Prevalence and associated risk factors of burnout amongst veterinary students in Ghana

Benjamin Obukowho Emikpe; Derrick Adu Asare; Abigael Omowumi Emikpe; Ludwig Albert Nortey Botchway; Richard Abeiku Bonney

doi:10.1371/journal.pone.0271434

Peer Review History

Original SubmissionSeptember 1, 2020
18 Jun 2021 Decision Letter - Avanti Dey, Editor PONE-D-20-27094 PREVALENCE AND ASSOCIATED RISK FACTORS OF BURNOUT AMONGST VETERINARY STUDENTS IN GHANA PLOS ONE Dear Dr. EMIKPE, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The manuscript has been evaluated by two reviewers, and their comments are available below. The reviewers have raised a number of major concerns. They feel the manuscript requires significant improvements to the English language and editing of this manuscript. They also suggest greater clarity in the methodological reporting of this study, and note that necessity for further detail on the methods and analyses, in addition to greater elaboration in the discussion section regarding the strengths, weaknesses and recommendations deduced from this study. Could you please carefully revise the manuscript to address all comments raised? Please submit your revised manuscript by Aug 01 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Avanti Dey, PhD Staff Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: No ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: English editing Table 2 indicate exercise hours if per day or week as well as sleeping hours Works “while” and not whiles Demographic characteristics and burnout 7 (70%) as well as the rest of the percentages in the same paragraph. Discussion and not discussion use abbreviations after being defined In the conclusion, burnout was noted due to high depersonalization so remove low levels of exhaustion and personal achievement. I highly recommend rewriting the conclusion as it doesn’t reflect the strengths, weaknesses and recommendations deduced from this study. Reviewer #2: The manuscript under review explored the prevalence and associated risk factors among veterinary students in Ghana. Although the researchers tackle an important area of study (burnout in veterinary students), there are some gaps in logic, omissions, and underdeveloped sections in the paper that I believe warrant consideration by the authors and editor. These more substantial edits/suggestions are provided in the list below and in the attached hard copy version. At a more basic level, there are typographical and grammatical errors throughout the document which detract from the clarity of content. I have attached my hard copy edits, which include suggestions for fixing these more minor errors. 1. In the Method section (p. 5), I am wondering how the researchers resolved the issue of the discrepancy between what was needed for Yamane formula and what was actually obtained? This limitation might be worth discussing in more detail in the discussion section (along with any other limitations of the study). 2. On pages 12 – 18, there are very limited descriptions of the statistics tests that were conducted, and the results of these tests are not well described. To remedy, I would suggest describing which tests were conducted at the outset of a paragraph or section (e.g., chi-square or logistic regression) and then include more statistical details for each of the tests (e.g., for a logistic regression you would report the overall model statistics and then individual coefficients, p values, and odds ratios). 3. In the discussion and/or the introduction section, can you provide specific percentages of the average rates of EE, RFA, and DP for the reader to make comparisons between the sample in this study and the larger population. 4. The authors state on p. 18 that “burnout is expressed the most due to depersonalization.” This doesn’t seem entirely accurate given that two of the Burnout components were actually lower than. 5. On p. 19, the discussion about why depersonalization is higher in this sample seems underdeveloped. I would like to see the authors explore the possible reasons for this manifestation of Burnout (and not the others) in the context of this population and the stressors and life experiences they have. 6. The finding that sleep may result in tiredness and a lack of productivity doesn’t seems quite simple and not particularly novel. I’m wondering if the authors can expand on the implications for this connection as it relates to students and practicing vets. 7. The statement that “burnout was observed” at the outset of the conclusion section seems somewhat misleading because you only found that one component of Burnout was observed and in fact the other two components were actually higher than average. I would suggest that this is rephrased here to capture the nuances of the results and, again, would suggest expanding on how and why depersonalization appears to the form that burnout takes with this group. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: reviewer comments.docx Attachment Submitted filename: Burnout Mansucript with Edits.pdf https://doi.org/10.1371/journal.pone.0271434.r001
Revision 1
10 Aug 2021 Author Response 31st July, 2021 Manuscript PONE-D-20-27094 Staff Editor PLOS ONE Dear Avanti Dey (PhD), Thank you for giving us the opportunity to submit a revised draft of the manuscript “PREVALENCE AND ASSOCIATED RISK FACTORS OF BURNOUT AMONGST VETERINARY STUDENTS IN GHANA” for publication in PLOS ONE. We appreciate the time and effort that you and the reviewers dedicated to providing feedback on our manuscript and are grateful for the insightful comments on and valuable improvements to our paper. We have incorporated most of the suggestions made by the reviewers. Those changes are highlighted within the manuscript. Please see below, in blue, for a point-by-point response to the editor’s and reviewers’ comments and concerns. Reviewers' Comments to the Authors: Reviewer 1 1. Table 2 indicate exercise hours if per day or week as well as sleeping hours Works “while” and not whiles Demographic characteristics and burnout 7 (70%) as well as the rest of the percentages in the same paragraph. Discussion and not discussion use abbreviations after being defined Authors’ response: The reviewer is correct, and we have made the necessary grammatical error corrections as indicated. The frequency of exercise and sleeping hours have been specified in our revised manuscript. 