Physical activity, burnout and quality of life in medical students: A systematic review

Interventions to promote medical student well-being: an overview of systematic reviews

OBJECTIVE

To conduct an overview of systematic reviews that explore the effectiveness of interventions to enhance medical student well-being.

DESIGN

Overview of systematic reviews.

DATA SOURCES

The Cochrane Library of Systematic Reviews, MEDLINE, APA PsychInfo, CINAHL and Scopus were searched from database inception until 31 May 2023 to identify systematic reviews of interventions to enhance medical student well-being. Ancestry searching and citation chasing were also conducted.

DATA EXTRACTION AND SYNTHESIS

The Assessing the Methodological Quality of Systematic Reviews V.2 tool was used to appraise the quality of the included reviews. A narrative synthesis was conducted, and the evidence of effectiveness for each intervention was rated.

RESULTS

13 reviews (with 94 independent studies and 17 616 students) were included. The reviews covered individual-level and curriculum-level interventions. Individual interventions included mindfulness (n=12), hypnosis (n=6), mental health programmes (n=7), yoga (n=4), cognitive and behavioural interventions (n=1), mind-sound technology (n=1), music-based interventions (n=1), omega-3 supplementation (n=1), electroacupuncture (n=1) and osteopathic manipulative treatment (n=1). The curriculum-level interventions included pass/fail grading (n=4), problem-based curriculum (n=2) and multicomponent curriculum reform (n=2). Most interventions were not supported by sufficient evidence to establish effectiveness. Eleven reviews were rated as having 'critically low' quality, and two reviews were rated as having 'low' quality.

CONCLUSIONS

Individual-level interventions (mindfulness and mental health programmes) and curriculum-level interventions (pass/fail grading) can improve medical student well-being. These conclusions should be tempered by the low quality of the evidence. Further high-quality research is required to explore additional effective interventions to enhance medical student well-being and the most efficient ways to implement and combine these for maximum benefit.

Prevalence of work-related burnout and associated factors among police officers in central Gondar zone, Northwest Ethiopia, 2023

Introduction

Work-related burnout is a state of physical and psychological fatigue and exhaustion resulting from chronic workplace stress related to work. The police workforce is vulnerable to this psychosocial hazard, which affects service delivery by police workers. However, there is little evidence about the prevalence of work-related burnout and associated factors among police officers in Ethiopia. Therefore, this research investigated the prevalence and predictor variables of work-related burnout among police officers in central Gondar zone, Northwest Ethiopia, 2023.

Methods

An institution-based cross-sectional study was carried out from April 12 to May 12, 2023. A sample of 633 police officers was recruited through multistage random sampling techniques. To measure work-related burnout, a standardized, self-administered Copenhagen Burnout Inventory was used. To enter the collected data, EpiData V 4.6 and to analyze SPSS V 26 were used. To examine the association between work-related burnout and its predictor variables, both bivariable (p < 0.2) and multivariable (<0.05) logistic regression analyses were performed, and statistical significance was established via multivariable logistic regression.

Results

The response rate in this study was 96.05% (n = 608). The majority, 452 (74.3%) of the police officers, were male; the median (IQR) age of participants was 28. In the past six months, 45.7% of the police officers had experienced work-related burnout (n = 278). Being female, having a high job demand, having a high level of organizational police stress, having a moderate level of operational police stress, having a high level of operational police stress, experiencing job dissatisfaction, and sleeping troubles were risk factors significantly related to the occurrence of work-related burnout among police officers.

Conclusion

According to this study, a significant number of police officers suffer from burnout due to their work. Police officers' work-related burnout was found to be influenced by factors such as sex, job demands, job satisfaction, workplace stress, organizational police stress, and sleeping troubles. To address this problem, improving the handling of work pressure, developing a stress management program, finding joy at work by improving interpersonal relationships and working conditions, offering support and inspiration to female police officers, and ensuring sufficient and restful sleep are advised.

Association of performance in medical residency selection with a psychiatric diagnosis, and depressive and anxiety symptoms

OBJECTIVE

Few studies have focused on medical students and residents' mental health impact on medical residency selection (MRS) performance. The authors evaluated the association of performance in MRS with depressive and anxiety symptoms and with a reported psychiatric diagnosis (rPD).

