Learning environment and its relationship with quality of life and burn-out among undergraduate medical students in Pakistan: a cross-sectional study

This study was conducted to determine the association between the learning environment, quality of life (QoL), and burn-out among students from selected public-sector and private-sector medical colleges in Lahore, Pakistan.

This was a cross-sectional study.

The study was conducted at six public-sector and private-sector medical colleges, selected randomly from a total of 21 medical colleges located in Lahore, Pakistan.

Study participants included a sample of 3400 undergraduate medical students from both genders and from all five classes of the programme. Data were collected using Google Forms after necessary ethical approval. The learning environment was the predictor variable, and QoL and burn-out were the outcome variables. The learning environment was measured by the Johns Hopkins Learning Environment Scale (JHLES). Students' QoL was measured using a validated linear analogue self-assessment question adopted from larger inventories for QoL, and student burn-out was measured using a validated single-item linear question (adopted from the Maslach Burnout Inventory) to measure the two parts (emotional exhaustion and depersonalisation) of burn-out. All undergraduate medical students currently enrolled in the graduation programme were included. Students in allied health sciences, dentistry and nursing programmes were excluded.

The overall JHLES Score was 82.0 for men and 81.6 for women. The mean QoL score was 7.0±1.9; for burn-out, that is, emotional exhaustion and depersonalisation, the mean scores were 21.0±13.8 and 17.5±9.0, respectively. A significant correlation (p<0.05) was found between the overall JHLES mean score and QoL, emotional exhaustion, and depersonalisation. The logistic regression model showed that the odds of higher QoL were less with a higher level of class Adjusted Odd Ratio (AOR) 0.679 (0.51-0.91) (p<0.01) and with a higher JHLES Score AOR 0.9 (0.89-0.91) p<0.0001.

Students were less likely to have a high QoL, even if they rated JHLES score on a higher side. They were more likely to have higher emotional exhaustion with successive higher class and residential status (boarders). Also, students had minimally high depersonalisation even when they rated higher scores on the JHLES scale. Based on this study, policies can be developed to improve students' well-being. Further studies are suggested postpandemic, with a bigger scope of intrinsic and extrinsic influencing factors for QoL and burn-out associated with the learning environment.