Purpose This study aimed to identify the academic stress experienced by medical students in basic medical science courses and analyze its underlying factors.
Methods A survey was conducted among 228 students from a medical school in Seoul, South Korea, of whom 204 who had completed at least one basic science course were included in the final analysis. A modified stress scale for medical students and a newly developed subject-specific academic stress scale, validated through literature review, student feedback, and expert review, were employed. Data were analyzed using IBM SPSS ver. 25.0 with descriptive statistics, t-tests, chi-square tests, and one-way analysis of variance.
Results The overall academic stress among students was relatively high. The highest stress levels were observed in cell biology (mean=7.15), followed by bioinformatics (mean=5.97), molecular biology (mean=5.47), and organic chemistry (mean=5.20). Key stress factors included a lack of connectivity with clinical subjects, excessive learning volume, and inappropriate difficulty levels.
Conclusion Academic stress varied significantly across courses, underscoring the need for curriculum improvements in basic medical science education. Faculty should consider adjusting course difficulty, enhancing clinical integration, motivating students, and managing workloads to reduce stress and support learning outcomes.
Purpose The aim of this study was to compare the prevalence of burnout and determine the predictive factors among the residents in the three major healthcare specialties in Syria (medicine, dentistry, and pharmacy).
Methods A web-based cross-sectional survey was used to investigate the experienced burnout among residents. The Maslach Burnout Inventory was used as a self-reported scale. Seven burnout-related factors were investigated and included in the survey.
Results The overall reported prevalence of burnout was 73% (149/204 respondents) in the total sample. Residents in medicine reported the highest values, followed by the residents in dentistry. The residents in pharmacy reported the lowest burnout prevalence. The prevalence was statistically different in selected domains of burnout according to the type of specialty, satisfaction with monthly income, marital status, gender, existence of night shifts, and was inversely correlated with age (p<0.05).
Conclusion Burnout rates among Syrian healthcare residents are high and concerning. Residents in medicine reported the highest percentage. Predictive factors should be considered by the directors of every medical program and the residency administrators.
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Purpose This study aims to confirm the degree of stress perceived by medical students in Korea and to study the difference between the methods used to relieve stress. In addition, this study evaluates the stress relief methods medical students believe are effective.
Methods The subjects of the study were 147 students of a medical school in Korea who voluntarily participated in an online survey. The degree of stress perceived by medical students in Korea was confirmed, and the differences between the methods used to relieve stress were analyzed, along with the effective stress relief methods considered by the students themselves.
Results There was no difference found in the degree of stress experienced by medical students based on their year in school and gender. The most commonly reported method to relieve stress was sleep, and it was found that this method provided the highest degree of stress relief.
Conclusion As stress has been consistently reported as an issue among medical students, tackling stress among medical students should not be handled solely at the individual level.
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Purpose This study aims to examine whether perceived levels of job stress, burnout, and mental health are different according to demographic characteristics and working conditions and to investigate the direct and indirect effects of job stress and burnout on the mental health of medical faculty members.
Methods The study sample consists of 855 faculty members in 40 medical schools nationwide in the 2020 Burnout of Faculty Members of Medical Schools in Korea data with a grant from the Korean Association of Medical Colleges. This study employed structural equation modeling to construct causality among latent variables in addition to t-test, analysis of variance, and correlation coefficients for bivariate analyses.
Results Perceived job stress, burnout, and mental health levels of medical faculty members showed significant group differences by demographic characteristics and working conditions. Job stress directly affected mental health (β=0.215, p<0.01) and indirectly affected mental health via burnout (β=0.493, p<0.001). Thus burnout significantly mediated the relationship between job stress and the mental health of medical faculty members.
Conclusion This study found that job stress has direct and indirect effects on the mental health of medical faculty members, and burnout partially mediated this relationship. Further studies need to intervene in job stress and burnout to prevent the adverse mental health of medical faculty members and to introduce proper measures to improve working conditions affecting job stress and burnout.
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Purpose The coronavirus disease 2019 (COVID-19) pandemic is a global health crisis that has impacted daily life due to the policies created to contain the outbreak. Recent studies showed that medical students, a high-stress population, experienced deteriorated mental well-being during the pandemic. The aim of the present study was to assess stress and the need for support among Thai medical students during the COVID-19 pandemic, as a multicenter study.
