of burnout.

CONCLUSION

This study showed a relatively low prevalence of burnout among students during the distance learning period with several factors associated with it. As a result, identifying these factors will help both students and educational institutions to implement strategies that are needed for the primary and secondary prevention of burnout.

Mental health and wellbeing among Egyptian medical students: a cross-sectional study

Background

Medical students are prone to experience high levels of stress during their studies, which can lead to burnout and mental health disorders such as anxiety and depression, that can affect their academic performance and ability to practice. We therefore conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 547 medical students from two universities in Cairo. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire.

Results

Our results indicated that 16% of participants were diagnosed with a mental illness while in medical school, with 88% screening positive for burnout on the OLBI, 63% reaching the threshold as cases on the GHQ-12 and 9% screening positive on the CAGE questionnaire. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12.

Conclusions

Our study indicated that there were very high levels of psychological distress (burnout, mental illness) among medical students, with high rates of disengagement and exhaustion.

The Relationship Between Anatomical Self-efficacy and Feelings of Burnout in First-year Medical Students

Feelings of burnout in professional students have been associated with additional psychological morbidities and decreased academic achievement. Due to the large volume of content that medical students need to learn during gross anatomy courses, it is possible that anatomical self-efficacy may be a contributing factor to feelings of burnout. Anatomical self-efficacy is defined as a student's judgment of their ability to execute tasks related to learning anatomy and perform course activities (e.g., dissection). First-year medical students were invited to provide basic demographic information at the beginning of the semester and to complete the Oldenburg Burnout Inventory-student version (OLBI-SS) and the Anatomical Self-Efficacy Instrument (ASEI); at the beginning, middle, and end of the semester, they were enrolled in gross anatomy. Typical descriptive statistics for the demographic information were conducted, as well as, correlational analyses assessing if the information had a relationship with either anatomical self-efficacy or burnout. Female students were more burnt out than male students. Repeated measures ANOVA revealed that students' feelings of burnout significantly increased from the beginning of the semester to the midpoint and the end of the semester (p < 0.05). Linear regression demonstrated a predictive relationship between anatomical self-efficacy and burnout (p < 0.05) at all three measurement points in which lower self-efficacy was predictive of increased feelings of burnout.

Stress, anxiety, and depression among students at the Faculty of Medicine of Sousse (Tunisia)

OBJECTIVE

To evaluate the frequency of anxious and depressive symptoms and to determine their associated factors in a population of students enrolled at the Faculty of Medicine of Sousse (Tunisia).

METHODS

this is a descriptive cross-sectional study that took place at the Faculty of Medicine of Sousse over the period from 09/15/2017 to 03/15/2018. An anonymous questionnaire was administered to the students in the guided teaching rooms. The assessment of anxiety and depressive symptoms was based on the Anxiety and Depression Scale (HADS) and the quality of sleep was assessed by the PSQI questionnaire.

RESULTS

A total of 202 medical students participated in the study. The average PSQI score was 5.62±2.87 and 47% of students had poor sleep quality (PSQI ≥ 6). Symptoms of anxiety and depression were observed in 73 (36.1%) and 45 (22.3%) students respectively. The mean HADS-A score was 9.21±4.17 and that of the HADS-D score was 7.37±4.06. In univariate analysis, the factors found to predict a high level of perceived stress were the study cycle (p=0.022) and poor quality of sleep (p 11) were the use of sleeping pills (p=0.004), the quality of sleep (p<0.001), and a high level of perceived stress (p<0.001). The high level of perceived stress was found to predict depression (p=0.006).In the multivariate analysis of variables in the present study, poor sleep quality was a factor independently related to high perceived stress in medical students (ORa=9.062 [4.247-19.334]) while being a medical student of the 1st cycle proved to be a protective factor (ORa=0.101 [0.025-0.406]). Use of sleeping pills (ORa=4.481 [1.135-17.682]), poor sleep quality (ORa=2.131 [1.081-4.203]) and high level of perceived stress (ORa=5.790 [2.444-13.716]) were factors independently related to anxiety symptoms. Female sex was a protective factor for depressive symptoms (ORa=0.440 [0.205-0.945]) while a high level of perceived stress was a factor independently related to depressive symptoms (ORa=3.429 [1.469-8.005]). HAD-A and HAD-D scores were correlated (r=0.631 ; p<0.001).

