School engagement and student burnout among medical and health science students in Saudi Arabia-cross-sectional study.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Students, Medical*/psychology ; Burnout, Psychological*/epidemiology ; Burnout, Psychological*/psychology ; Burnout, Professional*/epidemiology ; Burnout, Professional*/psychology ; Students*/psychology; Saudi Arabia/epidemiology ; Humans ; Male ; Female ; Cross-Sectional Studies ; Young Adult ; Surveys and Questionnaires ; Adult ; Universities ; Schools

School engagement and burnout are contributing factors influencing academic student performance. Student burnout is a serious concern in higher education, where it can result in poor mental and physical health and school dropout. Although recent studies indicate the significance of the relationship between academic engagement and achievement, little is known about how academic engagement and burnout affect medical sciences students in the Madinah region of Saudi Arabia. We aimed to assess the level of school engagement and student burnout among medical and health science students in Madinah, Saudi Arabia. Factors associated with school engagement and student burnout were also explored. A cross-sectional data of 297 students last year medical and health science undergraduate students who were recruited from Taibah University, Madinah. The online survey was shared with students to collect data on sample characteristics, school engagement (using the modified version of the University Student Engagement Inventory), and student burnout (using the modified version of the Maslach Burnout Inventory Student Survey). The data showed that 57.5% of medical science students in the sample were academically engaged, and 55.9% experienced burnout, indicating a moderate to high level of student engagement and burnout. However, there was no correlation between school engagement and student burnout (r = 0.27) among the sample in this study. Nevertheless, school engagement was affected by factors such as student living status (p = 0.036), dropout thoughts (p = 0.008), and cumulative GPA (p = 0.001). In addition to dropout thoughts and GPA, the student burnout level was also predicted by the college (p = 0.012), program duration (p < 0.001), sex (p = 0.016), and average sleeping hours per day (p = 0.019). These results imply that school engagement and burnout may not be directly related or opposites and can interact in a variety of ways depending on factors including student personality and lifestyle, as well as academic and institutional influences. Many factors were linked to school engagement and student burnout. Interventions that aim to reduce student burnout should be tailored based on many factors including program duration and sex of students.
(© 2025. The Author(s).)

Declarations. Ethics approval and consent to participate: “Informed consent to participate was obtained from all participants before data were collected”. The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by The study protocol was approved by the ethical committee of the Applied Medical Sciences, Taibah University (Certificate number 2024/188/401 NAMS). Competing interests: The authors declare no competing interests.