Methods The present study was a cross-sectional questionnaire-based study which collected data from second through sixth year medical students. Data was collected during the pandemic from multiple medical schools spanning all six regions of Thailand. Questionnaires included: demographic data; the Thai version of the Perceived Stress Scale-10 (T-PSS-10) assessing stress level and the sources of stress; and the received supports from medical schools, the satisfaction with the supports, and the further necessary needs.
Results There were 1,395 medical students who responded to the questionnaires. Mean T-PSS-10 score was 17.8. Most of the sources of stress were related to the changing of teaching and evaluation system. Students residing in larger medical schools were significantly more satisfied with received support and tended to gain greater support than those in medium and small sized schools. Stress-relieving activities arrangement was considered the most sought after additional support by students.
Conclusion Medical student stress levels were higher during the pandemic compared to pre-pandemic levels. Stress relieving activities, availability and access to mental health resources, and other strategies to reduce stress among medical students are urgently needed.
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Methods A cross-sectional study was conducted in the Faculty of Medicine, Chiang Mai University, Thailand. All undergraduate medical students were requested to voluntarily respond to an electronic survey. Demographic data, related factors of happiness and stress, scores from the Thai version of the Oxford Happiness Questionnaire (Thai-OHQ), and Thai Stress Questionnaire (Thai-ST5) were collected.
Results There were 369 responses, 64.8% from preclinical students and 35.2% responses from clinical students, and 53.9% were women. The mean age of the participants was 20.62±1.81 years. The most frequent platforms that the students used to track COVID-19 information were Facebook 43.9% and Twitter 43.4%. Both groups had a low level of stress. No difference was found in the Thai-OHQ score (p=0.323) and the Thai-ST5 score (p=0.278). With multivariable analysis, two factors significantly related to the happier students included higher health satisfaction scores (p<0.001) and maintaining an exercise program during the COVID-19 pandemic (p=0.015).
Conclusion There was no difference in the happiness and stress levels between the two groups during the first outbreak of COVID-19 in Thailand. To increase happiness, promoting awareness of health satisfaction and regularity of exercise for the medical students should be initiated. To direct the information during a disease outbreak such as the COVID-19 pandemic, Facebook, and Twitter are the primary platforms to use.
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Purpose The purpose of this study was to identify the possible correlations of ‘satisfaction with clinical practice (SA)’ with ‘clinical learning environment (EN)’ and ‘clinical practice stress (ST).’ We searched for the mediating effect of ‘clinical practice stress’ on ‘satisfaction with clinical practice’ when the clinical learning environment influences ‘satisfaction with clinical practice.’
Methods This research investigated 208 medical and nursing students attending the school of medicine and nursing in Korea. The total number of nursing students was 135 (64.9%); 73 medical students participated (35.1%). We used the Korean-Undergraduate Clinical Education Environment in 24 questions for EN, ST scale in 24 questions, and SA scale in 10 questions. We performed measurement structural equation model analysis to identify a path of the model.
Results Medical students had significantly higher levels of ST. EN had a significant negative correlation with ST and a significant positive correlation with SA. The ST had a significant negative correlation with SA. The results of the goodness of fit index have fulfilled the criteria of goodness of fit. There was a significant mediating effect of ST on SA when EN influences SA.
Conclusion The clinical learning environment affected satisfaction with the clinical practice directly or indirectly mediated by clinical practice stress. Therefore, educational institutes should try to increase satisfaction with clinical practice by continuously monitoring and improving the clinical learning environment in addition to taking measures for decreasing the clinical practice stress.
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Methods The authors explored medical students’ negative experiences using the critical incident technique. The authors conducted semi-structured in-depth interviews with 13 medical students, between February and May 2016. The authors focused on occurrences that significantly influenced medical students’ school lives negatively from the students’ perspective. All interviews were recorded and transcribed. The authors classified incidents into frames of reference for the use of faculty development for student support.
Results The authors extracted 22 themes from a total 334 codes and classified them into eight subcategories. Finally, four categories emerged from frames of reference. Students manipulate relationships and colluding for better specialty choice. They experience uncontrolled rifts in interpersonal relationships between peers including lawsuits, sexual assaults, and social network service conflicts. Today’s students feel resentment towards dependent hierarchical relationships with seniors. They struggle with gender discrimination but perpetuate outdated gender role toward the opposite gender.