2. In the conclusion, burnout was noted due to high depersonalization so remove low levels of exhaustion and personal achievement. I highly recommend rewriting the conclusion as it doesn’t reflect the strengths, weaknesses and recommendations deduced from this study. Authors’ response: The recommendation given has been considered and the authors have made changes to the conclusion to reflect the strengths, weaknesses and recommendations as indicated by the reviewer. Reviewer 2 1. In the Method section (p. 5), I am wondering how the researchers resolved the issue of the discrepancy between what was needed for Yamane formula and what was actually obtained? This limitation might be worth discussing in more detail in the discussion section (along with any other limitations of the study). Authors’ response: The cause for the discrepancy observed in the actual sample size used and that obtained from the Yamane Formula have been explained in detail in the Method section under the heading “Sample size”. 2. On pages 12 – 18, there are very limited descriptions of the statistics tests that were conducted, and the results of these tests are not well described. To remedy, I would suggest describing which tests were conducted at the outset of a paragraph or section (e.g., chi-square or logistic regression) and then include more statistical details for each of the tests (e.g., for a logistic regression you would report the overall model statistics and then individual coefficients, p values, and odds ratios). Authors’ response: The detailed descriptions of the statistics tests have been previously been spelt out in the Method section under the subsection “Data Analysis” where all tests have been spelt out and what they were used for. In addition, the results on the logistic regression and chi-square tests have been incorporated in the results section as recommended by the reviewer. 3. In the discussion and/or the introduction section, can you provide specific percentages of the average rates of EE, RFA, and DP for the reader to make comparisons between the sample in this study and the larger population. Authors’ response: The specific percentages of the average rates of EE, RFA and DP have been included in the revised manuscript. 4. The authors state on p. 18 that “burnout is expressed the most due to depersonalization.” This doesn’t seem entirely accurate given that two of the Burnout components were actually lower than. Authors’ response: The authors have revised this expression and have rectified and rephrased the statement to reflect the true findings of this study. 5. On p. 19, the discussion about why depersonalization is higher in this sample seems underdeveloped. I would like to see the authors explore the possible reasons for this manifestation of Burnout (and not the others) in the context of this population and the stressors and life experiences they have. Authors’ response: The recommendation given has been considered and the authors have developed the said deficit in writing that you have stated. More reasons have been adduced to why depersonalization was higher in this study. 6. The finding that sleep may result in tiredness and a lack of productivity doesn’t seems quite simple and not particularly novel. I’m wondering if the authors can expand on the implications for this connection as it relates to students and practicing vets Authors’ response: The connection between sleep and tiredness might not be novel but in our study, however, it adds on to the substantive argument of some the source of stresses that could have easily contribute to burnout in veterinary students. This study sought to explore the risk factors associated with burnout and so on a broader view the authors thought of taking a look at how long students are able to get enough rest as a suggestive predictor of burnout. 7. The statement that “burnout was observed” at the outset of the conclusion section seems somewhat misleading because you only found that one component of Burnout was observed and in fact the other two components were actually higher than average. I would suggest that this is rephrased here to capture the nuances of the results and, again, would suggest expanding on how and why depersonalization appears to the form that burnout takes with this group. Authors’ response: The recommendation given has been considered and the authors have rephrased the conclusion to reflect the findings of this study and not to mislead. Attachments Attachment Submitted filename: RESPONSE TO REVIEWERS(1)-1.docx https://doi.org/10.1371/journal.pone.0271434.r002
24 Jun 2022 Decision Letter - Mohammad Hossein Ebrahimi, Editor PONE-D-20-27094R1PREVALENCE AND ASSOCIATED RISK FACTORS OF BURNOUT AMONGST VETERINARY STUDENTS IN GHANAPLOS ONE Dear Dr. EMIKPE, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== The manuscript under review explored the prevalence and associated risk factors among veterinary students in Ghana. Although the researchers tackle an important area of study (burnout in veterinary students), there are some gaps in logic, omissions, and underdeveloped sections in the paper that I believe warrant consideration by the authors and editor. These more substantial edits/suggestions are provided in the list below and in the attached hard copy version. At a more basic level, there are typographical and grammatical errors throughout the document which detract from the clarity of content. I have attached my hard copy edits, which include suggestions for fixing these more minor errors. 1. In the Method section (p. 5), I am wondering how the researchers resolved the issue of the discrepancy between what was needed for Yamane formula and what was actually obtained? This limitation might be worth discussing in more detail in the discussion section (along with any other limitations of the study). 2. On pages 12 – 18, there are very limited descriptions of the statistics tests that were conducted, and the results of these tests are not well described. To remedy, I would suggest describing which tests were conducted at the outset of a paragraph or section (e.g., chi-square or logistic regression) and then include more statistical details for each of the tests (e.g., for a logistic regression you would report the overall model statistics and then individual coefficients, p values, and odds ratios). 3. In the discussion and/or the introduction section, can you provide specific percentages of the average rates of EE, RFA, and DP for the reader to make comparisons between the sample in this study and the larger population. 