Development Strategies in Medical Education

Introduction
Several factors can affect students’ academic performance. Some of these factors may improve academic performance, and some may have negative impacts. One of the most important factors with a negative impact on the academic performance of college students is academic burnout. Academic burnout involves a feeling of tiredness as a result of study demands and requirements (exhaustion), pessimistic and uninterested attitudes towards tasks (cynicism), and a sense of incompetence as a student (inefficacy) [1]. Evidence shows that students with academic burnout may have symptoms such as lack of interest in scientific subjects, inability to attend class regularly, lack of participation in class activities, sense of meaninglessness in scientific activities, and inability to solve scientific problems [2]. Academic burnout has a negative effect on learning and increasing efficiency in learning and hinders the achievement of the educational goals of higher education institutions and universities [4]. Therefore, to reduce academic burnout, it is necessary to improve academic progress and increase learning motivation in students [5]. Teaching and learning are stressful experiences, but medical students bear more stress during their academic course than other students because, in addition to the stress of theoretical training, they face the diseases and deaths of patients in teaching hospitals [6]. Screening students, especially dental students, for early signs of academic burnout may provide opportunities for intervention strategies to prevent adverse effects on students’ physical and mental health [12]. Therefore, the present study was conducted qualitatively to investigate the factors related to academic burnout in dental students of Shahid Sadougi University of Medical Sciences (SSUMS), Yazd, Iran.

Methods
This is a qualitative study using the content analysis approach which was conducted on 15 SSUMS students (male and female) from the Faculty of Dentistry in 2021. Sampling was done using a purposive method until data saturation. The data were collected through semi-structured interviews. Lincoln and Guba’s criteria were used to determine the trustworthiness of the data. For credibility, we used the technique used by different studies for data collection and analysis. For confirmability, all notes and recorded interviews after analysis by the researcher, were again provided to the research team to confirm the fit between the raw data and the results obtained from the analysis. For the transferability of the research results, the researcher carefully described the conditions of the research. According to the study objectives and methodology, we used the method proposed by Ramist [14] to analyze the collected data.

Results
In this study, 15 general dentistry students participated, including 11 males and 4 females; 9 were single, and the rest were married; 9 were residents of Yazd province, and the rest were non-residents. The mean age of the students was 24.86±2.29 (ranged 21-32) and their mean GPA was 15.90±0.98 (ranged 14.5-18). Achieving a high rank in the university entrance exam, parents’ insistence, good career prospects, familiarity with the dental clinic, and interest in artistic works were among the most important reasons for choosing dentistry as a major by students. Nine students said that their interest in dentistry increased during the years of study, and 5 students said that their interest decreased. The interest remained constant in one student. All students stated that they experienced a lack of motivation and fatigue from studying dentistry during the study period.
After reviewing the transcriptions several times and coding them, 65 codes were extracted as the factors related to academic burnout. After removing duplicate codes, 22 codes remained. Finally, four main themes were extracted: Professors’ academic/behavioral weaknesses, dissatisfaction with the faculty conditions, personal problems, and social issues (Table 1).



Conclusion
The results showed that the four main factors affecting dental students’ academic burnout included professors’ academic/behavioral weaknesses, dissatisfaction with faculty conditions, personal problems, and social issues. Classification of factors indicated the strong role of organizational factors (professors and faculty) in dental students’ academic burnout. The results of this study can help SSUMS officials and faculty members in reducing the academic burnout of dental students. Considering the important role of social support in academic burnout, it is recommended that families and professors support dental students who are more vulnerable, ask about their problems, and try to solve their problems in order to avoid their academic burnout and improve their academic performance. It is recommended to investigate the prevalence of academic burnout in SSUMS dental students in future studies. 

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Shahid Sadoughi University of Medical Sciences (Code: IR.SSU.REC.1399.184).

Funding
This study was extracted from a thesis funded by Shahid Sadoughi University of Medical Sciences.

Authors' contributions
The authors contributed equally to preparing this article.

Conflicts of interest
The authors declare no conflict of interest.

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