Conclusion Faculty members should understand today’s students’ level of career stress and desire for work life balance. They should motivate students’ professional identity, promote assertiveness against unfair authorities, and focus on mental health, teamwork, and relationship building. All generations need to understand other generations and develop appropriate leadership and gender sensitivity.
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Methods Using a cross-sectional design, the present study was conducted to identify whether the empathy levels of medical students are affected by their stress levels. A translated version of the Perceived Stress Scale-10 was used to measure the students’ stress levels, while the Jefferson Scale of Physician Empathy was used to measure their empathy levels.
Results A total of 464 students from one medical school in Indonesia participated in the study. Stress levels among medical students peak in their first year of study and maintain a downward trend over the following years. The students’ empathy levels increased during their first 3 years, declined significantly upon entering the first clinical year, and increased during the second clinical year. However, no correlations were found between stress level and empathy level.
Conclusion These findings suggest that there may be other underlying factors that contribute to empathy decline among medical students upon entering their first clinical year. Further research should be conducted to identify these factors. The bounced-back of empathy level to a higher level in the second year highlights the importance of student adaptation in the clinical learning environment and the support system.
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Purpose The purpose of this study was to identify the causal relationship between emotional intelligence, ego-resilience, coping efficacy, and academic stress.
Methods Participants were 424 medical students from four medical schools in Korea. We examined their emotional intelligence, ego-resilience, coping efficacy, and academic stress using a t-test, an analysis of variance, correlational analysis, and path analysis.
Results First- and second-year students scored higher on academic stress than did those from third- and fourth-year students. Further, coping efficacy mediated the relationships between emotional intelligence, ego-resilience, and academic stress. Academic stress was directly influenced by coping efficacy, and indirectly by emotional intelligence and ego-resilience. This showed that coping efficacy play an important role in academic stress.
Conclusion Our findings may help medical schools design educational programs to improve coping efficacy in students, and to reduce their academic stress.
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Purpose We examined two overarching topics: What are the Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B), Perceived Stress Scale (PSS), and Self-rating Depression Scale (SDS) scores in medical students? Do their interpersonal needs correlate with stress and depression? Methods: FIRO-B, PSS-10, and SDS were administered to 82 freshmen in College of Medicine, The Catholic University of Korea in 2014. The data were analyzed by descriptive statistics, frequency, two-way analysis of variance, independent t-test, and Pearson correlation analysis using SPSS version 21.0 (IBM Corp.). Results: The level of interpersonal needs was medium range (mean, 24.52). The mean perceived stress score was 18.6. Also, 59.8% and 40.2% of students had normal range (<20) and high stress (≥20). The mean score for depression was 36.3. Further, 97.6% and 2.4% of students had normal range (≤49) and mild depression (≤59). Wanted behavior correlated with stress (r=0.056) and depression (r=0.021). Expressed behavior correlated negatively with stress (r=-0.206) and depression (r=-0.301). Conclusion: The interpersonal needs of medical freshmen are related to stress and depression. These results can be used effectively in school adaptation programs for medical students to improve their quality of life.
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Purpose Medical students experience various stresses that arise in a special environment. However, there is no specific stress scale for medical students with regard to their environment in Korea. Therefore, in this study, we developed and confirmed the validity of a stress scale for medical students in Korea.
Methods A draft version of the scale was developed on the basis of open-ended questionnaires from 97 medical students. The validity of the content of this scale was evaluated by three medical educationists. The scale was administered to 435 third and fourth grade medical students as the main survey. For our data, we performed an exploratory factor analysis and confirmatory factor analysis. We used Cronbach α index to determine internal consistency.
Results Six factors with 40 items were extracted through the exploratory factor analysis: academic stress (9 items); clerkship stress (11 items); interpersonal stress (7 items); career stress (8 items); health-related stress (3 items); and financial stress (2 items). These factors showed a statistically significant correlation. The confirmatory factor analysis demonstrated a favorable RMSEA (0.053) and reasonable fit (CFI=0.847, TLI=0.833). Cronbach α values of the six factors ranged from 0.63 to 0.85.