CONCLUSION

sleep disturbances, perceived stress, anxious and depressive symptoms are common among Tunisian medical students. Prevention strategies targeting the improvement of sleep quality and student stress management should be developed at the faculty and ministerial level.

Emotional distress and psychiatric drug use among students in an Italian medical school: Assessing the role of gender and year of study

BACKGROUND

Previous studies have reported that medical students show high rates of depression, anxiety, and stress levels, but mixed findings were found regarding possible differences between gender and different years of medical training. This study evaluated depression, anxiety, and stress levels and psychiatric drug use in students in an Italian medical school and investigated the differences between gender and year of study.

MATERIALS AND METHODS

This cross-sectional study included 694 medical students in their 1^st (n = 286), 4^th (n = 209), and 6^th (n = 199) year of study. The questionnaire included demographic information, self-report questionnaires regarding depression, anxiety, and stress, and questions about psychiatric drug use. Data analysis was performed using SPSS/Ver 22 through descriptive and analytic statistics, including Mann-Whitney U-test, Fisher's exact test, and GLM two-way ANOVA.

RESULTS

Depression, anxiety, and stress symptoms were reported by 365 (52.6%), 428 (61.7%), and 545 (78.5%) medical students, respectively. Female students in their 4^th year of study reported higher depression levels than males of the same year (P = 0.004), whereas levels of anxiety were higher in 6^th-year female students compared with those in their 1^st and 4^th years (P = 0.001; P = 0.025). Stress levels were consistently higher in females than in males for all 3 years (1^st year: P = 0.041; 4^th year: P < 0.001; 6^th year: P = 0.004). No gender differences were found in the use of psychiatric and stimulant drugs.

CONCLUSION

This study provides preliminary evidence suggesting the importance of planning interventions aimed at reducing emotional distress among medical students that should be targeted on gender and year of the study.

Burnout among medical students of the University of Kerbala and its correlates

Background

Burnout is prevalent among medical students. Throughout their training, medical students face many psychosocial stresses that, if not managed, might cause burnout syndrome. Burnout could negatively impact students’ life and their academic performance. This study aims to estimate the prevalence of burnout among medical students at the College of Medicine, University of Kerbala, and assess factors associated with it.

An analytic cross-sectional study. A sample of 424 students from all academic years from the College of Medicine, University of Kerbala, was approached. Data collection was conducted from June 11 to July 3, 2020, through a self-administered online questionnaire based on the Maslach Burnout Inventory Student Survey (MBI-SS). The MBI-SS included 15 questions with a 7-point rating ranging from 0 (never) to 6 (always). The tool measures three subscales: emotional exhaustion (5 questions), Cynicism (4 questions), and professional efficacy (6 questions). Statistical Package for the Social Sciences (SPSS) program version 24 was used for data analysis. Binary logistic regression was used to assess the association between burnout and students̓ variables, P value of a level < 0.05 considered statistically significant.

Results

The prevalence of burnout syndrome among medical students was 38.2%. About 85.6% of students had high emotional exhaustion, 77.8% had high cynicism, and 32.5% exhibited low professional efficacy. Female gender, regular use of legal substances, and family history of mental diseases were associated with significantly high rates of burnout.

Conclusions

Burnout is prevalent among medical students of the University of Kerbala with quite high levels of emotional exhaustion and cynicism and lower professional efficacy levels. Faculties of medicine need to consider burnout among their students and works to reduce unnecessary stresses by modifying and upgrading the educational and clinical environments.

Prevalence of burnout in medical students in China: A meta-analysis of observational studies