METHODS

The authors enrolled candidates after the second round of MRS examinations at a Brazilian Medical School. Performance was assessed by final grade. Depressive and anxiety symptoms were assessed by the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the State-Trait Anxiety Inventory (STAI). The authors performed mediation analysis and multiple linear regression analysis to investigate the impact of rPD, state and trait anxiety, and depressive symptom severity on performance.

RESULTS

515 of the 643 MRS candidates (80.1%) participated in the study. Higher age, attending a preparatory course for MRS, rPD, and the number of MRS applications that year were associated with poorer performance. In mediation analysis, trait anxiety was associated with a direct effect on performance and an indirect effect mediated by rPD.

CONCLUSION

The data suggest that psychiatric diagnosis is associated with poorer performance on MRS, regardless of current symptoms of anxiety and depression. Additionally, increased levels of trait anxiety may negatively impact performance, directly and indirectly.

A National Survey Evaluating Burnout and Wellness During Radiology Residency

RATIONALE AND OBJECTIVES

Burnout is a serious problem during medical residency and can contribute to poorer resident and patient health. A thorough understanding of factors associated with burnout can provide insight into supporting resident well-being. The purpose of this study is to assess the prevalence of burnout and ascertain its associated factors among radiology residents in the U.S.

MATERIALS AND METHODS

This cross-sectional study involved sending an anonymous survey to radiology program directors, coordinators, and residents across the U.S. Data regarding demographics, burnout levels, and burnout-associated factors were collected in the month of August 2023. Multivariable linear regression models evaluated the association of demographic and burnout-associated variables with burnout scores in the dimensions of Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Chi-square analyses with Bonferroni correction and Kruskal-Wallis analyses were used to assess associations between program types and burnout as well as between program type and program effectiveness in managing burnout. Resident suggestions on addressing burnout were qualitatively assessed.

RESULTS

147 radiology residents responded to the survey. Emotional Exhaustion was positively associated with seeking social support (p = .03) and negatively associated with perceived program effectiveness in addressing burnout (p < .001). Respondents who identified as male experienced greater Depersonalization (p = .02). Increased frequency of physical activity was associated with higher Personal Accomplishment scores (p = .04). The most common resident suggestions related to Work Burden, Program Support, and Protected Wellness Time.

CONCLUSION

Radiology programs should consider designing interventions addressing burnout, such as enhancing avenues for feedback and tailoring resident training based on individual preferences for remote work. Understanding the unique challenges faced by radiology residents is essential to tackle burnout and improve wellness.

A Meta-analysis of Burnout in Radiology Trainees and Radiologists: Insights From the Maslach Burnout Inventory

RATIONALE AND OBJECTIVES

Burnout, stemming from chronic work stress, is a significant issue in the medical field, especially among radiologists. It leads to compromised patient care and reduced job satisfaction. Addressing burnout in radiology is essential for the well-being of radiologists and, in turn, for improving patient care. This study aimed to assess the prevalence and dimensions of burnout among radiology trainees (RTs) and practicing radiologists (PRs).

MATERIALS AND METHODS

A systematic review and meta-analysis were conducted in accordance with established guidelines. The search encompassed PubMed, Scopus, Web of Science, and Embase databases up to June 20, 2023. Eligible studies that assessed the rate of burnout syndrome and/or its subscales, including depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA), among RTs and/or PRs using the Maslach Burnout Inventory (MBI), were included. Relevant data were extracted and analyzed using R and STATA.

RESULTS

Among the 22 included studies, the pooled rates of positive MBI subscales for RTs and PRs were as follows: 54.7% (95% confidence interval [CI]: 43.8%-65.1%, I2 = 95.2%) for DP, 57.2% (95% CI: 48.7%-65.4%, I2 = 92.9%) for EE, and 38.6% (95% CI: 27%-51.7%, I2 = 95.5%) for low PA. The pooled rate indicating the presence of at least one positive MBI subscale was 82.9% (95% CI: 79.2%-86.1%, I2 = 57.4%). For two or more positive MBI subscales, the pooled rate was 55.5% (95% CI: 49.7%-61.3%, I2 = 60.2%), and for three positive MBI subscales, it was 16.7% (95% CI: 11.7%-23.3%, I2 = 82.7%).

CONCLUSION

This study emphasizes a notable prevalence of burnout in the radiology specialty, with 8 of 10 individuals exhibiting positive results in at least one MBI subscale. This highlights the urgent need for interventions and support systems to protect the well-being of both trainees and practitioners and uphold the quality of patient care.

