{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:55:10Z","timestamp":1792292110589,"version":"4.4.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Online learning has emerged as an alternative to continuing higher education during the ongoing conflict in Sudan. Despite its numerous benefits, online learning is often associated with challenges like stress, anxiety, and depression. Satisfaction plays a pivotal role in shaping students\u2019 perceptions of online education quality and their mental well-being, especially under adverse conditions like conflict. Hence, this study aimed to evaluate the satisfaction of Sudanese medical students with online learning and its association with psychological distress issues, including anxiety, depression, and stress, during the current Sudan war.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A cross-sectional study was conducted among Sudanese medical students who transitioned to online learning during the conflict. Satisfaction with online learning was assessed using a validated questionnaire consisting of eight dimensions, while depression symptoms were measured with the Patient Health Questionnaire-9, anxiety with the Generalized Anxiety Disorder-7, and perceived stress with the Perceived Stress Scale-10. Associations between demographic factors and key outcomes were analyzed using independent t-tests, chi-square tests, and one-way ANOVA, with statistical significance set at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among the 1,891 medical students surveyed, the mean satisfaction score for online learning was 26.2 out of 40. Mild to moderate depression was reported by 59.4% of students, while 62% experienced mild to moderate anxiety, and 21% reported high stress levels. Lower satisfaction was significantly associated with higher levels of depression, anxiety, and stress (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Sudanese medical students reported positive satisfaction with online learning during the conflict, yet this was accompanied by high levels of depression, anxiety, and stress. These findings highlight the need for integrated mental health support and improved digital access to enhance online education. Addressing these challenges is essential to ensuring student well-being and sustaining quality education in conflict settings. Further research across different settings can help develop more effective interventions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12909-025-07228-1","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:15:24Z","timestamp":1747217724000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Sudanese medical students\u2019 satisfaction with online learning and its association with their psychological distress: a cross-sectional study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1549-8155","authenticated-orcid":false,"given":"Muhannad Bushra Masaad","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6224-485X","authenticated-orcid":false,"given":"Ahmed Balla M.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1101-4698","authenticated-orcid":false,"given":"Moram Elfadel Abdelrhaman","family":"Gasmalha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olla Zuhair Elamin","family":"Abdalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safinat Hassan Mohammed","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blsam Abdelmoneam Ahmed","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabaa Alamein Omer","family":"Ebrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maab Hisham Saeed","family":"Abdeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esraa Obeid Mohammed","family":"Babiker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasneem Abdelgader Abdelrhman","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkhansa Ahmed Osman","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa Salaheldin Mohamed","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Mubashir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2824-4642","authenticated-orcid":false,"given":"Sohaib Mohammed Mokhtar","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"issue":"2","key":"7228_CR1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.55982\/openpraxis.16.2.668","volume":"16","author":"S Salha","year":"2024","unstructured":"Salha S, Tlili A, Shehata B, Zhang X, Endris A, Khalid A, et al. How to maintain education during wars?? An integrative approach to ensure the right to education. Open Praxis. 