{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:37:52Z","timestamp":1789771072084,"version":"4.0.1"},"reference-count":63,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>While the need to measure burnout, stress and mental health among pharmacy students has been emphasized in the literature, there is limited information on which validated scales should be used. The objective of this scoping review was to identify published studies that used validated scales for burnout, stress and mental health among pharmacy students to provide recommendations for implementation at schools\/colleges of pharmacy. Thirty-two out of 153 articles published in the United States from 1 January 2000 to 30 September 2022 were included and categorized into studies measuring stress (20), burnout (4) and depression\/anxiety (8). The most common validated scales used to assess stress and burnout among pharmacy students were the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory and the Oldenburg Burnout Inventory, respectively. For mental health, anxiety was most commonly investigated using a variety of scales such as the Generalized Anxiety Disorder-7; the Patient Health Questionnaire, 9-item was used to measure depression in two studies. Validity, ease of use, cost and generalizability are important considerations for selecting a scale. The PSS has been studied extensively in pharmacy students and has been correlated with other well-being domains. Studies that measured burnout and mental health (specifically, depression and anxiety) have less published evidence among pharmacy students.<\/jats:p>","DOI":"10.3390\/pharmacy12050157","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T07:41:42Z","timestamp":1729237302000},"page":"157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Review of Survey Instruments and Pharmacy Student Outcomes for Stress, Burnout, Depression and Anxiety"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1674-4210","authenticated-orcid":false,"given":"Kelly C.","family":"Lee","sequence":"first","affiliation":[{"name":"UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Yan","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tram B.","family":"Cat","sequence":"additional","affiliation":[{"name":"UC San Francisco School of Pharmacy, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shareen Y.","family":"El-Ibiary","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale Campus, Glendale, AZ 85308, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"ref_1","unstructured":"National Academies of Sciences, Engineering, and Medicine (2019). Taking Action against Clinician Burnout: A Systems Approach to Professional Well-Being, The National Academies Press."},{"key":"ref_2","unstructured":"(2024, September 21). Enhancing Well-Being and Resilience among the Pharmacist Workforce: A National Consensus Conference. Available online: https:\/\/www.pharmacist.com\/consensusrecs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7159","DOI":"10.5688\/ajpe7159","article-title":"Report of the 2017\u20132018 Student Affairs Standing Committee","volume":"82","author":"Miller","year":"2018","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_4","unstructured":"American Association of Colleges of Pharmacy (2024, September 21). Preparing Pharmacists and the Academy to Thrive in Challenging Times. 2021\u20132024 Strategic Plan Priorities, Goals and Objectives. Available online: https:\/\/www.aacp.org\/sites\/default\/files\/2023-05\/StrategicPlan-2021-2024.pdf."},{"key":"ref_5","unstructured":"Dzau, V.J., Kirch, D., Murthy, V., and Nasca, T. (2022). National Plan for Health Workforce Well-Being, The National Academies Press. Available online: https:\/\/nap.nationalacademies.org\/catalog\/26744\/national-plan-for-health-workforce-well-being."},{"key":"ref_6","unstructured":"Dyrbye, L.N., Meyers, D., Ripp, J., Dalal, N., Bird, S.B., Sen, S., Agency for Healthcare Research & Quality, Collaborative for Healing and Renewal in Medicine, and Emory University (2018). A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being NAM Perspectives, National Academy of Medicine. Discussion Paper."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8793","DOI":"10.5688\/ajpe8793","article-title":"A scoping review of well-being assessment and interventions in student pharmacists","volume":"86","author":"Mayberry","year":"2022","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"8522","DOI":"10.5688\/ajpe8522","article-title":"General anxiety, academic distress, and family distress among doctor of pharmacy students","volume":"85","author":"Zakeri","year":"2021","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/j.1559-1816.2012.00900.x","article-title":"Who\u2019s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009","volume":"42","author":"Cohen","year":"2012","journal-title":"J. Appl. Soc. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2466\/pr0.1994.74.2.395","article-title":"Student-Life Stress Inventory: Identification of and reactions to stressors","volume":"74","author":"Gadzella","year":"1994","journal-title":"Psychol. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"82","DOI":"10.5688\/ajpe80582","article-title":"A comparative analysis of perceptions of pharmacy students\u2019 stress and stressors across two multicampus universities","volume":"80","author":"Awe","year":"2016","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/job.4030020205","article-title":"The measurement of experienced burnout","volume":"2","author":"Maslach","year":"1981","journal-title":"J. Occup. Behav."