Drivers of medical student burnout and engagement since the COVID-19 pandemic: a scoping review

BACKGROUND: The COVID-19 pandemic presented medical students with novel social, emotional, and environmental challenges that affected their mental wellbeing and, in addition to this, pre-pandemic literature has demonstrated that medical students experience high rates of burnout. We conducted a scoping review to identify the social and environmental factors that have impacted medical students since the COVID-19 pandemic. We explored the key concepts, vocabulary and identified gaps in the literature published since the pandemic relating to burnout and engagement. MATERIALS AND METHODS: We conducted this scoping review by following Joanna Briggs Institute guidelines and reported using the PRISMA Extension for Scoping Reviews. Ovid MEDLINE, EMBASE, PsycInfo, and Cochrane Library were searched from 30 January 2020 to 6 December 2023. Included studies had a sample of solely medical students, had burnout or engagement as a key focus whilst matching our predetermined definitions of those concepts and must have collected data after 30 January 2020. Studies not published in English and Grey literature were excluded. We used an a priori framework adapted from a physician model to categorise the drivers of medical student burnout and engagement and the extracted data from the included studies was charted in a Microsoft Excel spreadsheet. RESULTS: Of 4897 initial titles, we identified 71 eligible papers, with a total of 62,892 participants. Most studies were cross-sectional in study design (77.5%). Three studies (4.2%) reported on both burnout and engagement, with none reporting on engagement alone. ‘Workload and job demands’ (43.7%) and ‘social support and community at work’ (31.0%) were the most prominent drivers from the a priori model cited in the literature whilst ‘control and flexibility’ (7.0%) and ‘efficiency and resources’ (4.2%) were the least. These findings suggest that burnout and engagement in medical students during the pandemic were most significantly impacted by changes to their expected workload and the social isolation that occurred with lockdowns. CONCLUSIONS: The literature related to medical student burnout and engagement since the COVID-19 pandemic is limited in design, topic, and geographical distribution. Focus on engagement and positive constructs in medical student burnout is a significant gap in the literature and should be targeted by future research.