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. 2022 Dec 7:1–8. Online ahead of print. doi: 10.1038/s41432-022-0831-0

Table 2.

Outcome measures

Outcome measure/tool Description of tool Citations
Anxiety
Dentists Anxieties in Clinical Situation Scale (DACSS) It consists of 20 frequently experienced stressful situations. Dentists are asked to rate their anxiety for each situation on an 11-point Likert scale anchored 0 (not at all) & 10 (the most intense emotion you can experience). For each item they are asked, 'Does the anxiety ever change something about the way you work?' and are asked to indicate yes or no (Y/N). The scale has 2 subscales; the DACSS-R which rated anxiety and the DACSS-C which reported change in decision-making. Chapman et al. (2017)27
Depression, Anxiety and Stress Scale (DASS-21) It is used to measure the levels of depression, anxiety, and stress. It contains 21 questions with subscales for each of the three domains. Each question has four answers, ranging from 0 'Did not apply to me at all' to 3 'Applied to me very much, or most of the time.' The score in each subscale ranges from 0 to 21, and the lower the score, the lower the level of psychological distress. Aboalshamat et al. (2020)29
Spielberger State-Trait Anxiety Inventory (STAI) There are 2 subscales within this measure. First, the State Anxiety Scale (S-Anxiety) evaluates the current state of anxiety, asking how respondents feel 'right now' using items that measure subjective feelings of apprehension, tension, nervousness, worry, and activation/arousal of the autonomic nervous system. The Trait Anxiety Scale (T-Anxiety) evaluates relatively stable aspects of 'anxiety proneness' including general states of calmness, confidence, and security. The STAI has 40 items, 20 items allocated to each of the S-Anxiety and T-Anxiety subscales. Piazza-Waggoner et al. (2003)26
Burnout
Malshach Burnout Inventory (BMI) It contains 22 statements which relate to each of the three burnout domains, emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Respondents are asked to use a seven-point Likert scale to indicate the frequency with which they experience the feeling described by the statement, ranging from 0 (never) to 6 (every day). Summing the appropriate items derives scores for each of the three domains. Indicative of burnout are high scores on EE and DP and low scores on PA. No summative burnout score is made.

Brake (2001)22

Chapman et al. (2017)27

Gorter (2001)23

Depression
Depression, Anxiety and Stress Scale (DASS-21) It is used to measure the levels of depression, anxiety, and stress. It contains 21 questions with subscales for each of the three domains. Each question has four answers, ranging from 0 'Did not apply to me at all' to 3 'Applied to me very much, or most of the time.' The score in each subscale ranges from 0 to 21, and the lower the score, the lower the level of psychological distress. Aboalshamat et al. (2020)29
Impostor syndrome
Clance Impostor Phenomenon Scale (CIPS) It consists of 20 Likert-scale questions, with responses ranging from (1) not at all true to (5) very true. A total score ranges from 20 to 100. The higher the score, the more frequently and seriously the Impostor Phenomenon interferes in a person's life. Metz et al. (2020)24
Resilience
Resilience scale RS-14 It is a seven-point Likert scale. Total scores range from 14 to 98, and the higher the score, the greater the resilience. Aboalshamat et al. (2020)29
Psychological health and wellbeing
Clinical Outcomes in Routine Evaluation (CORE) It is a self-report measure of psychological distress designed to be administered before and after counselling or psychotherapy. The client is asked to respond to questions about how they have been feeling over the last week, using a 5-point scale ranging from 'not at all' to 'most or all of the time'. It covers four dimensions: subjective wellbeing, problems/symptoms, life functioning and risk/harm. Newton et al. (2006)28
Counselling Centre Assessment of Psychological Symptoms - 34 (CCAPS-34) It is a 34-item, standardised, multidimensional assessment tool designed to be administered before and after counselling or psychotherapy. It provides a brief measurement tool targeting symptoms and presenting problems that most commonly affect students in university settings. Items on the CCAPS-34 are scored along a 5-point, Likert-type rating scale. Adams (2017)25
General Health Questionnaire (GHQ-12) It consists of 12 items, each assessing the severity of a mental problem over the past few weeks using a 4-point scale (from 0 to 3). It is comprised of 6 positive and 6 negative items to assess positive and negative mental health. The score can range from 0 to 36, with higher scores indicating worse conditions. A bimodal scoring can also be used, ranging from 0 to 12, in which case a cut-off point of >3 is a determinant for psychological ill health. Newton et al. (2006)28
Outcome Questionnaire - 45.2 (OQ 45.2) It comprises of 45 items associated with a person's quality of life, designed to measure repeatedly changes during and after counselling or psychotherapy. It yields a total score in which higher scores indicate lower levels of general wellbeing. Its cut-off point is 73, therefore scores under 73 belong to the normal population and those above 73 belong to the dysfunctional population. It also provides information on three sub-scales: anxiety-depressive symptomatology (DS), interpersonal relations (IR), and social relations (SR), whose cut-off points are 43, 16 and 14, respectively. Scores above these values imply significant interference in the life of the individual. Gonzalez & Quezada (2016)30
Outcome Rating Scale (ORS) It is a four-item measure designed to assess overall counselling or psychotherapy outcomes. The items assess individual, interpersonal, social, and overall wellbeing. Adams (2017)25
Psychological Well-Being Scale - Short (PWB-S) It is an 18-item seven-point Likert-type scale with responses ranging from 1 'strongly disagree' to 7 'strongly agree.' It measures six psychological fields of wellbeing: autonomy, environmental mastery, self-acceptance, positive relations with others, purpose in life, and personal growth. Each one of the domains is calculated by sum field's questions. PWB-S is not represented as one total score. Lower scores reflect low levels of psychological wellbeing. Aboalshamat et al. (2020)29
Stress
Dental Environment Stress questionnaire (DES) The DES questionnaire assesses sources of stress associated with undergraduate course work and training in dental students. The DES can be used in two versions, the 38-item full version or the 16-item short version. Each item is scored in a four-point Likert scale, with scores ranging from one (not stressful) to four (very stressful). Higher scores on this scale indicate greater levels of stress. It includes six areas: academic load; pre-clinical and clinical practice; treatment of patients; faculty and administration; interpersonal relations and others. However, these domains may be adapted to each dental school's needs and characteristics. Gonzalez & Quezada (2016)30
Depression, Anxiety and Stress Scale (DASS-21) It is used to measure the levels of depression, anxiety, and stress. It contains 21 questions with subscales for each of the three domains. Each question has four answers, ranging from 0 'Did not apply to me at all' to 3 'Applied to me very much, or most of the time.' The score in each subscale ranges from 0 to 21, and the lower the score, the lower the level of psychological distress. Aboalshamat et al. (2020)29
Work Stress Inventory (WSI) This scale comprises a number of sources of stress and respondents are asked to indicate which source of stress they have experienced in their work life recently. Higher scores on this scale indicate higher amounts of stress. Newton et al. (2006)28