Conclusion The medical student stress scale had a good model fit. It is a valid and reliable instrument in identifying stress in medical students and can be used in future studies. Also, the scale is expected to provide individual stress profiles for students to help them manage stress more effectively.
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PURPOSE This study examined the stress, resilience, social support, and quality of life (QOL) of medical students during a clinical clerkship and identified the factors that affected their QOL.
METHODS The subjects were 53 medical college students and 43 postgraduate medical school students of D medical school in Korea. They completed a demographic questionnaire and self-rated questionnaires on stress, resilience, social support, and QOL. Frequency and descriptive analysis, correlation analysis, and regression analysis were performed.
RESULTS The level of students' QOL was moderate. QOL correlated negatively with stress and positively with resilience and social support. Stress correlated negatively with resilience and social support. By regression analysis, stress and resilience affected the QOL of medical students.
CONCLUSION The results of this study indicate that stress negatively affects the QOL of medical students during clinical clerkship, which can be mitigated by resilience.
Therefore, it is advisable to develop measures to ease stress and enhance resilience.
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PURPOSE Recently, concern of the college students' mental health has increased due to their continuous psychologic problems such as suicidal attempt. This study aimed to examine the correlation among depression, stress, self-esteem, and coping strategies of the medical students and also according to the academic year.
METHODS The subject was 384 medical students of K medical school in Korea. Self-rating depression scale, stress scale, self-esteem scale was used for the survey, and academic stress and coping strategies of the students were asked.
Frequency analysis, one-way ANOVA, t-test, correlation analysis was carried out.
RESULTS Third year students were under most stress (F=5.67, p=0.000) and had the most students who were moderately (22.9%) and mildly depressed (6.3%). Stress form academic studies and grade was also the highest in third year students. For English fluency, freshmen students scored the top. Academic career stress and school culture stress were higher for year 3, 4, 5, 6 than year 1, 2 students.
Differences of the coping strategies by academic year was significant in emotional display. Students who showed high level of depression and stress, also students with low self-esteem used emotional display as their major coping strategy.
CONCLUSION Depending on their academic year medical students' level of depression and stress was different, and they did not use a variety of coping strategies. Therefore, a program which can give a diverse access to variety of coping strategies to relieve students' stress should be developed taking their characteristics of academic year into consideration.
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PURPOSE The purpose of this research was to examine the medical students' personality with stress and developmental level. The study explored three overarching topics: How are medical students' personality types reflected in an enneagram? Are there any differences between subtypes of stress points? How are the students' developmental levels by gender, academic level, and enneatypes? METHODS: The subjects were 414 medical students in three Korean medical schools. Enneagram Personality Types Inventory (Korean version) was used. These enneatypes were divided into four subtypes: centers of intelligence, hornevian triads, self-consciousness, and harmonic group.
Enneatypes and stress points were analyzed statistically by frequency and percentage of enneatypes, chi-square test, and ANOVA.
RESULTS Distribution of enneatypes; type 9 was the most frequent class (n=136, 32.9%). Types 1, 3, 4, and 9 had more disintegrated students than other types (chi2=59.2, p=0.000). Subtype analysis; in body-centered type more students were disintegrated than integrated or mediocre (chi2=25.8, p=0.000). In behavior patterns, aggressive and passive types showed more disintegration (chi2=25.2, p=0.000), and in self-consciousness groups only inner order types showed integration (chi2=19.3, p=0.001). In harmonic group, positive outlook types contained the most disintegrated students (chi2=20.5, p=0.000). Majority of medical students were in disintegrated developmental status.
CONCLUSION A program should be developed for students to know their ego-identity plainly and overcome their disintegration, based on their enneatypes. Such a program will help students improve their ways of thinking or their behavior and become more secure.
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PURPOSE This study investigated the relationship among types of attribution tendencies, academic stress, coping efficacy, and academic adjustment in medical students and identified the means by which the academic adjustment of medical students can improve.
METHODS Four hundred forty-two subjects from 2 medical schools in Korea were analyzed; 202 were male, 206 were female, and 34 did not identify their gender. We surveyed their academic adjustment, attribution tendencies, academic stress, and coping efficacy. The data were analyzed by descriptive statistics, t-test, and stepwise multiple regression analysis.