2024;16(2):160\u201379.","journal-title":"Open Praxis"},{"key":"7228_CR2","unstructured":"Swerdloff M. Online Learning - an overview| ScienceDirect Topics [Internet]. www.sciencedirect.com.2016. Available from: https:\/\/www.sciencedirect.com\/topics\/psychology\/online-learning"},{"key":"7228_CR3","doi-asserted-by":"crossref","unstructured":"Xu T, Xue L. Satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak: evidence from a meta-analysis. Front Psychol. 2023;14.","DOI":"10.3389\/fpsyg.2023.1128034"},{"key":"7228_CR4","doi-asserted-by":"crossref","unstructured":"Sabir M. Challenges of online medical education in Khartoum Sudan during COVID-19 pandemic 2021. Annals Adv Biomedical Sci. 2023;6(1).","DOI":"10.23880\/aabsc-16000195"},{"key":"7228_CR5","doi-asserted-by":"publisher","unstructured":"Johnson IE, Ofoegbu T, Asogwa U, Offiong AEA, Eteng IJ, Abanyam VA et al. Comparing the Academic Achievement of Students Taught Educational Technology with Doodly-designed Multimedia Instructions in Classroom and Online Learning Environments [Internet]. Ianna Journal of Interdisciplinary Studies. 2024. Available from: https:\/\/doi.org\/10.5281\/zenodo.12189075","DOI":"10.5281\/zenodo.12189075"},{"key":"7228_CR6","doi-asserted-by":"crossref","unstructured":"Thandevaraj EJ, Gani NAN, Nasir MKM. A Review of Psychological Impact on Students Online Learning during Covid-19 in Malaysia. Creative Education [Internet]. 2021;12(06):1296\u2013306. Available from: https:\/\/www.scirp.org\/journal\/paperinformation.aspx?paperid=109894","DOI":"10.4236\/ce.2021.126097"},{"key":"7228_CR7","unstructured":"Reid J. Satellite Data Captures Power Outages in Sudan\u2019s Civil War - Payne Institute for Public Policy [Internet]. Payne Institute for Public Policy. 2024. Available from: https:\/\/payneinstitute.mines.edu\/satellite-data-captures-power-outages-in-sudans-civil-war\/"},{"key":"7228_CR8","unstructured":"Internet in Conflict: Sudan\u2019s Battle for Connection [Internet]. The Tahrir Institute for Middle East Policy -. 2024. Available from: https:\/\/timep.org\/2024\/09\/19\/internet-in-conflict-sudans-battle-for-connection\/"},{"key":"7228_CR9","doi-asserted-by":"crossref","unstructured":"Rutkowska A, Cie\u015blik B, Tomaszczyk A, Szczepa\u0144ska-Gieracha J. Mental health conditions among E-Learning students during the COVID-19 pandemic. Front Public Health. 2022;10.","DOI":"10.3389\/fpubh.2022.871934"},{"key":"7228_CR10","doi-asserted-by":"publisher","unstructured":"Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and Health [Internet]. 2020;16(1):1\u201311. Available from: https:\/\/globalizationandhealth.biomedcentral.com\/articles\/https:\/\/doi.org\/10.1186\/s12992-020-00589-w","DOI":"10.1186\/s12992-020-00589-w"},{"key":"7228_CR11","doi-asserted-by":"publisher","first-page":"104954","DOI":"10.1016\/j.neubiorev.2022.104954","volume":"143","author":"Y Zhu","year":"2022","unstructured":"Zhu Y, Jha SC, Shutta KH, Huang T, Balasubramanian R, Estruch R, et al. Psychological distress and metabolomic markers: A systematic review of posttraumatic stress disorder, anxiety, and subclinical distress. Neurosci Biobehavioral Reviews. 2022;143:104954\u20134.","journal-title":"Neurosci Biobehavioral Reviews"},{"issue":"1","key":"7228_CR12","doi-asserted-by":"publisher","first-page":"243","DOI":"10.17162\/au.v13i1.1326","volume":"13","author":"S Grynyuk","year":"2022","unstructured":"Grynyuk S, Zaytseva I, Vysotchenko S. The impact of distance education on students\u2019 motivation and emotional state in the context of the pandemic and the armed conflict in Ukraine. Apuntes Universitarios. 2022;13(1):243\u201359.","journal-title":"Apuntes Universitarios"},{"key":"7228_CR13","doi-asserted-by":"crossref","unstructured":"Neyazi A, Rahimi BA, Mohammadi AQ, Razaqi N, Qanawezi L, Sarem S et al. Anxiety symptoms, sleep disturbance, and academic achievement among Afghan female school students: A cross-sectional study. Sleep Epidemiology [Internet]. 