Kahu, E. R. Framing student engagement in higher education. Stud. High. Educ. 38 (5), 758–773 (2013).
Li, Y. et al. Analysis of factors influencing medical students’ learning engagement and its implications for teaching work—— a network analysis perspective. BMC Med. Educ. 24, 918. https://doi.org/10.1186/s12909-024-05908-y (2024). (PMID: 3918208811344382)
Finn, J. D. & Zimmer, K. S. Student engagement: what is it? Why does it matter? In: Handbook of Research on Student Engagement. edn.: Springer; : 97–131. (2012).
Coates, H. The value of student engagement for higher education quality assurance. Qual. High. Educ. 11 (1), 25–36 (2005).
Lv, S., Chen, C., Zheng, W. & Zhu, Y. The relationship between study engagement and critical thinking among higher vocational college students in china: a longitudinal study. Psychology Res. Behav. Management :2989–3002. (2022).
Nabizadeh, S., Hajian, S., Sheikhan, Z. & Rafiei, F. Prediction of academic achievement based on learning strategies and outcome expectations among medical students. BMC Med. Educ. 19, 1–11 (2019).
Wang, M-T., Fredricks, J., Ye, F., Hofkens, T. & Linn, J. S. Conceptualization and assessment of adolescents’ engagement and disengagement in school. Eur. J. Psychol. Assess. 35 (4), 1–15 (2017).
Watt, H. M., Carmichael, C. & Callingham, R. Students’ engagement profiles in mathematics according to learning environment dimensions: developing an evidence base for best practice in mathematics education. School Psychol. Int. 38 (2), 166–183 (2017).
Bae, C. L. & DeBusk-Lane, M. Middle school engagement profiles: implications for motivation and achievement in science. Learn. Individual Differences. 74, 101753 (2019).
Milles, L. S. et al. Student engagement in medical education: a mixed-method study on medical students as module co-directors in curriculum development. Med. Teach. 41 (10), 1143–1150 (2019). (PMID: 31203695)
Kajjimu, J., Kaggwa, M. M. & Bongomin, F. Burnout and associated factors among medical students in a public university in uganda: a cross-sectional study. Adv. Med. Educ. Pract. 12, 63–75 (2021). (PMID: 335318527846825)
Yahya, M. S., Abutiheen, A. A. & Al- Haidary, A. F. Burnout among medical students of the university of Kerbala and its correlates. Middle East. Curr. Psychiatry. 28, 1–7 (2021).
Altannir, Y. et al. Assessment of burnout in medical undergraduate students in riyadh, Saudi Arabia. BMC Med. Educ. 19, 1–8 (2019).
Zucoloto, M. L., de Oliveira, V., Maroco, J. & Campos, J. A. D. B. School engagement and burnout in a sample of Brazilian students. Currents Pharm. Teach. Learn. 8 (5), 659–666 (2016).
Hulley, S. in Designing Clinical Research. (eds Hulley, S. B., Cummings, S. R., Browner, W. S. & Grady, D. G. N.) (Lippincott Williams & Wilkins, 2013).
Maslach, C. & Jackson, S. E. The measurement of experienced burnout. J. Organizational Behav. 2 (2), 99–113 (1981).
Jiang, J. & Tanaka, A. Autonomy support from support staff in higher education and students’ academic engagement and psychological well-being. Educational Psychol. 42 (1), 42–63 (2022).
Tzafea, O. Examining the relationship between student’s engagement and socioeconomic background in higher education. Student Engagem. High. Educ. J. 3 (2), 141–157 (2021).
Enochs, W. K. & Roland, C. B. Social adjustment of college freshmen: the importance of gender and living environment. College Student Journal 40(1). (2006).
Jain, T. & Kapoor, M. The impact of study groups and roommates on academic performance. Rev. Econ. Stat. 97 (1), 44–54 (2015).
Sunawan, S., Amin, Z. N., Hafina, A. & Kholili, M. The differences of students’ burnout from level of education and duration daily online learning during COVID-19 pandemics. In: Proceedings of the International Conference on Industrial Engineering and Operations Management: ; 2021: 3723–3729. ; 2021: 3723–3729. (2021).
Pokhrel, N. B., Khadayat, R. & Tulachan, P. Depression, anxiety, and burnout among medical students and residents of a medical school in nepal: a cross-sectional study. BMC Psychiatry. 20, 1–18 (2020).
Almutairi, H. et al. Prevalence of burnout in medical students: A systematic review and meta-analysis. Int. J. Soc. Psychiatry. 68 (6), 1157–1170 (2022). (PMID: 35775726)
Ranasinghe, P. D. et al. Depressive symptoms and burnout among medical students: A prospective study. J. Gen. Intern. Med. 37 (1), 64–69 (2022). (PMID: 34037922)
Shadid, A. et al. Stress, burnout, and associated risk factors in medical students. Cureus 12 (1), 1–13 (2020).
Abdul, N. S. A. N., Alhumam, N. A., Alenayaq, A. H. A. & Alshehri, S. M. Prevalence of burnout syndrome and its associated factors among undergraduate, graduate and postgraduate dental students in a private university, riyadh, Saudi Arabia. Med. Sci. 25 (116), 2698–2707 (2021).
