Table 4 Summary of recommendations in primary studies.

From: Burnout increased among university students during the COVID-19 pandemic: a systematic review and meta-analysis

1. Prevention

 Individual-level interventions

 Encourage healthy behaviors among students such as eating a healthy and nutritious diet, regular exercise, restful sleep and striking a balance between academic and leisure activities

 Promote well-being and foster resilience for stress management utilizing cognitive behavioral therapy, mindfulness, yoga, etc

 Consider off-site clinic accessibility for students during the pandemic to preserve confidentiality

Organizational-level interventions

 Implement interventions to raise awareness and understanding of—and reduce stigma around—psychological distress, burnout, and other mental health illness among students

 Educators should consider adapting curricula to reduce workload, increase flexibility and incorporate virtual delivery

 Innovations in teaching should be embraced and educators should make efforts to provide a supportive learning environment

 Institutions should establish student-led services and encourage senior students’ mentorship programs

 Wellness initiatives should be offered to students to overcome any academic, financial, educational and technological barriers

 Educators should arrange research opportunities and career counseling to prepare students to join the workforce

2. Early diagnosis and management

 Early diagnosis is critical to ensure reduced burden of burnout

 Adapt and validate screening tools for local populations

 Provide professional support services like counseling and psychological care outside the student campus to avoid embarrassment and stigma associated with accessing these services

 Mental health services that are easily accessible, flexible (outside of study hours and during the weekends)

3. Research

 Better designed prospective studies to enhance understanding of the prevalence of burnout

 Further exploration of contributory factors such as sex, academic pressures, field of study, living situation, financial difficulties and cultural context is necessary to develop and deliver interventions to reduce the prevalence of burnout

 Research should assess viability of various interventions such as specific curriculum changes or mindfulness programs

 Regularly evaluate applied interventions and make modifications as appropriate

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