Perceived Sources of Stress Among Greek Dental Students

A Qualitative Analysis of Students' Perceptions and Experiences of Stressors and Well-Being in Dentistry

INTRODUCTION

Well-being is increasingly regarded as an integral component of a graduating dentist's professional responsibility, yet studies demonstrate significant levels of stress and poor mental health in the dental student population. The aim of this qualitative study was to explore final-year dental students' perceptions of stressors in dentistry and their experiences of managing their individual well-being and supporting the well-being of their colleagues and patients.

METHODS

A literature search was performed to guide the development of an interview framework which included questions centred around three higher domains based on self, peers and patients. Participants were randomly sampled and the interviews audio recorded and transcribed verbatim. An inductive-deductive approach was adopted for thematic analysis of the results.

RESULTS

Fourteen interviews were conducted, revealing four themes and 15 subthemes. Students were acutely aware of poor well-being symptoms amongst themselves and their peers. Treating dental patients with mental illness was common but some students expressed uncertainties in managing these patients. The key stressors were assessments and clinical stress. Students frequently sought support from peers and half had received professional help. Barriers to approaching faculty staff were identified. The role of stigma in preventing students from openly sharing their well-being experiences was discussed.

CONCLUSION

A range of curricular and clinical stressors, and potential sources of support to manage these stressors, have been explored from the perspectives of final-year dental students. From these experiences, action points have been proposed to address knowledge gaps and enhance faculty-level wellness support for dental students.

Perceived stress among dental students and the role of parental influence in career decision-making

OBJECTIVES

The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress.

METHODS

This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics.

RESULTS

A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry.

CONCLUSION

Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

Emotional Intelligence, Perceived Stress and Life Quality Assessment Among Dental Students

Background

The capacity to grasp and recognize one's own and human feelings, use cognitive awareness to control actions and behavior, and modify moods in response to difficult situations is known as emotional intelligence (EI). Perceived stress has been linked to higher levels of depression among healthcare students. This study set out to assess EI, perceived stress (PS), and life quality assessment (LQA) among dental undergraduates and to ascertain how these factors are linked to one another.

Materials and Methods

The self-reported cross-sectional research was organized among preclinical and clinical years of dental students to examine their emotional intelligence and stress-coping capacity. About 146 students participated in the study, with ages ranging from 19 to 25, irrespective of gender. The students were given the Schutte Emotional Intelligence and Perceived Stress Scale tools (PSS10) by Cohen, and with World Health Organization Quality of Life (WHOQOL-BREF) tool examined the characteristics that contribute to life quality among students.

Results

The study included 146 individuals, 38 males (26.02%) and 108 females (73.97%), with an unresponsiveness rate of 2.66%. The correlation revealed statistically high significance among emotional intelligence and perceived stress (P = 0.000), perceived stress and life quality (P = 0.02), and emotional intelligence and life quality (P = 0.008). The statistical analysis of the influence of EI, PS, and LQA on academic year-wise analysis determined non-significant (P > 0.05).

Conclusion

Due to the time constraints of their job, dentistry training may be highly stressful, yet regular evaluations of student performance and the accompanying factors would help us to understand how students behave in challenging circumstances.

Prevalence, Symptoms, and Triggering Factors of Panic Attacks among Dental Students in Riyadh Saudi Arabia-A Cross Sectional Survey

Panic disorder by definition is an anxiety disorder of unexpected and repeated episodes of intense fear. Panic attacks are usually diagnosed by four or more of a set of symptoms that include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, and hot flushes. They usually interfere with daily life situations and also interfere with education. Hence, the aim of this study was to assess the prevalence of panic attacks, their symptoms, and triggering factors among dental students in Riyadh, Saudi Arabia. Data were collected from 394 students using a structured and validated questionnaire. The prevalence of panic attacks among dental students in Riyadh, Saudi Arabia, was 42.9%. Most of the participants who experienced higher episodes of panic attacks were females (53.4%) when compared to males (24.5%). Third year students displayed greater (58.3%) episodes of panic attacks compared to their respective counterparts. The most reported symptom of panic attacks was rapid or pounding heartbeat followed by breathlessness, chest pain, and shaking or trembling. It was also noted that most of the participants (63.31%) encountered a panic attack for the first time after joining dental school. The situations where dental students frequently experienced panic attacks were during exams, clinic procedures, giving presentations, and especially while under a lot of stress. The high occurrence of panic attacks among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions. Dental students experiencing panic attacks should be provided with necessary counseling sessions or psychiatric consultation in order to overcome such scenarios. Dental schools should consider these findings when planning the dental curriculum. Hence, the role of the faculty members is essential in these situations to provide support for the affected students.

