Clinical validity and diagnostic accuracy of the Maslach Burnout Inventory-Student Survey in Sri Lanka

Background: Absence of context-specific clinically validated cut-off values for assessing burnout as a dichotomous phenomenon has hindered the progress of student burnout research with regard to quantifying the magnitude of the problem. Hence, the present study was aimed at developing clinically validated cut-off values and evaluating the diagnostic accuracy of the Sinhala translation of the 15-item Maslach Burnout Inventory-Student Survey (MBI-SS) in assessing burnout among collegiate cycle students in Sri Lanka. Methods: This prospective validation study was conducted among 194 grade thirteen students in the Kurunegala district, Sri Lanka. Clinically validated cut-off values for the subscale scores of the MBI-SS test was developed by computing ROC curves, using the clinical diagnosis made by the Consultant Psychiatrist as the reference standard. Diagnostic accuracy of the MBI-SS test results based on "exhaustion+1" criterion was assessed comparing with the results of the clinical diagnosis. Results: The clinically validated cut-off values for the exhaustion, cynicism and reduced professional efficacy subscale scores were 12.5, 7.5 and 10.5 for the respectively. The sensitivity, specificity, positive and negative predictive values of the Sinhala translation of the 15-item MBI-SS were 91.9% (95% CI = 82.5-96.5%), 93.2% (95% CI = 87.5-96.4%), 86.4% (95% CI = 76.1-92.7%) and 96.1% (95% CI = 91.2-98.3%) respectively. The positive and negative likelihood ratios were 13.48 (95% CI = 7.15-25.44) and 0.09 (95% CI = 0.04-0.20) respectively. Conclusions: By using the clinically validated cut-off values for the subscale scores and based on the "exhaustion + 1" criterion, the Sinhala translation of the 15-item MBI-SS could be effectively used as a screening tool to assess burnout among collegiate cycle students. The study findings broaden the global evidence base pertaining to validated cut-off values of the MBI-SS.