Well-being assessment in medical students since the COVID-19 pandemic: a mixed method study.

Introduction: Since the COVID-19, changes have occurred for the Moroccan medical students, which represent a vulnerable population. Coping with this situation could be difficult. Our objective was to estimate and understand the psychosocial barriers to the medical students' well-being at the Faculty of Medicine and Pharmacy of Marrakesh (FMPM) by evaluating their coping strategies, difficulties and needs. Methods: We conducted a mixed method study among pre-graduate medical students. For the quantitative part, we did a cross-sectional study using an online four-part self-administered questionnaire. We compared Likert scales of perceived well-being before and one year after the lockdown. The scales ranged from 0 (very low state of well-being) to 10 (complete state of well-being). Coping strategies were assessed by the Brief-COPE questionnaire. The qualitative perspective was a case-study with semi-structured interviews using an interview guide based on the literature review. Finally, a one-phase triangulation analysis, underlined by a convergence model, was done. Results: We had 355 participants for the quantitative part (participation rate of 16.6%). The mean age was 19.2±1.6. The female/male sex ratio was 1.8. The first cycle students represented 76%. The well-being mean state was better before than after the pandemic (7.8 vs 5.4; p<0.001). The main coping strategy was the acceptance of the situation (5.8±1.7). According to the students, their principal need for promoting their well-being at the faculty was having courses about technologies for studies (89.3%). For the qualitative part, we interviewed 16 students. Thirteen had a decline of their well-being after the lockdown. Isolation and adaptation to e-learning were the principal difficulties. However, mainly, they adopted engaging in coping strategies. Conclusion: The medical students' well-being decreased since the COVID-19 pandemic. Students adopting coping strategies were in the best well-being state. Psychosocial and solution-based measures should be put in place at the FMPM to foster the students' well-being.