2024;4:100102. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2667343624000283","DOI":"10.1016\/j.sleepe.2024.100102"},{"key":"7228_CR14","first-page":"1","volume":"2023","author":"F Adnan Innab, Aldawood","year":"2023","unstructured":"Adnan Innab, Aldawood F, Abdali NO, Arishi OK. Abdullah Mansi alomary. The influence of satisfaction with E-Learning on the psychological state of nursing students. Perspect Psychiatr Care. 2023;2023:1\u20138.","journal-title":"Perspect Psychiatr Care"},{"issue":"3","key":"7228_CR15","first-page":"580","volume":"13","author":"CG Ionescu","year":"2023","unstructured":"Ionescu CG, Chendea A, Licu M. Is satisfaction with online learning related to depression, anxiety, and insomnia symptoms?? A Cross-Sectional study on medical undergraduates in Romania. Eur J Invest Health Psychol Educ. 2023;13(3):580\u201394.","journal-title":"Eur J Invest Health Psychol Educ"},{"key":"7228_CR16","doi-asserted-by":"crossref","unstructured":"Abdulhamid SM, Almokdad FK, Ahmed RMAM, Elbashir, Ahmed A. Psychological status of medical students and interns in the wake of the armed conflict of April 2023 in Sudan. A cross-sectional study. medRxiv (Cold Spring Harbor Laboratory; 2024.","DOI":"10.1101\/2024.02.27.24303455"},{"key":"7228_CR17","doi-asserted-by":"publisher","unstructured":"Celestine GV. The Comparative advantage of digital and face-to-face data collection in 21st century research. Evidence from Agricultural research [Internet]. Torkwase Journal of Agricultural Research. 2024. Available from: https:\/\/doi.org\/10.5281\/zenodo.13992563","DOI":"10.5281\/zenodo.13992563"},{"key":"7228_CR18","unstructured":"Zaheer M, Babar ME, Gondal UH, Qadri MM. E-Learning and Student Satisfaction. 9th Annual conference of Asian Association of Open Universities (AAOU) [Internet]. 2015; Available from: https:\/\/www.researchgate.net\/publication\/295400881"},{"issue":"4","key":"7228_CR19","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.genhosppsych.2010.03.006","volume":"32","author":"K Kroenke","year":"2010","unstructured":"Kroenke K, Spitzer RL, Williams JBW, L\u00f6we B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345\u201359.","journal-title":"Gen Hosp Psychiatry"},{"key":"7228_CR20","unstructured":"American Psychological Association. Patient health questionnaire (PHQ-9 & PHQ-2). American Psychological Association [Internet]. 2020; Available from: https:\/\/www.apa.org\/pi\/about\/publications\/caregivers\/practice-settings\/assessment\/tools\/patient-health"},{"key":"7228_CR21","doi-asserted-by":"crossref","unstructured":"Spitzer R, Kroenke K, Williams J, L\u00f6we B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7 [Internet]. Archives of internal medicine. 2006. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/16717171\/","DOI":"10.1001\/archinte.166.10.1092"},{"key":"7228_CR22","unstructured":"Child Outcomes Research Consortium. Generalised Anxiety Disorder Assessment (GAD-7) [Internet]. www.corc.uk.net.2024. Available from: https:\/\/www.corc.uk.net\/outcome-experience-measures\/generalised-anxiety-disorder-assessment-gad-7\/"},{"key":"7228_CR23","unstructured":"Child Outcomes Research Consortium. Perceived Stress Scale (PSS-10) [Internet]. www.corc.uk.net. Available from: https:\/\/www.corc.uk.net\/outcome-experience-measures\/perceived-stress-scale-pss-10\/"},{"key":"7228_CR24","unstructured":"State of New Hampshire Employee Assistance Program. Perceived Stress Scale [Internet]. 1983. Available from: https:\/\/www.das.nh.gov\/wellness\/docs\/percieved%20stress%20scale.pdf"},{"key":"7228_CR25","doi-asserted-by":"crossref","unstructured":"Salih KM, Idris ME, Elfaki OA, Osman NM, Nour SM, Elsidig HA et al. MBBS teaching programme, according to DREEM in College of Medicine, University of Bahri, Khartoum, Sudan. Advances in Medical Education and Practice [Internet]. 2018 Sep 4 [cited 2021 Nov 10];9:617\u201322. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6129022\/","DOI":"10.2147\/AMEP.S160218"},{"issue":"5","key":"7228_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.46299\/j.isjel.20220105.01","volume":"1","author":"O Galynska","year":"2022","unstructured":"Galynska O, Bilous S. Remote learning during the war: challenges for higher education in Ukraine. Int Sci J Educ Linguistics. 