The impact of endodontic workload and allocated treatment time of dentists in turkey on perceived stress and complication frequency and suggested solutions

Background

Procedural complications and workload have been reported as sources of stress in dentistry.

Aim

To investigate the impact of endodontic workload and allocated treatment time of dentists on perceived stress and frequency of complications.

Material and Methods

The online survey included questions to evaluate the average number of root canal treatments per week, stress levels during root canal treatment, frequency of single-visit root canal treatments, time spent on single-visit treatments, frequency of endodontic complications per week, preference for management of complication, and proposed solutions.

Results

A negative correlation was found between endodontic workload and perceived stress, which was statistically significant at slight and moderate stress levels (P < 0.05). Amongst the clinicians who feel "very stressful" during the treatment, the clinicians who allocate only 20 minutes or less per treatment had the highest frequency, and their numbers were significantly higher than clinicians who spent 20-40 minutes per treatment (P < 0.05). Amongst the clinicians who experience instrument separation 4-6 times/week, the number of clinicians who spent 40-60 minutes or more than 60 minutes per root canal treatment was significantly lower in comparison to the number of clinicians who spent 20-40 minutes (P < 0.05).

Conclusion

Increasing the quality of dental equipment and reducing the time pressure on dentists might result in lesser stress levels of clinicians and fewer endodontic complications.

Medical students' attitudes toward sleeping pill usage: A cross-sectional study

Medical students experience significant stress, which may interfere with their sleeping routines; consequently, they are at a higher risk of misusing sleeping pills. Therefore, this cross-sectional convenience sampling study aims to evaluate medical students' attitudes toward the usage of sleeping pills, as well as the prevalence of their misuse and the associated factors. A self-administered online questionnaire survey was completed by 338 medical students at the College of Medicine of the King Saud bin Abdulaziz University for Health Sciences. Of 338 participants, 84 (24.85%) reported using sleeping pills. The prevalence of sleeping pill misuse was 26.63% (n = 90). The most common misuse behavior of sleeping pills was self-prescription (n = 72, 21.30%). The factors associated with sleeping pill misuse were stimulants usage (n = 69, 92%, p = 0.0072), high grade point average (n = 63, 84%, p = 0.046), preclinical years (n = 52, 69.3%, p = 0.042), and longer average time required to fall asleep (n = 53, 70.7%, p = 0.008). The prevalence of sleeping pill misuse is high among medical students, particularly among those in preclinical years. Therefore, enhancing awareness regarding sleeping pill misuse is crucial. This can be achieved through campaigns, workshops, and providing information regarding the dangers of sleeping pill misuse in the curriculum.

Stress amongst dental students in the transition from preclinical training to clinical training: A qualitative study

OBJECTIVES

The present study sought to qualitatively evaluate third-year undergraduate dental students' perceptions of sources of stress during the transition from preclinical to clinical training.

METHODS

This was an observational, cross-sectional, and qualitative study with a nonprobabilistic sampling design. The sample consisted of students in the third year of the five-year undergraduate degree program in dentistry offered by the São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo State, Brazil (n = 37). Data were collected using open-ended, semistructured, and individual interviews that were recorded on a digital voice recorder. The students were interviewed on campus at a previously scheduled time. Efforts were made to provide a secure and welcoming environment for the interview. The interview questions addressed students' adaptation to clinical training and their perceptions of stress resulting from this transition. Data analysis was based on the qualitative and quantitative Discourse of the Collective Subject (DCS) technique performed with the aid of Qualiquantisoft®.