ABSTRACT

This meta-analysis aimed to estimate the prevalence of burnout among medical students in China.A systematic search from the following electronic databases: China National Knowledge Infrastructure, Wangfang database, VIP database, Chinese biomedical literature database, PubMed, Embase, Web of Science, and Google Scholar was independently conducted by 2 reviewers from inception to September 2019. The data were analyzed using stata software Version 11. Heterogeneity was assessed using I2 tests, and publication bias was evaluated using funnel plots and Egger's test. The source of heterogeneity among subgroups was determined by subgroup analysis of different parameters.A total of 48 articles with a sample size of 29,020 met the inclusion criteria. The aggregate prevalence of learning burnout was 45.9% (95% confidence interval [CI] = 38.1%-53.8%). The prevalence rate of high emotional exhaustion was 37.5% (95% CI: 21.4%-53.7%). The percentage was 44.0% (95% CI: 29.2%-58.8%) for low personal accomplishment. The prevalence rate was 36.0% (95% CI: 23.0%-48.9%) in depersonalization dimension. In the subgroup analysis by specialty, the prevalence of burnout was 30.3% (95% CI: 28.6%-32.0%) for clinical medicine and 43.8% (95% CI: 41.8%-45.8%) for other medical specialties. The total prevalence of burnout between men and women was 46.4% (95% CI: 44.8%-47.9%) and 46.6% (95% CI: 45.5%-47.6%), respectively. The prevalence of burnout with Rong Lian's scale was 43.7% (42.1%-45.2%), and that with the other scales was 51.4% (50.4%-52.4%). The prevalence rates were 62.9% (61.3%-64.6%), 58.7% (56.3%-61.1%), 46.5% (42.9%-50.2%), and 56.0% (51.6%-60.4%) from Grades 1 to 4, respectively. There was a statistically significant difference among the different grades (P = .000).Our findings suggest a high prevalence of burnout among medical students. Society, universities, and families should take appropriate measures and allot more care to prevent burnout among medical students.

Epidemiology of Burnout and Its Association with Academic Performance Among Medical Students at Hail University, Saudi Arabia

Objectives

Burnout syndrome is a condition that is well-documented globally among medical students and affects their academic performance due to high levels of associated stress and psychiatric morbidities. This study aimed to assess burnout prevalence and predictors along with its association with academic performance among medical students at Hail University, Saudi Arabia.

Methods

A questionnaire-based cross-sectional survey of medical students was conducted between May and June 2019 at the Medical College at Hail University. The English version of the Maslach Burnout Inventory (MBI)-Student Survey was used to assess the three components of burnout syndrome—cynicism, emotional exhaustion and professional efficacy. A fixed-model multivariate logistic regression analysis was conducted for each of the three MBI components’ levels and for total burnout to identify factors significantly associated with burnout syndrome.

Results

A total of 218 students were included in this study (response rate: 53.8%). The majority of participants were female (n = 121; 55.5%) medical students ranging between 21–24 years of age. High emotional exhaustion, high cynicism and low professional efficacy was found among 79.4%, 61.0%, and 37.6%, respectively, of respondents. The overall prevalence of high burnout was 27.1% (n = 59). Female students were at almost double the risk for high emotional exhaustion compared to male students (adjusted odds ratio [AOR] = 2.14, 95% confidence interval [CI]: 1.06–4.34; P = 0.034). Students with grade point averages (GPA; on a four-point scale) ranging between 3.51–4.0 were considerably less prone (83% less risk) to experience burnout as compared to students with a GPA ≤2.0 (AOR = 0.17, 95% CI = 0.03–0.91, P = 0.039).

Conclusion

High levels of overall burnout were reported among Hail University medical students. Students with a higher GPA, however, were found to be less prone to burnout.

The role of extracurricular activities and lectures in mitigating medical student burnout

CONTEXT

Strong evidence throughout the literature highlights burnout as a significant and increasing problem among medical students, impacting students' ability to effectively care for and empathize with patients.

OBJECTIVES

To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students.

METHODS

An anonymous digital survey including the Maslach Burnout Inventory (MBI) was sent to all students (n=765) at Rowan University School of Osteopathic Medicine. The survey included questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents.

RESULTS

Of the 765 students enrolled, 597 completed the survey. Results indicated that women participated in significantly more clubs than men (t[456]=-4.30; p<0.001). Men had higher scores on the depersonalization subscale of the MBI than women (t[463)=2.98; p<0.01]. There were no gender differences in emotional exhaustion or personal accomplishment. Linear regression analyses including gender and club participation as predictors of each of the burnout subscales indicated a significant interaction between gender and number of clubs (β=0.34; p<0.05), in that more club participation was associated with higher depersonalization scores for women, but lower depersonalization scores for men. The number of wellness/burnout prevention lectures attended was not predictive of scores on any of the burnout subscales.

CONCLUSIONS

Our results indicate the importance of understanding what drives burnout on the individual level and adapting interventions to suit the needs of individual students, rather than the student body as a whole.