Are active school transport and leisure-time physical activity associated with performance and wellbeing at secondary school? A population-based study

BACKGROUND

Physically active pupils may be better and more resilient learners. However, it is unclear whether walking or cycling to school yields similar educational and school-related mental health benefits as leisure-time physical activity. We examined the associations of active school transport and leisure-time moderate-to-vigorous physical activity with perceived academic performance, competency in academic skills, school burnout and school enjoyment.

METHODS

We included 34 103 Finnish adolescents (mean age 15.4 years; 53% girls) from the 2015 School Health Promotion study cohort. For the analyses, we used logistic regression, adjusting for major sociodemographic, environmental, lifestyle and physical activity covariates.

RESULTS

Active school transport was positively associated with educational outcomes and school enjoyment, but not with school burnout. For example, compared with non-active transport, 10-30 min of daily active school transport was linked to 30% [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.21-1.40] and 17% (OR 1.17, 95% CI 1.08-1.27) higher odds of high perceived academic performance and high reading competency, respectively. Leisure-time physical activity was robustly associated with all outcomes. For example, compared with the inactive, the most physically active adolescents had 86% higher odds of high perceived academic performance (OR 1.86, 95% CI 1.66-2.08), 57% higher odds of high competency in mathematics (OR 1.57, 95% CI 1.39-1.77) and 40% lower odds of school burnout (OR 0.60, 95% CI 0.52-0.69).

CONCLUSIONS

Compared with active school transport, leisure-time physical activity was more strongly associated with educational and school-related mental health outcomes. Nevertheless, walking or cycling to school might lead to improvements in classroom performance and school enjoyment.

Burnout and motivation to study medicine among students during the COVID-19 pandemic

Aim

To investigate medical students' burnout and motivation levels in each of the six years of their studies during the COVID-19 pandemic and identify independent predictors of burnout and motivation.

Methods

An anonymous cross-sectional survey was sent to the students of all six years within our school. Burnout was measured with the adapted Oldenburg Burnout Inventory questionnaire (OLBI-S) and motivation with the updated Strength of Motivation for Medical School (SMMS-R) questionnaire. Univariate analysis was performed with the Kruskal-Wallis test and Spearman's correlation, while multivariable analysis with linear regression models.

Results

A total of 333 medical students (52% of student body) responded. Higher burnout levels correlated with lower motivation to study medicine (rho = -0.30, p < 0.001). Burnout levels differed between the six years of medical studies, peaking in years two and four whereas being the lowest in year one (p = 0.01). Motivation levels differed significantly as well, peaking in years one and four whereas being the lowest in years five and six (p = 0.012). In the multivariable linear regression models, being a female (b = 2.22, p = 0.016), studying in the fourth year vs. first year (b = 2.54, p = 0.049), having a perceived beginner/intermediate vs. advanced/expert technology level (b = 2.05, p = 0.032) and a perceived poor school support system (b = 6.35, p < 0.001) were independently associated with higher burnout levels. Furthermore, studying in the fifth year vs. first year (b = -5.17, p = 0.019) and a perceived poor school support system (b = -3.09, p = 0.01) were independently associated with a reduced motivation to study medicine.

Conclusion

Our study highlighted potential areas for intervention to decrease the rate of burnout and low motivation among medical students. However, further research is needed to unravel the full effect of the pandemic on medical students.

Physical Fitness, Nutrition and Quality of Life in German Medical Students

BACKGROUND

Medical students are exposed to high cognitive demands as well as to a high learning effort, which as a consequence can lead to a limited quality of life (Qol) with reduced physical performance and unhealthy eating behaviors. The aim of this retrospective analysis was to evaluate the abovementioned factors and their relationship to each other.

METHODS

We included 380 medical students (167 men, 213 women, age 22.2 ± 3.9 yrs) who participated in the sports medicine elective subject. Qol was measured with the SF-36 questionnaire, and endurance capacity was measured by using an incremental running test. Daily dietary intake was measured using a 7-day diary protocol. Depending on sex and the maximum speed achieved, students were divided into three performance groups.

RESULTS

Men achieved higher maximal speed, heart rate, and lactate. Carbohydrates and fat intake did not meet recommendations in either group. Dietary fibre intake differed significantly between the performance groups in men and women, with the better groups having higher intakes.

CONCLUSIONS

Our data do not suggest increased risk or health-damaging behaviors in medical students compared with the general population. Irrespective of this, incentives should be set to enable a healthy life even during complex studies with a high learning effort.