4. The authors state on p. 18 that “burnout is expressed the most due to depersonalization.” This doesn’t seem entirely accurate given that two of the Burnout components were actually lower than. 5. On p. 19, the discussion about why depersonalization is higher in this sample seems underdeveloped. I would like to see the authors explore the possible reasons for this manifestation of Burnout (and not the others) in the context of this population and the stressors and life experiences they have. 6. The finding that sleep may result in tiredness and a lack of productivity doesn’t seems quite simple and not particularly novel. I’m wondering if the authors can expand on the implications for this connection as it relates to students and practicing vets. 7. The statement that “burnout was observed” at the outset of the conclusion section seems somewhat misleading because you only found that one component of Burnout was observed and in fact the other two components were actually higher than average. I would suggest that this is rephrased here to capture the nuances of the results and, again, would suggest expanding on how and why depersonalization appears to the form that burnout takes with this group. ============================== Please submit your revised manuscript by Aug 08 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Regards, Mohammad Hossein Ebrahimi PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0271434.r003
Revision 2
28 Jun 2022 Author Response RESPONSE TO REVIEWER’S COMMENTS ON PREVALENCE AND ASSOCIATED RISK FACTORS OF BURNOUT AMONGST VETERINARY STUDENTS IN GHANA Comment 1: In the Method section (p. 5), I am wondering how the researchers resolved the issue of the discrepancy between what was needed for Yamane formula and what was actually obtained? This limitation might be worth discussing in more detail in the discussion section (along with any other limitations of the study). Response: The discrepancy between the sample size used and the actual sample size obtained from the Yamane formula has been explained in the methodology aspect under the sample size section in the reviewed manuscript. Comment 2: On pages 12 – 18, there are very limited descriptions of the statistics tests that were conducted, and the results of these tests are not well described. To remedy, I would suggest describing which tests were conducted at the outset of a paragraph or section (e.g., chi-square or logistic regression) and then include more statistical details for each of the tests (e.g., for a logistic regression you would report the overall model statistics and then individual coefficients, p values, and odds ratios). Response: This suggestion by the reviewer has been considered by the authors. The statistical tests conducted have been described in details in the data analysis section in the reviewed manuscript. Comment 3: In the discussion and/or the introduction section, can you provide specific percentages of the average rates of EE, RFA, and DP for the reader to make comparisons between the sample in this study and the larger population. Response: The specific percentages of the average rates of EE, RFA, and DP have been provided appropriately to enhance comparison between the sample in this study. This has been added in the new manuscript under the discussion section. Comment 4: The authors state on p. 18 that “burnout is expressed the most due to depersonalization.” This doesn’t seem entirely accurate given that two of the Burnout components were actually lower than. Response: The statement “burnout is expressed the most due to depersonalization” has been looked at. The write-up in that section has been re-written to reflect the findings on the burnout components in this study. This has been highlighted in the revised manuscript with tracked changes. Comment 5: On p. 19, the discussion about why depersonalization is higher in this sample seems underdeveloped. I would like to see the authors explore the possible reasons for this manifestation of Burnout (and not the others) in the context of this population and the stressors and life experiences they have. Response: The authors have acknowledged the concern of the reviewer. In view of this, authors have provided possible reasons for depersonalization being the manifestation of burnout amongst the students in this study. This adjustment is found in the discussion section in the revised manuscript with tracked changes. Comment 6: The finding that sleep may result in tiredness and a lack of productivity doesn’t seems quite simple and not particularly novel. I’m wondering if the authors can expand on the implications for this connection as it relates to students and practicing vets. Response: The authors have provided further explanations on sleep affecting productivity and the academic performance of students and practicing veterinarians but rather focusing more on veterinary students. Comment 7: The statement that “burnout was observed” at the outset of the conclusion section seems somewhat misleading because you only found that one component of Burnout was observed and in fact the other two components were actually higher than average. I would suggest that this is rephrased here to capture the nuances of the results and, again, would suggest expanding on how and why depersonalization appears to the form that burnout takes with this group. Response: The conclusion has been recaptured and in the revised manuscript to capture the nuances of the results and have slightly expanded on how and why depersonalization appears to the form that burnout takes in this study. Attachments Attachment Submitted filename: RESPONSE TO REVIEWER burn out.docx https://doi.org/10.1371/journal.pone.0271434.r004
1 Jul 2022 Decision Letter - Mohammad Hossein Ebrahimi, Editor PREVALENCE AND ASSOCIATED RISK FACTORS OF BURNOUT AMONGST VETERINARY STUDENTS IN GHANA PONE-D-20-27094R2 Dear Dr. EMIKPE, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Mohammad Hossein Ebrahimi Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0271434.r005
Formally Accepted
7 Jul 2022 Acceptance Letter - Mohammad Hossein Ebrahimi, Editor PONE-D-20-27094R2 Prevalence and associated risk factors of burnout amongst veterinary students in Ghana Dear Dr. Emikpe: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Mohammad Hossein Ebrahimi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0271434.r006

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