Depression, anxiety and stress and their associated social determinants in the Saudi college students

Globally, students suffer from stress, anxiety, and depression in higher education and seek counselling since education process has negative impacts on mental health of some students. This study was aimed at measuring the depression, stress, and anxiety and their associated social determinants like (income, education, residence, marital status, and educational difficulties) in undergraduate students of Umm Al-Qura University (UQU). Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21) validated from the original English version instrument by Lovibond and Lovibond (1995) was used; A sample of 373 respondents through clustered sampling was drawn from the five randomly chosen faculties of the University. Data was analyzed by running ANOVA and t-test procedures in SPSS software. The study found that the prevalence of stress, anxiety, and depression in the students was 30%, 60%, and 50% respectively. A statistically significant difference was found in the stress levels of students of different colleges (p=0.000). Students’ stress levels were significantly higher (p=0.000) in the Applied Medical Sciences and in the final year students (p=0.015). Significantly high levels of depression (p=0.000), anxiety (p=0.000), and stress (p=0.000) were found in the students belonging to the poor economic strata. Depression (p=0.038), Anxiety (p=0.022), and stress (p=0.001) were statistically high in the students whose father had a low level of education. Statistically high level (p=0.028) of stress was also found in the students whose mothers had a low level of education. Students who reported educational difficulties had significantly (p=0.001) high levels depression. However, the results of stress, anxiety, and depression in married students and the location of the students’ variables were not found statistically significant. The findings may be useful for informed policymaking in the higher learning institutions and initiation of counseling provisions in the concerned faculties for the distressed students with a view to enhancing their educational outcomes.

Prevalence and determinants of burnout syndrome and depression among medical students at Qassim University, Saudi Arabia

Objectives:

To investigate the prevalence and determinants of burnout syndrome and depression among medical students at Unaizah College of Medicine (UCM), Qassim University, Qassim, Kingdom of Saudi Arabia (KSA).

Methods:

A cross-sectional study of all Saudi medical students studying at UCM, Qassim University, Al Qassim, KSA, between February to March 2020.

Results:

Of the total 305 students sampled, 153 (50.2%) fit the category of depression. Concerning burnout, only 5.6% of the total population met the Maslach Burnout Inventory diagnostic criteria for burnout, with those determined to have burnout having ranked high on the emotional exhaustion and cynicism subscales, and low on the academic efficacy subscale. Male was strongly associated with burnout, while female gender and raising children were strongly associated with the presence of depression. Emotional exhaustion and high cynicism as determinants of burnout elevate the risk of depression.

Conclusion:

Our results highlight the high rate of depression and burnout, as well as the need for psychological intervention programs at medical schools to prevent the deterioration of student’s mental health that has been associated with advancement in medical school.

Burnout and its associated factors among medical students of Jazan University, Jazan, Saudi Arabia

Purpose

The purpose of this study is to assess the prevalence of burnout syndrome and its associated factors among medical students at Jazan University, Jazan, Kingdom of Saudi Arabia.

Design/methodology/approach

A cross-sectional survey was conducted among 440 randomly selected medical students at Jazan University. The questionnaire used for this study was based on the Copenhagen Burnout Inventory.

Findings

The overall prevalence of burnout was estimated at 60.2% (95% CI 55.6–64.8). The prevalence was higher for females (64.1%) than for males (56.2%) but without statistically significant differences (p > 0.05). On average, the students scored the highest averages in the personal burnout category, followed by the study-related and client-related burnout categories. In the multivariate analysis, a lower age (beta = −3.17, p = 0.026), female (beta = −0.896, p = 0.016), and having better burnout knowledge (beta = 0.710, p = 0.025) predict significantly higher personal burnout.

Practical implications

It is necessary to implement strategies to reduce the incidence of burnout among medical students for the sake of a better quality of life for future doctors.

Originality/value

There is a high prevalence of burnout among Jazan’s medical students.

Prevalence of burnout among health sciences students and determination of its associated factors

Burnout is a major issue among healthcare students and a public health issue in general. Indeed, the consequences of student burnout are as complex as other mental distress factors, such as those concerned with smoking and alcohol consumption, or an unhealthy lifestyle.  This study aimed to determine the prevalence of burnout among health sciences students and to determine its associated factors. This is a cross-sectional descriptive study conducted among 368 students of a Tunisian institution using the French validated version of the MBI-SS. The prevalence of burnout was 64.4%. The presence of a diagnosed health problem, a diagnosed mental disorder or sleep problems were associated with burnout. Students who live alone are significantly the most emotionally exhausted (p=0.010) and the most cynical (p=0.033). Students who had a low socio-economic level are significantly more cynical than those who had a medium or high socio-economic level (p=0.032). Performing leisure activities and practicing physical activities were associated with emotional exhaustion (p=0.007, p= 0.008, respectively).In our study, burnout is prevalent among Tunisian health sciences students. Many factors were found to be associated with this syndrome. These findings reinforce the need to establish early preventive strategies to encounter this problem and its consequent risks.