RESULTS The male group scored higher on academic adjustment, internal attribution tendency, and coping efficacy but lower on academic stress than the female group.
Coping efficacy and internal attribution tendency affected the academic adjustment positively while academic stress influenced it negatively.
CONCLUSION The study indicates that students with higher scores on coping efficacy and internal attribution tendency and who have lower scores on academic stress tend to adjust better academically in medical school. Therefore, these findings may be helpful for medical schools in designing effective academic adjustment programs to improve coping efficacy and internal attribution tendency and reduce academic stress. Further, these findings have important implications for planning learning consultation programs, especially in Year 1.
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PURPOSE To determine the prevalence of severe distress and its correlates among Cheju medical college students.
METHODS Data were gathered in December 2005, and all medical college students were included. Of a total of 170 medical college students, 52(30.6%), 41(24.1%), 37(21.8%), and 40(23.5%) were 1st, 2nd, 3rd, and 4th year students, respectively. The questionnaire for sociodemographic information included age, sex, year, hometown, accommodation, education level of parents, socioeconomic status of parents, GPA(grade point average), and standing.
Subjective sense of health status, level of health concern, smoking habit, drinking habit(CAGE), sleep pattern, degree of obesity, and body image satisfaction were included to reveal health habits and health behaviors of the subjects.
CES-D for depression, Psychosocial Well-being Index(PWI) for stress level, State-Trait Anxiety Inventory(STAI) for level of anxiety, and SCL-90-R(Symptom Checklist 90 revised) for level of general psychopathology were used RESULTS: 1st year students were 4.338 times(95% CI; 1.412-13.324) more likely than other years to experience severe distress. Students who felt that they had insufficient time for relaxation showed 5.027 times(95% CI; 1.489-16.969) higher prevalence of severe distress than those who felt they had sufficient time for relaxation.
Those with poor self-esteem were 18.347 times(95% CI; 5.484-61.382) more likely to experience severe distress than those with 'good' self-esteem.
CONCLUSION Offering various programs for improving coping skills, advanced counseling program, or tutoring system and providing sufficient relaxation timeby various methods, such as modifying curriculum, are needed to ameliorate severe distress.
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PURPOSE This study aims to explore which coping strategies medical students use more often, and how coping styles account for medical students' subjective well-being.
METHODS Subjects included 249 medical students from undergraduate and Graduate Entry Programme of a medical school in Seoul, Korea. Coping style was measured using the Ways of Coping Checklist. Subjective well-being was measured with Positive/Negative Affect Scale and Satisfaction with Life Scale. Analysis of Variance(ANOVA) was used to compare four coping strategies, and stepwise multiple regression was used to analyze the accountability of each of the coping strategy for subjective well-being.
RESULTS Medical students used avoidance and problem-focused coping strategy more often than they used emotion-focused coping strategy and seeking social support. Graduate Entry Programme students used avoidance less often and seeking social support more often than undergraduate students. Among subscales of subjective well-being, positive affect can be accounted for by problem-focused coping and seeking social support, and negative affect can be accounted for by problem-focused coping and avoidance. Life satisfaction can be accounted for by problem-focused coping as well.
CONCLUSION The results of this study showed that medical students had high adaptability as well as strong anxiety toward stressful situations in medical school. Moreover, three among the four coping strategies accounted for medical students' subjective well-being. These findings should be considered as a baseline for future research looking into additional variables affecting medical students' well-being.
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PURPOSE This study was to examine whether medical students' academic motivation, general academic stress influence their perceived academic performance.
METHODS Of the 606 medical students surveyed from two universities in Seoul and Incheon, 308 completed and returned the questionnaires yielding a total response rate of 50.8%. The final sample consisted of 129 premedical students (41.9%) and 179 medical students (58.1%). Of these, 189 were male (61.4%), 94 were female (30.5%), and 25 did not identify their gender (8.1%). Their average age was 22.43 years. Measures of students' academic motivation, general academic stress, medical stress, and their perceptions of academic performance were obtained.