RESULTS

Most of the students evaluated (75.7%) reported difficulty in the transition from the preclinical to the clinical phase of their program and that this difficulty increased their stress levels during this transition (81.1%). The most frequently cited reason for the increase in stress was the responsibility and demands associated with caring for real patients (54.1%). Almost half of the students (48.6%) reported feeling physical symptoms of stress such as tachycardia, dizziness, headache, and muscle tension during this period. Most of the students (81.1%) required up to one semester to feel that they had adapted to the clinic. Many students used stress reduction strategies such as simply trying to calm down, studying before their clinical work, improving organisation, and asking professors for help. Adaptation to ergonomics and biosafety in the clinic was the most frequently cited impediment (45.9%) to the adaptation process. The students' main suggestions for reducing stress in this transition phase were additional preclinical training in a clinical setting, a more gradual transition, and greater professor receptiveness.

CONCLUSION

The dental students interviewed herein perceived high levels of stress during the transition from preclinical to clinical training.

Stress, Sleep Quality, and Academic Performance among Dental Students in Shiraz, Iran

Background

Quality of sleep and stress level can affect the health, capacity of learning, and academic performance of the students. This study aimed to investigate the association between stress and sleep quality with academic performance among undergraduate clinical dental students in Shiraz, Iran.

Methods

This cross-sectional study was conducted during the second semester of the academic year 2020–2021 among clinical dental students at Shiraz Dental School, Iran. A total of 138 students completed Pittsburgh Sleep Quality Index (PSQI) and dental environment stress (DES) questionnaire. The grade point averages (GPAs) of the previous terms of the participants were also collected. Data analysis was performed using Kolmogorov–Smirnov test, the one-way ANOVA, post hoc Duncan's test, nonparametric Kruskal–Wallis H test, Wilcoxon–Mann–Whitney test, and the chi-squared test. The p values of less than 0.05 were considered statistically significant.

Results

Clinical dental students participated in this study experienced moderate levels of stress and poor sleep quality. Mean total DES and PSGI scores did not differ by sex, year of study, marital status, and place of residence (p values >0.05). Most of the students (52.9%) had moderate GPAs. A significant relationship was observed between sex and GPA as well as between place of residence and GPA (p values <0.05). No significant differences were found between DES total score or PSQI score and GPA categories (p values >0.05). A significant direct relationship between DES total score and PSQI score was observed (p < 0.05).

Conclusion

Dental undergraduates in Shiraz, Iran, experienced moderate levels of stress and poor sleep quality. The results showed no significant difference between sleep quality or DES and academic achievement. However, a significant direct correlation was observed between sleep quality and dental environment stress.

Extreme Situation Experienced by Dental Students of the Medical University of Silesia Due to the SARS-CoV-2 Epidemic during the First Lockdown

The pandemic declared in many countries in 2020 due to COVID-19 led to the freezing of economies and the introduction of distance learning in both schools and universities. This unusual situation has affected the mental state of citizens, which has the potential to lead to the development of post-traumatic stress and depression. This study aimed to assess the level of stress in dental students in the context of the outbreak of the SARS-CoV-2 virus pandemic. A survey on the PSS-10 scale was prepared to measure the level of perceived stress. The study included 164 dental students at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice, Poland. The results showed the impact of COVID-19 on the stress of students, with 67.7% reporting high levels of stress. The study also revealed that stress was higher among older female students. This paper recommends that the university provide more intensive psychological care as psychological first aid strategies in epidemics or natural disasters and to consider telemedicine in order to deliver services due to the limitations of the pandemic.