Grit protects medical students from burnout: a longitudinal study

BACKGROUND

Burnout is a serious issue plaguing the medical profession with potential negative consequences on patient care. Burnout symptoms are observed as early as medical school. Based on a Job Demands-Resources model, this study aims to assess associations between specific job resources measured at the beginning of the first year of medical school with burnout symptoms occurring later in the first year.

METHODS

The specific job resources of grit, tolerance for ambiguity, social support and gender were measured in Duke-NUS Medical School students at the start of Year 1. Students were then surveyed for burnout symptoms at approximately quarterly intervals throughout the year. Using high ratings of cynicism and exhaustion as the definition of burnout, we investigated the associations of the occurrence of burnout with student job resources using multivariable logistic regression analysis.

RESULTS

Out of 59 students, 19 (32.2%) indicated evidence of burnout at some point across the first year of medical school. Stepwise multivariable logistic regression analysis identified grit as having a significant protective effect against experiencing burnout (Odds Ratio, 0.84; 95%CI 0.74 to 0.96). Using grit as a single predictor of burnout, area under the ROC curve was 0.76 (95%CI: 0.62 to 0.89).

CONCLUSIONS

Grit was identified as a protective factor against later burnout, suggesting that less gritty students are more susceptible to burnout. The results indicate that grit is a robust character trait which can prognosticate burnout in medical students. These students would potentially benefit from enhanced efforts to develop grit as a personal job resource.

Burnout in medical students of a tertiary care Indian medical center: How much protection does resilience confer?

CONTEXT

Medical profession continues to grapple with burnout; even medical students are not spared of this self-destructive psychological experience. Attempts are being made to control and contain burnout in medical students by the medical fraternity.

AIMS

We intend to study the prevalence and determinants of burnout in medical students in a tertiary medical center and also to study the relationship of resilience with the experience of burnout.

SETTINGS AND DESIGN

This was a cross-sectional anonymous survey method.

MATERIALS AND METHODS

Randomized stratified sampling method was used wherein roll numbers of MBBS students belonging to four different semesters were chosen using randomization software. Based on prevailing prevalence of burnout, sample size calculation was done, and 196 completed questionnaires were included in analysis. The Maslach Burnout Inventory (MBI) and the Resilience Scale for Adults (RSA) were used. Two-dimensional approach toward diagnosing burnout was used.

STATISTICAL ANALYSIS

Association tests were carried out to analyze the association between means, and Spearman's rho was used to assess the correlation of MBI subscales with RSA subscales. We also used binary logistic regression to assess the relationship of burnout with resilience.

RESULTS

The prevalence of burnout was 16.84%, and high scores on depersonalization (DP) subscale were seen in males. Personal accomplishment (PA) scores were lower in the fifth and seventh semesters. A statistically significant correlation was observed between MBI and RSA subscales. Binary regression analysis revealed higher resilience scores were significantly associated with decreased likelihood of burnout in emotional exhaustion (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.93-0.97), DP (OR = 0.95; 95% CI = 0.93-0.98), and PA (OR = 0.91; 95% CI = 0.84-0.98).

CONCLUSIONS

Burnout prevalence in our sample lies at the lower range of global prevalence rates. Resilience is protective from burnout.