RESULTS Pearson's correlations indicated that students' perceptions of academic performance were associated with academic motivation, general academic stress, and medical stress. It was observed that there were gender differences in 'perceptions of academic performance,' 'intrinsic academic motivation,' and 'extrinsic academic motivation.' Females scored themselves higher in 'perceptions of academic performance,'and 'ntrinsic academic motivation,'but lower in 'xtrinsic academic motivation'than did the males. Moreover, premedical students had higher 'perceptions of academic performance' and 'extrinsic academic motivation' scores, but lower 'eneral academic stress'and 'edical stress'scores than medical students. Hierarchical multiple regression analyses showed that the 'motivation'subscale from the academic motivation measure and 'social-psychological' subscale from the general academic stress measure predicted the perceptions of academic performances of the medical students after controlling for gender and education level.
CONCLUSION Medical educators need to be aware that medical students' perceived stress and their academic motivation affects their academic performance which can have a tremendous impact on their quality of life and psychological well-being. Perhaps an academic adjustment program needs to be developed to reduce students' perceived stress in medical training.
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PURPOSE The purpose of this study was to investigate the perceived sources of stress among dental students. The relationships of these stresses to the year of study and gender were also examined. METHODS: The responses from the first to fourth year dental students to 30 items adapted from Dental Environment Stress (DES) questionnaire were subjected to confirmatory factor analysis. The Likert scale, ranging from 0 (not applicable) to 4 (very stressful), was applied to these items. A total of 341 students (male=196, female=145) participated, their average age being 24.7.
Multivariate analysis of variance (MANOVA) was conducted to analyze the effects of the year of study and gender on stressors. RESULTS: Confirmatory factor analysis established a five-factor model including 1) clinical practice, 2) academic load and pressure, 3) personal problems, 4) low self-esteem, and 5) school administration or climate.
Subscales for each factor show good internal consistency with Cronbach's alpha ranging from .71 to .88. Mean score for factor II (academic load and pressure) was the highest among all factors for all of 4 years, which meant that primary stressors were amount of classwork, shortage of time, and competition among classmates regardless of the year of study. MANOVA result showed that the amount of stress from clinical practice and school climate generally increased through the years (p < .01), and that female students were more stressed than male students (p < .01).
CONCLUSION Students' stress is related to the features of the curricula and the learning environment. In reducing this stress, it would be helpful to modify the curriculum as well as to introduce mentor or counselor programs.
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The mental health of medical students deserves attention because the problems in students may negatively influence learning ability and create consequences for later adjustment to doctor's role. The purpose of this study is to understand the stress, copying, self-esteem and subjective general well-being of medical students and compare them with other students group (students of law, science and humanities).
The results was as follows : First, medical students did not report more stress but they use less copying strategy than other students group.
Second, there was no differences in stress, copying, self-esteem and general well-being between high and low academic achievement group in medical students. Futhermore, study-related stress had more close relationship with self-esteem, general well-being.
Third, the preparatory course students showed lower score in general well-being, especially health, cheerful-depressive mood domain.
These results imply that mental health promotion programmes focused in guiding adjustment for the preparatory course students are helpful. And psychiatric, academic counseling should be made available to them. It can lead to an improvement in our health care delivery system. The need of additional longitudinal research is discussed.
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In this article, we critically reviewed various literatures on stress and adjustment in medical schools as a preliminary work for the future empirical study. We adopted Biopsychosocial Model as the frame of reference, which considers not only the relationship between stressor and psychological distress, but also their interaction with moderating variables such as psychosocial resources and vulnerabilities.
According to the model, three important aspects of medical school stress were reviewed: 1) the types of medical school stresses, 2) the adverse effects of stressors on the adjustment such as depression, anxiety, physical symptoms, drug abuse, eating problem, attrition, change of attitude and personality, etc, 3) the moderating effects of various vulnerabilities and resources including Type A behavior pattern, masculinity/femininity, locus of control, optimism, anger expression, coping style, social support, and study skills on the suppression or development of psychological distress. Investigating the moderating variables in particular may have great clinical implications since these variables are closely related to the psychological factors concerning successful adjustment in medical school.
Conclusions drawn from this review suggests several directions of future research. First, a comprehensive study which covers the whole process of medical school stress is recommended. Longitudinal design will be more suitable for dealing with the developmental features of medical education. Finally, the severity of medical school stress must be compared with the stress of general colleges and other professional graduate schools. This article is expected to provide some theoretical basis for future studies regarding the successful adjustment in the medical school, the development of preventive intervention programs and the reform of medical education systems.
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