Depression, Anxiety, and Stress During Times of COVID-19: An Analysis of Youngsters Studying in Higher Education in India

This study addressed the critical problems of depression, anxiety, and stress, which are prevalent among students pursuing higher education. Specifically, this article aimed to study the level of psychological distress due to the COVID-19 pandemic experienced by young people studying in higher education institutions in India. The study also attempted to identify various coping strategies students adopted to overcome this difficult time. Following a descriptive research design, this study used surveys to collect primary data from 235 students in graduate and undergraduate programs in India. The DASS-21 scale was used to check the levels of depression, anxiety, and stress students experienced. Furthermore, a four-point COPE scale was used to identify coping strategies students adopted. The results showed that students experienced high levels of stress and anxiety during the ongoing COVID-19 pandemic. Although depression levels were not alarming, most students were worried about several aspects of their lives and careers. However, because the data were collected from a relatively small sample, the study is likely not generalisable. Furthermore, most of the data were collected online, which has its limitations. This research likely has significant implications for various stakeholders, such as students, parents, institutions, counsellors, and government and non-government bodies, because it may help them take appropriate actions. These research contributions are original and novel, because the COVID-19 pandemic has posed unprecedented challenges and inspired new solutions to the problems of students and society.

Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies-A Systematic Review

The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search for the articles was carried out in the electronic databases by four independent researchers. The data search was performed in the electronic search engines like PubMed, Google Scholar, Web of Science, Scopus, Medline, Embase, Cochrane and Saudi Digital Library for scientific research articles published from January 2000 until December 2020. STROBE guidelines were adopted for qualitative analysis of six articles which met the eligibility criteria. The analysis of the literature revealed that most of the studies included were conducted in the past 8 years in different regions of Saudi Arabia. Findings of this systematic review clearly state that dental students in Saudi Arabia experience higher levels of depression, stress and anxiety and stress during their education period, with a higher stress for female students compared to male students. There is an urgent need to introduce interventional programs and preventive strategies to overcome the long-term effects.

COVID-19 and Dental and Dental Hygiene Students' Career Plans

OBJECTIVE

The aims of this study were to investigate whether dental and dental hygiene students' career plans postgraduation were affected by the coronavirus disease 2019 (COVID-19) pandemic and to examine wellness and readiness for clinical practice among students who reported a change in career plans.

METHODS

An anonymous online REDCap survey was developed and emailed to 436 dental and dental hygiene students at a US dental school. The survey consisted of 81 questions that covered demographics, career plans postgraduation, and readiness and wellness measures. An open-ended question assessing how students' career plans have changed during the pandemic was also included.

RESULTS

A total of 252 students completed the survey, of whom 11.5% reported that their plans for future dental practice have changed since the COVID-19 outbreak. Students who reported a change to their career plans had significantly higher mean perceived stress (20.1 vs. 16.3; P = 0.003) and anxiety (9.2 vs. 6.2; P = 0.004) scores and lower mean resilience (18.9 vs. 20.9; P = 0.01) scores than those who reported no change to their career plans. Concerns were raised regarding the limited employment opportunities, long-term stability of the dental profession, and the interruptions to clinical education and licensure examinations consequent to the pandemic.

CONCLUSIONS

A comprehensive effort inclusive of adeptly designed clinical and curriculum experiences paired with wellness interventions and support tailored to students is needed. These measures need to support trainees across varying years in training and resilience levels to be effective for dental and dental hygiene students as they approach their future career intentions in the dental profession. Additional longitudinal research is needed to assess if change in career intentions during the COVID-19 pandemic corresponds with actual change postpandemic and affects the dental profession.

KNOWLEDGE TRANSFER STATEMENT

This study explores the potential short-term change in career intentions of dental hygiene and dental students during the COVID-19 pandemic. Findings can inform workforce planning as well as interventions developed and implemented by academic dental institutions to support student wellness during unexpected and prolonged emergency situations.

A descriptive pilot study of the immediate impacts of COVID-19 on dental and dental hygiene students' readiness and wellness

BACKGROUND

The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has impacted dental students training across the U.S. academic dental institutions by moving classroom instruction to an online modality, limiting patient care, canceling external rotations, and rescheduling of licensure examinations.

OBJECTIVE

The aim of this study was to assess the immediate impacts of COVID-19 on students' readiness to enter clinical practice or residency and its association with well-being (anxiety, perceived stress, coping and social support, and resilience).

METHODS

An online REDCap survey was distributed to 407 D1-D4 year dental students and 29 DH3-DH4 year dental hygiene students enrolled at a U.S. dental school. The survey consisted of readiness and wellness measures as well as socio-demographic variables.