2022;1(5):1\u20136.","journal-title":"Int Sci J Educ Linguistics"},{"issue":"1","key":"7228_CR27","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.compedu.2011.08.017","volume":"58","author":"F Gonz\u00e1lez-G\u00f3mez","year":"2012","unstructured":"Gonz\u00e1lez-G\u00f3mez F, Guardiola J, Mart\u00edn Rodr\u00edguez \u00d3, Montero Alonso M\u00c1. Gender differences in e-learning satisfaction. Comput Educ. 2012;58(1):283\u201390.","journal-title":"Comput Educ"},{"key":"7228_CR28","doi-asserted-by":"crossref","unstructured":"Enyoojo SF, Ijah CE, Etukudo EM, Usman IM, Ezeonuogu CS, Adaramati T et al. Satisfaction and learning experience of students using online learning platforms for medical education. BMC Med Educ. 2024;24(1).","DOI":"10.1186\/s12909-024-06411-0"},{"key":"7228_CR29","doi-asserted-by":"crossref","unstructured":"Zhu X, Chu CKM, Lam YC. The predictive effects of family and individual wellbeing on university students\u2019 online learning during the COVID-19 pandemic. Front Psychol. 2022;13.","DOI":"10.3389\/fpsyg.2022.898171"},{"key":"7228_CR30","doi-asserted-by":"crossref","unstructured":"Dafallah A, Osman, Ibrahim M, Rania E, Elsheikh, Blanchet K. Destruction, disruption and disaster: Sudan\u2019s health system amidst armed conflict. Confl Health. 2023;17(1).","DOI":"10.1186\/s13031-023-00542-9"},{"key":"7228_CR31","unstructured":"Ukraine\u2019s national health system maintains financing. and service provision during times of war [Internet]. www.who.int. Available from: https:\/\/www.who.int\/about\/accountability\/results\/who-results-report-2020-mtr\/country-story\/2022\/ukraine-s-national-health-system-maintains-financing-and-service-provision-during-times-of-war"},{"key":"7228_CR32","doi-asserted-by":"crossref","unstructured":"Ali SH, Agyapong VIO. Barriers to mental health service utilisation in Sudan - perspectives of carers and psychiatrists. BMC Health Serv Res. 2015;16(1).","DOI":"10.1186\/s12913-016-1280-2"},{"key":"7228_CR33","doi-asserted-by":"crossref","unstructured":"Quirke E, Klymchuk V, Suvalo O, Bakolis I, Thornicroft G. Mental health stigma in Ukraine: cross-sectional survey. Global Mental Health. 2021;8.","DOI":"10.1017\/gmh.2021.9"},{"key":"7228_CR34","unstructured":"Report on\u2013 33rd IC Resolution 2. Addressing mental health and psychosocial needs of people affected by armed conflicts, natural disasters and other emergencies (33IC\/19\/R2)\u2013 Ukraine\u2013 Statutory Meetings [Internet]. Rcrcconference.org. 2024 [cited 2025 Jan 30]. Available from: https:\/\/rcrcconference.org\/res-report-33rd\/report-on-33rd-ic-resolution-2-addressing-mental-health-and-psychosocial-needs-of-people-affected-by-armed-conflicts-natural-disasters-and-other-emergencies-33ic-19-r2-ukraine\/."},{"key":"7228_CR35","unstructured":"Mental Health Atlas. 2020 Country Profile: Sudan [Internet]. www.who.int. Available from: https:\/\/www.who.int\/publications\/m\/item\/mental-health-atlas-2020-country-profile--sudan"},{"issue":"7","key":"7228_CR36","doi-asserted-by":"publisher","first-page":"e0307648","DOI":"10.1371\/journal.pone.0307648","volume":"19","author":"A Balla","year":"2024","unstructured":"Balla A, Yeddi AA, Alrawa SS, Esraa SA, Alfadul. Anxiety and depression symptoms among a sample of Khartoum civilians during the 2023 Sudan armed conflict: A cross-sectional study. PLoS ONE. 2024;19(7):e0307648\u20138.","journal-title":"PLoS ONE"},{"issue":"1","key":"7228_CR37","doi-asserted-by":"publisher","first-page":"2305","DOI":"10.1080\/07853890.2021.2009908","volume":"53","author":"H Kabir","year":"2021","unstructured":"Kabir H, Hasan MK, Mitra DK. E-learning readiness and perceived stress among the university students of Bangladesh during COVID-19: a countrywide cross-sectional study. Ann Med. 2021;53(1):2305\u201314.","journal-title":"Ann Med"},{"key":"7228_CR38","doi-asserted-by":"crossref","unstructured":"Yousif MA, Arbab AH, Yousef BA. Perceived Academic Stress, Causes, and Coping Strategies Among Undergraduate Pharmacy Students During the COVID-19 Pandemic. Advances in Medical Education and Practice [Internet]. 