A systematic scoping review on the impact of the COVID-19 quarantine on the psychological wellbeing of medical students

  1. Divya I. Vythilingam
  2. William U. Atiomo

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Abstract

Objectives

The goal of this study was to identify the nature and extent of the available published research on the impact of social isolation, on the psychological wellbeing of medical students, who had to quarantine due to the COVID-19 pandemic.

Design

Scoping review.

Search strategy

The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews), guideline, was used to structure this study. A search strategy was carried out across six bibliographic databases. PubMed, Embase, ERIC, Scopus, Cochrane Database of Systematic Reviews and Web of Science. The following search terms were used, “medical student*” AND “impact” AND “quarantine” AND “COVID-19”. Searches were confined to articles published (excluding conference abstracts) between 1 January 2019-21 August 2021. A search of secondary references was conducted. Data from the selected studies were extracted, and the following variables recorded; first author and year of publication, country of study, study design, sample size, focus group, mode of analyzing impact of quarantine from COVID-19 on mental health and results of the studies.

Results

A total of 223 articles were identified across the six databases, from which 69 duplicates were excluded resulting in 154 full-text articles. Of these, 29 met the inclusion criteria. Following a review of the abstracts of these 29, ten full-text articles were identified all of which were cross sectional studies. Sample sizes ranged from 182 to 860 students and all studies used a variety of self-administered questionnaires to measure psychological wellbeing. Eight of the 10 articles showed that quarantine had a negative impact on the psychological well-being of medical students.

Conclusion

The evidence is small but growing. Quarantine because of the COVID-19 pandemic appears to have had a negative impact on the psychological wellbeing of medical students. There is a need for more studies to further evaluate this research question.

Article summary

Strengths and limitations of this study.

  • This was the first scoping review as far as we know of the literature in this area.

  • Many of the studies analysed in this review were cross-sectional in nature.

  • A variety of measurement tools were used to assess psychological wellbeing, preventing comparison of results and data synthesis.

  • Many of the studies included in the review did not include a control group of medical students, pre-COVID-19 quarantine.

  • A detailed critical appraisal of the studies included was not conducted, however this is not mandatory for scoping reviews.

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    1. ScreenIT

      SciScore for 10.1101/2021.11.28.21266956: (What is this?)

      Please note, not all rigor criteria are appropriate for all manuscripts.

      Table 1: Rigor

      Ethicsnot detected.
      Sex as a biological variableHowever, despite these two outlier studies, overall a substantial negative impact on the psychological wellbeing of medical students resulted due to quarantine during the COVID-19 pandemic, particularly amongst females and those in their early years of their medical degree,[4, 6, 12, 13, 16,].
      Randomizationnot detected.
      Blindingnot detected.
      Power Analysisnot detected.

      Table 2: Resources

      Software and Algorithms
      SentencesResources
      Searches were confined to articles published (excluding conference abstracts) between 1 January 2019-21 August 2021 on PubMed, Embase, ERIC, Scopus, Cochrane Database of Systematic Reviews and Web of Science as highlighted in Table 1.
      PubMed
      suggested: (PubMed, RRID:SCR_004846)
      Embase
      suggested: (EMBASE, RRID:SCR_001650)
      Cochrane Database of Systematic Reviews
      suggested: None

      Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

      Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
      Strengths and limitations: The strengths of this study are associated with this study being the first systematic scoping review which encompasses findings from a range of universities globally. As such, this allowed for a comparison across institutions regarding their various methods of innovative online education teaching platforms as well as their associated negative impacts it has had on medical students. This is vital as it allows for a greater understanding of the various consequences that affect medical students. This is beneficial and significant for future studies which can aim to focus on developing methods to reduce future negative impacts on the mental health of students and ensure that the negative impacts that were caused are effectively managed and eliminated. There were however, some limitations of this scoping review. Firstly, many of the studies analysed in this review were cross-sectional in nature and thus this potentially could have led to casual associations. Future studies should therefore, focus on being conducted in a longitudinal series. Secondly, because online questionnaires were used, different modes were used for analysing the data and student responses were mostly subjective. It was therefore difficult to accurately compare results across studies in a meta-analysis. Many of the studies also did not include a control group of medical students, pre-COVID-19 quarantine, highlighting the need for future studies to include two separate groups to allow...

      Results from TrialIdentifier: No clinical trial numbers were referenced.

      Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

      Results from JetFighter: We did not find any issues relating to colormaps.

      Results from rtransparent:
      • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
      • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
      • No protocol registration statement was detected.

      Results from scite Reference Check: We found no unreliable references.

      About SciScore

      SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

    2. Version published to 10.1101/2021.11.28.21266956v2 on medRxiv
    3. Version published to 10.1101/2021.11.28.21266956v1 on medRxiv