RESULTS

Overall response rate was 58% (N = 252) ranging from 40% among D4 students to 72% among D1 students. About half (55%) of the respondents were White, a third (34%) Asians and 5% were African Americans. Ninety-two percent were non-Hispanics while 62% were female. Overall mean (SD) anxiety score was 6.5 (5.3) and 26% of respondents reported moderate or severe levels of anxiety. Anxiety score differed significantly by gender with females reporting higher anxiety levels, mean (SD) = 7.3 (5.5) versus 5.2 (4.7) for males; P = 0.002). Furthermore, mean anxiety score differed significantly among the dental school classes, ranging from 5.5 (5.3) among D2 students to 11.8 (6.2) in DH4 students (P = 0.02).

CONCLUSION

Academic dental institutions need to be responsive to the heightened anxiety and uncertainly levels of students and provide responsive training and support to mitigate its effects.

Reliability and Validity of the Turkish Adaptation of Dental Environmental Stress Scale: A Methodological Study

Aim:

This paper aims to develop the Turkish version of the dental environmental stress (DES) scale that can evaluate perceived DES in Turkish dental students.

Materials and Methods:

A methodological study was conducted to adapt the DES scale to Turkish language in Gaziantep University, Faculty of Dentistry. The study group consisted of 392 students in the academic year 2018/19. The students were surveyed using the DES scale, translated into Turkish language. The demographic characteristics were analyzed by using descriptive statistical analyses. Kaiser-Meyer-Olkin and Bartlett’s Test of Sphericity were employed to evaluate the suitability of the dataset. Exploratory factor analysis was performed to assess construct validity. Depression Anxiety Stress Scale-21 was used to predict the power of the scale. In reliability analysis, the instrument’s internal consistency and corrected item-total correlation, Cronbach’s α reliability were studied.

Results:

Content Validity Index of the scale items was found to have a high validity range of 0.97. Two items with an estimate value less than 0.4 were excluded and 30 items yielded five factor. Five factors having eigenvalues greater than 1.0 explained 52.299% of the total variance. Each factor showed adequate internal consistency. Factor loadings ranged from 0.46 to 0.77. In the concurrent validity, significant positive relationship was found between DASS-21 and Turkish DES.

Conclusion:

According to psychometric properties, the Turkish version of the DES presented good results, thus it could be a valid instrument to assess the perceived stress in Turkish dental students.

An 8-year retrospective survey of assessment in postgraduate dental training in complicated tooth extraction competency

BACKGROUND/PURPOSE

Direct observation of procedural skills (DOPS) has been increasingly used in health education in recent years. This study evaluated the effect of education and trainees' perception of assessment on the clinical skills of postgraduate dental trainees in complicated tooth extraction.

MATERIALS AND METHODS

This study was conducted as a retrospective survey among postgraduate dental trainees learning complicated tooth extraction in Taipei and Linkou Chang Gung Memorial Hospital from 2012 to 2019. Practical skills were assessed using DOPS by trainees and faculty members. Each clinical case included a complicated extraction of a permanent tooth.

RESULTS

A total of 69 participants (26 men and 43 women, average age = 26.49 years, range = 24-34 years) were included in this study. Within the survey cohort, faculty assessments scored significantly higher than did trainees' self-assessments in each complicated tooth extraction procedure, with no difference between both sexes. The higher-performing trainees tended to underrate their performance much more than did the lower-performing trainees. More than 40% of the trainees evaluated themselves as having "poor capability" in some invasive surgical procedures, even though their actual performance was not lower than that of those who evaluated themselves as having adequate or good capability.

CONCLUSION

Self-assessment skills should be developed with more practice and experience. We hope that these findings can guide the planning of faculty development programs for clinical instructors, particularly the new cohort of faculty who will succeed the rapidly retiring boomer generation in the next 10 years.