2022 Feb 28 [cited 2022 Feb 28];13:189\u201397. Available from: https:\/\/www.dovepress.com\/perceived-academic-stress-causes-and-coping-strategies-among-undergrad-peer-reviewed-fulltext-article-AMEP#ref-cit0027","DOI":"10.2147\/AMEP.S350562"},{"issue":"1","key":"7228_CR39","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s40359-024-02188-5","volume":"12","author":"B Aldabbour","year":"2024","unstructured":"Aldabbour B, Abuabada A, Lahlouh A, Halimy M, Elamassie S, Sammour AAK, et al. Psychological impacts of the Gaza war on Palestinian young adults: a cross-sectional study of depression, anxiety, stress, and PTSD symptoms. BMC Psychol. 2024;12(1):44.","journal-title":"BMC Psychol"},{"key":"7228_CR40","doi-asserted-by":"crossref","unstructured":"Mazlan N. Norzuwana Sumarjan. Stress, Anxiety and Satisfaction in Online Learning: The Moderating Role of Instructor Support. International Journal of Academic Research in Business and Social Sciences [Internet]. 2022;12(11):669\u201383. Available from: https:\/\/hrmars.com\/index.php\/IJARPED\/article\/view\/15611\/Stress-Anxiety-and-Satisfaction-in-Online-Learning-The-Moderating-Role-of-Instructor-Support","DOI":"10.6007\/IJARBSS\/v12-i11\/15611"},{"key":"7228_CR41","doi-asserted-by":"crossref","unstructured":"Concei\u00e7\u00e3o V, Rothes I, Gusm\u00e3o R. The association between changes in the university educational setting and peer relationships: effects in students\u2019 depressive symptoms during the COVID-19 pandemic. Front Psychiatry. 2021;12.","DOI":"10.3389\/fpsyt.2021.783776"},{"key":"7228_CR42","doi-asserted-by":"crossref","unstructured":"Khatatbeh H, Amer F, Amira Mohammed Ali, ALBashtawy M, Kurnianto A, Manar Abu-Abbas et al. Challenges of distance learning encountering nursing students after the COVID-19 pandemic: a study from the middle East. BMC Nurs. 2024;23(1).","DOI":"10.1186\/s12912-024-02236-w"},{"key":"7228_CR43","doi-asserted-by":"crossref","unstructured":"Joy B, Hudes M. High risk of depression among low-income women raises awareness about treatment options. California Agriculture [Internet]. 2024;64(1). Available from: https:\/\/escholarship.org\/uc\/item\/85h2c61g","DOI":"10.3733\/ca.v064n01p22"},{"key":"7228_CR44","doi-asserted-by":"crossref","unstructured":"Morin D, Fard HS, Saad\u00e9 RG. Understanding Online Learning Based on Different Age Categories. Issues in Informing Science and Information Technology [Internet]. 2019;16:307\u201317. Available from: https:\/\/www.informingscience.org\/Publications\/4313","DOI":"10.28945\/4313"},{"key":"7228_CR45","doi-asserted-by":"publisher","first-page":"117340","DOI":"10.1016\/j.socscimed.2024.117340","volume":"360","author":"TP Nguyen","year":"2024","unstructured":"Nguyen TP, Al Asaad M, Sena M, Slewa-Younan S. Loneliness and social isolation amongst refugees resettled in high-income countries: a systematic review. Soc Sci Med. 2024;360:117340.","journal-title":"Soc Sci Med"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07228-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-025-07228-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07228-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:15:59Z","timestamp":1747217759000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-025-07228-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7228"],"URL":"https:\/\/doi.org\/10.1186\/s12909-025-07228-1","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,14]]},"assertion":[{"value":"12 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was granted by the Medical Research Ethics Committee of Gadarif University (Approval No.: GU\/FM\/REC\/Q3.11.24.4). The study adhered to the ethical principles outlined in the Declaration of Helsinki, ensuring respect for participants\u2019 rights and dignity. The findings and methodology of this study were meticulously reported in the manuscript in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Informed written consent was then acquired from every participant after thoroughly explaining the research purpose, with the option to withdraw from the study at any time.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"706"}}