Hemodynamic Adaptations Induced by Short-Term Run Interval Training in College Students

Perceived lack of time is one of the most often cited barriers to exercise participation. High intensity interval training has become a popular training modality that incorporates intervals of maximal and low-intensity exercise with a time commitment usually shorter than 30 min. The purpose of this study was to examine the effects of short-term run interval training (RIT) on body composition (BC) and cardiorespiratory responses in undergraduate college students. Nineteen males (21.5 ± 1.6 years) were randomly assigned to a non-exercise control (CON, n = 10) or RIT (n = 9). Baseline measurements of systolic and diastolic blood pressure, resting heart rate (HRrest), double product (DP) and BC were obtained from both groups. VO_2max and running speed associated with VO_2peak (sVO_2peak) were then measured. RIT consisted of three running treadmill sessions per week over 4 weeks (intervals at 100% sVO_2peak, recovery periods at 40% sVO_2peak). There were no differences in post-training BC or VO₂max between groups (p > 0.05). HRrest (p = 0.006) and DP (p ≤ 0.001) were lower in the RIT group compared to CON at completion of the study. RIT lowered HRrest and DP in the absence of appreciable BC and VO_2max changes. Thereby, RIT could be an alternative model of training to diminish health-related risk factors in undergraduate college students.

Burnout Prevalence and Associated Stressors in Medical Students of Traditional and Problem-Based Learning Curricula in a Saudi University

Background:

Medical students are prone to burnout, and several stressors have been associated with it. From the literature, it is yet unclear if type of curricula in medical schools plays a role in burnout among students.

Aims:

To assess the prevalence of burnout and its associated stressors in medical students in problem-based learning and traditional curricula at Imam Abdulrahman Bin Faisal University.

Subjects and Methods:

The analytical, cross-sectional study was conducted between February and May 2017 and included all third- to sixth-year medical students of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. In the 2016–2017 academic year, third- and fourth-year students were in problem-based learning, whereas fifth- and sixth-year students were in traditional learning. All eligible students were verbally invited to complete a 56-item questionnaire comprising three sections eliciting sociodemographic information, level of burnout (using a modified Copenhagen Burnout Inventory with personal, medical school- and faculty-related subsections) and stressors associated with burnout. Burnout was measured using a Likert-type scale, and scores of >50 were considered as high burnout. Chi-square and logistic regression analysis were used for statistical analysis.

Results:

Of 947 eligible students, 593 (62.6%) completed the questionnaire: 317 (53.5%) were in problem-based learning and 276 (46.5%) in traditional learning. Of these, 329 (55.5%) had high burnout, with no difference between type of curricula (problem-based learning = 178 [56.2%]; traditional = 151 [54.7%]; P = 0.73). All measured stressors were significantly associated with high burnout, including lack of sleep (odds ratio [OR] = 2.139, P = 0.005) and perceiving teaching staff as inflexible and unsupportive (OR = 2.995, P < 0.001).

Conclusions:

This study found high prevalence of burnout among medical students in a university from Saudi Arabia, but no significant difference between students in problem-based learning and traditional curricula. A longitudinal study is recommended to better understand the long-term effect of type of curricula on burnout.

Burnout and imposter syndrome among Saudi young adults. The strings in the puppet show of psychological morbidity

OBJECTIVES

To determine the prevalence of imposter syndrome (IS) among Saudi adults and its association with burnout.

METHODS

Using non-probability convenience sampling, we carried out a cross-sectional analytical study among adults in Northern Saudi Arabia. Data collection toll was a self-administered questionnaire containing young imposter scale (YIS), Maslach burnout inventory (MBI) and depression, anxiety, and stress scale 21 (DASS 21). These 3 scales are valid and reliable measurement tools for measuring IS, burnout, and psychological morbidity.

RESULTS

In the study sample (n=384), imposterism was present among 222 adults (57.8%). Moderate and severe symptoms of depression were present in 217 (56.5%), symptoms of stress in 210 (54.7%), and symptoms of anxiety in 126 (32.8%). Burnout was measured in 3 domains of depersonalization, emotion exhaustion, and personal accomplishments. High degree of depersonalization was found in 221 (57.6%), higher emotional exhaustion in 246 (64.1%) while lower personal accomplishment was present in 126 (32.8%). We found statistical association between IS and gender (p less than 0.01), depression (p less than 0.001) stress (p less than 0.001) and all 3 domains of burnout (p less than 0.01). Imposter syndrome was not found associated with anxiety (p=0.97). Young imposter scale score was associated with all the 3 domains of burnout even after controlling for depression, anxiety, and stress.

CONCLUSION

Imposter syndrome is frequent among Saudi adults and associated with all 3 burnout domains. Mental health domains like burnout, depression, stress, and anxiety were found associated with IS.

Burnout among healthcare providers in the complex environment of the Middle East: a systematic review

BACKGROUND

Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used.

METHODS

Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East.

RESULTS

There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support.

CONCLUSIONS

Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.