The Influence of Gender and Year of Study on Stress Levels and Coping Strategies among Polish Dental

Background and objectives: Stress is a common term used to describe various adverse psychological conditions. Students in the dentistry field face many negative psychological outcomes. The core factors for stress among dental students are related to their training course and social contacts with peers. This research aimed to assess the stress of dental students depending on their gender and study year. Materials and methods: We used the Perceived Stress Scale (PSS-10) and Mini-COPE questionnaire. The surveys were conducted among 446 dental students (320 women and 126 men) at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice. Results: For the second-year and fifth-year students, the differences in scores were statistically significant, while in both cases, men had significantly lower values on the analysed scale. The results of the Kruskal-Wallis test indicated significantly lower values on the PSS-10 scale for the third-year and fourth-year students than in first-year students. The performed statistical analysis of the data obtained from the Mini-COPE questionnaire showed significant differences between men and women in individual years of study. In the first year, women chose more often the strategies related to turning to religion (p = 0.007), seeking emotional support (p = 0.046), seeking instrumental support (p = 0.045) and dealing with something else (p = 0.029) in coping with stress than men. Conclusions: The highest level of stress was found among first-year dental students. Moreover, women were characterised with higher stress levels than men. Men more often use psychoactive substances and resort to a sense of humour to cope with stress. On the other hand, women turn to religion, seek instrumental and emotional support.

Stress and coping strategies in pediatric dental residents

PURPOSE/OBJECTIVES

This study examines the amount and sources of stress, as well as coping strategies, exercise, and alcohol use, among pediatric dental residents in the United States.

METHODS

One hundred fifty pediatric dental residents (n = 76 postgraduate year [PGY] 1; n = 74 PGY2) in 2-year residency programs responded to an anonymous survey that included demographic questions, the Perceived Stress Scale (PSS), Graduate Dental Environment Stress Scale (GDES), Tactics For Coping With Stress Inventory, and questions about alcohol consumption and exercise.

RESULTS

Stress scores were moderate (mean PSS = 16.7 ± 7.1; GDES = 61.7 ± 16.0). The largest sources of stress were research requirements, program/clinic issues, and finances. There were no significant differences in amount and sources of stress between PGY1 and PGY2 residents (P ≥ 0.10). Residents from western programs (based on AAPD districts) reported less stress than those in other areas (PSS, P = 0.04; GDES, P = 0.09). Number of negative coping tactics used was positively correlated (PPS, P < 0.0001; GDES, P = 0.0004), while number of positive coping tactics was negatively correlated (PSS, P < 0.0001; GDES, P = 0.0008) with stress scores. Younger residents (< 30yrs) used more coping tactics than older residents (P = 0.0002). Hospital-based residents used more negative coping tactics than those in university-based and combined programs (P = 0.05). Residents exercising > 150 min/wk had lower PSS (P = 0.03) and GDES (P = 0.09) scores. Alcohol consumption was unrelated to stress scores.

CONCLUSION(S)

Amount and sources of stress do not differ by residency year. Residents utilizing positive coping strategies and exercising had lower stress than those using negative coping strategies. Pediatric dental residency programs should educate and encourage residents to use positive coping strategies and exercise.

Health-related impediments to learning among dental and oral surgery students

Dental education is a challenging experience that places significant demands on students' intellectual, financial, and psychosocial well-being. Dental students who simultaneously experience physical illness, emotional upset, or interpersonal difficulty may be at greater risk of experiencing negative academic consequences. It is well documented that stress affects student learning, however, the impact of other health concerns on academic success is less understood. The purpose of this manuscript is to document the prevalence and perceived academic impact of 24 health concerns on the academic performance of a sample of 130 undergraduate dental students as measured by the National College Health Assessment (NCHA). Health concerns that were most prevalent among dental students were generally also perceived to be most detrimental to their learning. These included upper respiratory infections (cold, flu, sore throat), interpersonal concerns (concerns about a troubled friend or family member, and relationship difficulty), and mental health issues (depression/anxiety/seasonal affective disorder, and stress).

Stress and its association with academic performance among dental undergraduate students in Fujian, China: a cross-sectional online questionnaire survey

BACKGROUND

The aim of this study was to investigate the amount and sources of stress in dental undergraduate students in Fujian, China, and the factors associated with stress.

