Background: This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students. Methods: The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS). Results: Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI–HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology. Conclusion: This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students’ mental health impairment to enable more meaningful comparisons and adequate prevention strategies.

Background: High levels of burnout rates amongst medical students have been confirmed by numerous studies from diverse contexts. This study aims to explore the functional and dysfunctional coping strategies of medical students with regard to their respective burnout factors. Methods: About 845 medical students in the 3^rd, 6^th, and 9^th semesters and students in their final year were invited to take part in the survey. The self-administered questionnaire included items on potential functional and dysfunctional behavioural-based coping strategies as well as the Maslach Burnout Inventory-Student Version (MBI-SS). In addition, a comparison of the local results with a German reference sample involving other students was calculated. Results: A total of 597 medical students (70.7%) participated in the cross-sectional study. The results showed high burnout rates, averaging 35%. Students in earlier stages of university education showed lower values for cynicism (a subdimension of burnout), but higher values for emotional exhaustion than students in higher stages. Concerning academic efficacy, there was a trend towards less efficient perception among students in higher education. The identified functional coping strategies were ‘seeking support from friends’, ‘seeking support from family’, ‘doing relaxing exercise’, ‘doing sports’ and ‘seeking support from fellow students’. The identified dysfunctional coping strategies were ‘taking tranquilizers’, ‘taking stimulants’, ‘drinking alcohol’, ‘withdrawal and ruminating’, and ‘playing games on the PC or mobile phone’. The medical students surveyed are more affected by burnout symptoms like emotional exhaustion than the reference populations, but the overall result was difficult to interpret. Conclusions: The identified behavioural-based functional coping strategies suggest that social support and active relaxing exercises seem to be very important possibilities for medical students to reduce stress and exhaustion. The use of drugs and alcohol for stress reduction raises concerns. Programs are recommended to improve resilient behaviour and to impart the identified functional coping strategies to medical students.

Numerous studies from diverse contexts have confirmed high stress levels and stress-associated health impairment in medical students. This study aimed to explore the differential association of perceived stress with private and training-related stressors in medical students according to their stage of medical education. Participants were high-school graduates who plan to study medicine and students in their first, third, sixth, or ninth semester of medical school or in practical medical training. The self-administered questionnaire included items addressing demographic information, the Perceived Stress Questionnaire, and items addressing potential private and training-related stressors. Results confirmed a substantial burden of perceived stress in students at different stages of their medical education. In particular, 10–28% of students in their third or ninth semesters of medical school showed the highest values for perceived stress. Training-related stressors were most strongly associated with perceived stress, although specific stressors that determined perceived stress varied across different stages of students’ medical education. High-school graduates highly interested in pursuing medical education showed specific stressors similar to those of medical students in their third, sixth, or ninth semesters of medical school, as well as stress structures with heights of general stress rates similar to those of medical students at the beginning of practical medical training. High-school graduates offer new, interesting information about students’ fears and needs before they begin medical school. Medical students and high-school graduates need open, comprehensive information about possible stressors at the outset of and during medical education. Programmes geared toward improving resilience behaviour and teaching new, functional coping strategies are recommended.

The teaching of students by peers, so-called peer-assisted learning, is effective based on cognitive and social congruence among students and student tutors. This study aims to investigate cognitiv...

Purpose: Patients who have access to information online may feel empowered and also confront their physicians with more detailed questions. Medical students are not well-prepared for dealing with so-called “e-patients.” We created a teaching module to deal with this, and evaluate its effectiveness. Method: Senior medical students had to manage encounters with standardized patients (SPE) in a cross-over design. They received blended-learning teaching on e-patients and a control intervention according to their randomization group (EI/LI = early/late intervention). Each SPE was rated by two blinded video raters, the SP and the student. Results: N = 46 students could be included. After the intervention, each group (EI, LI) significantly improved their competency in dealing with e-patients as judged by expert video raters (EI: M_T0 = 9.75 (2.51) versus M_T1 = 16.60 (2.80); LI: M_T0 = 8.70 (2.14) versus M_T2 = 15.20 (2.84); both p < 0.001) and SP (EI: M_T0 = 24.13 (4.83) versus M_T1 = 26.52 (3.06); LI: M_T0 = 23.37 (3.10) versus M_T2 = 27.47 (4.38); both p < 0.001). Students’ rating showed a similar non-significant trend. Conclusions: Students, SP and expert video raters determined that blended-learning teaching can improve students’ competencies when dealing with e-patients. Within the study period, this effect was lasting; however, further studies should look at long-term outcomes.

Background: Professionals in the healthcare sector are a particularly vulnerable group for occupational strain due to high work-related psychological stress. For the implementation of targeted stress-prevention interventions as an important part of a workplace health management programme for all occupational groups and hierarchy levels, information about the current state of their mental health is mandatory. Hence, this study investigated the association of general well-being and different leadership styles among employees in a German tertiary hospital. Methods: Via an online survey, 10,101 employees were contacted. The final sample consisted of 1137 employees. Of these, 27.7% described themselves as leaders and 72.3% as followers. Most participants were female (74.8%), more than half were under 41 years old. Besides control variables, general well-being (WHO-5) and leadership style (transactional and transformational, laissez-faire and destructive leadership) were assessed. Results: Leaders reported higher well-being scores than followers. Physicians without leadership responsibilities had the lowest scores for well-being. Practitioners of both transformational and transactional leadership were associated with higher well-being scores, while those practicing laissez-faire and destructive leadership had lower scores for almost every professional group. Conclusion: Results highlight the necessity for future multimodal health-preventive leadership interventions feature behavioural and organizational intervention modules specifically tailored to hospital professionals at different hierarchical and functional levels to foster the mental health of employees.