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7945","DOI":"10.5688\/ajpe7945","article-title":"An investigation of prevalence and predictors of disengagement and exhaustion in pharmacy students","volume":"84","author":"Fuller","year":"2020","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1477-7525-5-63","article-title":"The Warwick-Edinburgh Mental Well-being scale (WEMWBS): Development and UK validation","volume":"5","author":"Tennant","year":"2007","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1037\/a0021282","article-title":"Development of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62)","volume":"58","author":"Locke","year":"2011","journal-title":"J. Couns. Psychol."},{"key":"ref_17","unstructured":"Spielberger, C.D., Gorsuch, R.L., Lushene, R., Vagg, P.R., and Jacobs, G.A. (1983). Manual for the State-Trait Anxiety Inventory, Consulting Psychologists Press."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.genhosppsych.2005.07.003","article-title":"Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population","volume":"28","author":"Martin","year":"2006","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population","volume":"46","author":"Lowe","year":"2008","journal-title":"Med. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1037\/0022-006X.56.6.893","article-title":"An inventory for measuring clinical anxiety: Psychometric properties","volume":"56","author":"Beck","year":"1988","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S467","DOI":"10.1002\/acr.20561","article-title":"Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A)","volume":"63","author":"Julian","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1348\/014466505X29657","article-title":"The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample","volume":"44","author":"Henry","year":"2005","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dunstan, D.A., and Scott, N. (2020). Norms for Zung\u2019s Self-rating Anxiety Scale. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-019-2427-6"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/S0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"Zung","year":"1971","journal-title":"Psychosomatics"},{"key":"ref_26","unstructured":"Centers for Disease Control and Prevention (2024, September 21). Measuring Healthy Days: Population Assessment of Health-Related Quality of Life, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/6406."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1177\/1073191105283504","article-title":"Using self-report assessment methods to explore facets of mindfulness","volume":"13","author":"Baer","year":"2006","journal-title":"Assessment"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"52","DOI":"10.5688\/ajpe79452","article-title":"Pharmacy students\u2019 attitudes toward debt","volume":"79","author":"Park","year":"2015","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1207\/s15327558ijbm0401_6","article-title":"You want to measure coping but your protocol\u2019s too long: Consider the brief COPE","volume":"4","author":"Carver","year":"1997","journal-title":"Int. J. Behav. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1207\/s15327752jpa5202_4","article-title":"Measurement of academic self-concept in college students","volume":"52","author":"Reynolds","year":"1988","journal-title":"J. Personal. Assess."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3109\/01612849409009390","article-title":"Operationalizing Maslow\u2019s theory: Development and testing of the basic need satisfaction inventory","volume":"15","author":"Leidy","year":"1994","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_32","first-page":"139","article-title":"Perceived stress by students in a pharmacy curriculum","volume":"129","author":"Kranz","year":"2008","journal-title":"Education"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.2224\/sbp.2013.41.9.1457","article-title":"Perceived stress, stressors, and mental distress among doctor of pharmacy students","volume":"41","author":"Geslani","year":"2013","journal-title":"Soc. Behav. Pers."},{"key":"ref_34","first-page":"292","article-title":"The impact of student life stress on health related quality of life among doctor of pharmacy students","volume":"38","author":"Gupchup","year":"2004","journal-title":"Coll. Stud. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5688\/aj7206137","article-title":"Perceived stress and quality of life among doctor of pharmacy students","volume":"72","author":"Marshall","year":"2008","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"147","DOI":"10.5688\/aj7308147","article-title":"Students\u2019 health-related quality of life across the preclinical pharmacy curriculum","volume":"73","author":"Hirsch","year":"2009","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.cptl.2013.06.014","article-title":"Predictors of stress in doctor of pharmacy students: Results from a nation wide survey","volume":"5","author":"Votta","year":"2013","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5688\/ajpe75464","article-title":"Student stress in a three-year doctor of pharmacy program using a mastery learning educational model","volume":"75","author":"Frick","year":"2011","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_39","first-page":"189","article-title":"Factors contributing to perceived stress among doctor of pharmacy (PharmD) students","volume":"48","author":"Ford","year":"2014","journal-title":"Coll. Stud. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"344","DOI":"10.3390\/pharmacy3040344","article-title":"Perceived stress, stressors, and coping mechanisms among doctor of pharmacy students","volume":"3","author":"Beall","year":"2015","journal-title":"Pharmacy"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"5918","DOI":"10.5688\/ajpe8175918","article-title":"Associations between pharmacy students\u2019 attitudes toward debt, stress, and student loans","volume":"81","author":"Spivey","year":"2017","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"50","DOI":"10.5688\/ajpe81350","article-title":"Exercise as a stress coping mechanism in a pharmacy student population","volume":"81","author":"Garber","year":"2017","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.cptl.2019.01.014","article-title":"Sources of stress in a pharmacy student population","volume":"11","author":"Garber","year":"2019","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.cptl.2020.05.002","article-title":"Longitudinal examination of perceived stress and academic performance of first-year student pharmacists","volume":"12","author":"Spivey","year":"2020","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_45","first-page":"2","article-title":"Perceived stress, academic self concept, and coping strategies of pharmacy students","volume":"9","author":"Maynor","year":"2012","journal-title":"Int. J. Pharm. Educ. Pr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.cptl.2021.11.013","article-title":"Perceived stress, academic self-concept, and coping mechanisms among pharmacy students following a curricular revision","volume":"14","author":"Maynor","year":"2022","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"8351","DOI":"10.5688\/ajpe8351","article-title":"Assessment of stress and quality of life in non-native and native english-speaking pharmacy students","volume":"85","author":"Saul","year":"2021","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s40670-021-01207-z","article-title":"Stress and basic need satisfaction of first-year healthcare professional students","volume":"31","author":"Verdone","year":"2021","journal-title":"Med. Sci. Educ."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7547","DOI":"10.5688\/ajpe7547","article-title":"Patterns of stress, coping and health-related quality of life in doctor of pharmacy students","volume":"84","author":"Hirsch","year":"2020","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1016\/j.cptl.2021.09.017","article-title":"Design and implementation of a pilot student wellness program at a school of pharmacy","volume":"13","author":"Holman","year":"2021","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0002-9459(24)07771-4","article-title":"Comparing self-reported burnout of pharmacy students on the founding campus with those at distance campuses","volume":"70","author":"Ried","year":"2006","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"7571","DOI":"10.5688\/ajpe7571","article-title":"Relationship of burnout and engagement to pharmacy students\u2019 perception of their academic ability","volume":"84","author":"Kaur","year":"2020","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1177\/08971900211021259","article-title":"Measures of burnout and empathy in United States doctor of pharmacy students: Time for a change?","volume":"35","author":"Jacoby","year":"2022","journal-title":"J. Pharm. Pr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5688\/ajpe8117","article-title":"Pharmacy student anxiety and success with objective structured clinical examinations","volume":"81","author":"Longyhore","year":"2017","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.cptl.2018.12.004","article-title":"Assessment of mental health in doctor of pharmacy students","volume":"11","author":"Sabourin","year":"2019","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"7558","DOI":"10.5688\/ajpe7558","article-title":"Pharmacy and medical Students\u2019 mental health symptoms, experiences, attitudes and help-seeking behaviors","volume":"83","author":"Fischbein","year":"2019","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.cptl.2019.06.005","article-title":"Effects of mindfulness meditation on mindfulness, mental well-being, and perceived stress","volume":"11","author":"Zollars","year":"2019","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"7001","DOI":"10.5688\/ajpe7001","article-title":"Impact of a yoga and meditation intervention on students\u2019 stress and anxiety levels","volume":"83","author":"Lemay","year":"2019","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"8166","DOI":"10.5688\/ajpe8166","article-title":"Prevalence of anxiety and depressive symptoms among pharmacy students","volume":"85","author":"Shangraw","year":"2021","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.cptl.2021.01.045","article-title":"Evaluation of anxiety in doctor of pharmacy students in their first through fourth professional years","volume":"13","author":"Khorassani","year":"2021","journal-title":"Curr. Pharm. Teach. Learn."},{"key":"ref_61","first-page":"47","article-title":"Pharmacist and student pharmacist views of professional and personal well-being and resilience","volume":"60","author":"Schommer","year":"2020","journal-title":"JAPhA"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"ajpe7831","DOI":"10.5688\/ajpe7831","article-title":"Student pharmacist perspectives on factors that influence wellbeing during pharmacy school","volume":"84","author":"Babal","year":"2020","journal-title":"Am. J. Pharm. Educ."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.15585\/mmwr.mm6932a1","article-title":"Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic\u2014United States, 24\u201330 June 2020","volume":"69","author":"Czeisler","year":"2020","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."}],"container-title":["Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2226-4787\/12\/5\/157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:16:12Z","timestamp":1760112972000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2226-4787\/12\/5\/157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,18]]},"references-count":63,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["pharmacy12050157"],"URL":"https:\/\/doi.org\/10.3390\/pharmacy12050157","relation":{},"ISSN":["2226-4787"],"issn-type":[{"value":"2226-4787","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,18]]}}}