Muzafar, Y. et al. Burnout and its associated factors in medical students of Lahore. Pakistan Cureus. 7 (11), 1–12 (2015).
Fares, J. et al. Extracurricular activities associated with stress and burnout in preclinical medical students. J. Epidemiol. Global Health. 6 (3), 177–185 (2016).
Worly, B., Verbeck, N., Walker, C. & Clinchot, D. M. Burnout, perceived stress, and empathic concern: differences in female and male millennial medical students. Psychol. Health Med. 24 (4), 429–438 (2019). (PMID: 30295048)
Rami, Y., Abidli, Z., Elturk, J. & Badaoui, B. Assessment of factors associated with academic engagement and student burnout in the Moroccan context. Bangladesh J. Med. Sci. 23 (1), 228–236 (2024).
Misra, R. & McKean, M. College students’ academic stress and its relation to their anxiety, time management, and leisure satisfaction. Am. J. Health Stud. 16 (1), 41–51 (2000).
Taka, F. et al. Organizational climate with gender equity and burnout among university academics in Japan. Ind. Health. 54 (6), 480–487 (2016). (PMID: 277255625136604)
Dyrbye, L. N. et al. Burnout and serious thoughts of dropping out of medical school: a multi-institutional study. Acad. Med. 85 (1), 94–102 (2010). (PMID: 20042833)
Yang, H-J. Factors affecting student burnout and academic achievement in multiple enrollment programs in taiwan’s technical–vocational colleges. Int. J. Educational Dev. 24 (3), 283–301 (2004).
Abreu Alves, S. et al. Burnout and dropout intention in medical students: the protective role of academic engagement. BMC Med. Educ. 22 (1), 1–11 (2022).
Bahlaq, M. A. et al. Burnout, stress, and stimulant abuse among medical and dental students in the Western region of Saudi arabia: an analytical study. Saudi J. Med. Med. Sci. 11 (1), 44–53 (2023). (PMID: 369090019997854)
Asiri, S. et al. Prevalence of burnout syndrome and its relationship with GPA among medical students at al Maarefa university, Saudi arabia, 2022. Med. Sci. 27, 1–6 (2023).
Alfawaz, R. A. et al. The recommended amount of physical activity, sedentary behavior, and sleep duration for healthy saudis: A joint consensus statement of the Saudi public health authority. Annals Thorac. Med. 16 (3), 239–244 (2021).
Watson, N. et al. Joint consensus statement of the American academy of sleep medicine and sleep research society on the recommended amount of sleep for a healthy adult: methodology and discussion. Sleep 38 (8), 1161–1183 (2015). (PMID: 261945764507722)
Paruthi, S. et al. Consensus statement of the American academy of sleep medicine on the recommended amount of sleep for healthy children: methodology and discussion. J. Clin. Sleep Med. 12 (11), 1549–1561 (2016). (PMID: 277074475078711)
Giri, P. A., Baviskar, M. P. & Phalke, D. B. Study of sleep habits and sleep problems among medical students of Pravara Institute of medical sciences loni, Western maharashtra, India. Annals Med. Health Sci. Res. 3 (1), 51–54 (2013).
Chinawa, J. M., Chukwu, B. F. & Obu, H. A. Sleep practices among medical students in pediatrics department of university of Nigeria teaching hospital, ituku/ozalla, enugu, Nigeria. Niger. J. Clin. Pract. 17 (2), 232–236 (2014). (PMID: 24553037)
Alsaggaf, M. A., Wali, S. O., Merdad, R. A. & Merdad, L. A. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years: relationship with stress and academic performance. Saudi Med. J. 37 (2), 173–182 (2016). (PMID: 268374014800917)
Alotaibi, A. D., Alosaimi, F. M., Alajlan, A. A. & Abdulrahman, K. A. B. The relationship between sleep quality, stress, and academic performance among medical students. J. Family Community Med. 27 (1), 23–28 (2020). (PMID: 320300756984036)
Abdulghani, H. M. et al. Sleep disorder among medical students: relationship to their academic performance. Med. Teach. 34 (sup1), S37–S41 (2012). (PMID: 22409189)
Safhi, M. A. et al. The association of stress with sleep quality among medical students at King Abdulaziz university. J. Family Med. Prim. Care. 9 (3), 1662–1667 (2020). (PMID: 325096687266176)
Brick, C. A., Seely, D. L. & Palermo, T. M. Association between sleep hygiene and sleep quality in medical students. Behav. Sleep. Med. 8 (2), 113–121 (2010). (PMID: 203525473572193)
Wolf, M. R. & Rosenstock, J. B. Inadequate sleep and exercise associated with burnout and depression among medical students. Acad. Psychiatry. 41, 174–179 (2017). (PMID: 26976402)
Grady, F. & Roberts, L. W. Sleep deprived and overwhelmed: sleep behaviors of medical students in the USA. In., vol. 41: Springer; : 661–663. (2017).

Keywords: Health science; Medical; Saudi arabia; School engagement; Student burnout

Date Created: 20250803 Date Completed: 20250803 Latest Revision: 20250808

20260130

PMC12319107

10.1038/s41598-025-12879-7

40754633