METHODS

This cross-sectional study was conducted during the second semester of the 2017-2018 academic year at the School of Stomatology, Fujian Medical University, China. A total of 396 students were surveyed with the Dental Environment Stress Questionnaire (DES) and the Perceived Stress Scale (PSS) using an online survey system. The participants' demographic information, including sex, age, year of study, and grade point average (GPA) was also collected. One-way analysis of variance (ANOVA) was performed to compare the stress scores. Pearson correlation and multiple linear regression analyses were conducted to explore the associated factors of stress and academic performance. All statistical analyses were performed at a significance level of 5%.

RESULTS

A total of 347 undergraduate students participated in the present study, for a response rate of 87.6%. There were no significant differences in the DES and PSS total scores among students of different grades and sexes. Significant differences were found in the DES "workload" and "self-efficacy beliefs" scores among students from different study years (all P < 0.05). The Multiple linear regression showed that DES and PSS scores were negatively correlated with GPA, while sex was positively correlated with GPA (all P < 0.05). Female students had significantly higher GPAs than male students.

CONCLUSIONS

Dental undergraduates in Fujian, China experienced moderate levels of stress. While the amount of stress did not differ by year of study, the sources of stress did differ. Stress scores and sex were negatively correlated with academic performance.

Mental Well-being of the First and Final-Year Medical and Dental Students of Kermanshah University of Medical Sciences

Background and Aim:

Medical and dental students are predisposed to developing psychiatric disorders owing to heavy physical, intellectual, and emotional activities. This study was conducted to evaluate the mental health status of medical and dental students.

Materials and Methods:

This cross-sectional study was conducted on the first- and final-year medical and dental students at Kermanshah University of Medical Sciences in 2016. The mental health status was measured by the General Health Questionnaire-28 (GHQ-28) involving somatic, social, anxiety, and depression domains. Scores > 6 (out of 28) and > 2 (out of 7) were considered to show psychiatric disorder for each domain, respectively. Data were analyzed by SPSS-18 using Kruskal-Wallis and Chi-square tests (P< 0.05).

Results:

The participants consisted of 246 students (39.4% first- and 37.8% last-year medical students; 8.1% first- and 14.6% last-year dental students) aged 18-37 years (22.6 ± 3.3). Psychiatric disorder, somatic symptoms, social dysfunction, anxiety, and depression were experienced by 44.7, 42.7, 46.3, 49.6, and 28.5% of the students, respectively. The prevalence of psychiatric disorder was comparable between the first- and final-year medical students (40.2% and 48.4%, respectively;P= 0.258). The final-year dental students significantly underwent more psychiatric disorder than the first-year dental students (61.1% and 20%, respectively;P= 0.003). There were no significant differences between the medical and dental students in the first (P= 0.089) and final (P= 0.196) years. There was also no significant association between the occurrence of psychiatric disorder and gender and age group (P> 0.05).

Conclusion:

Psychiatric disorder was common among dental and medical students. Hence, preventive and control measures are suggested to improve their mental health.

Perceived sources of stress amongst dental students: A multicountry study

AIMS

The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries.

METHODS

A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05.

RESULTS

Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress.

CONCLUSION

The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.

Stress predictors in two Asian dental schools with an integrated curriculum and traditional curriculum

INTRODUCTION

This study explored stress predictors and the role of instructional methods and institutional differences in perceived stress levels amongst students at two Asian dental schools.

MATERIALS AND METHODS

An anonymous questionnaire was distributed to undergraduate dental students at Tokyo Medical and Dental University (TMDU), Japan and the University of Medicine and Pharmacy (UMP), Hochiminh City, Vietnam in 2016. Data concerning the students' demographic information and grades, and responses to the Perceived Stress Scale (PSS) and Dental Environment Stress questionnaire (DES) were collected. The questionnaires were prepared in English and translated into Japanese and Vietnamese following a forward-backward translation process.

RESULTS

Altogether 684 students answered the questionnaire with a response rate of 97% for TMDU and 89% for UMP. The mean DES score of UMP students was significantly higher than TMDU (P < .001). TMDU students with dentistry as their first programme choice had significantly lower PSS and DES scores in several categories than other TMDU students, whilst UMP clinical students reported higher stress scores in several areas than UMP preclinical students.

CONCLUSION

Having dentistry as their first choice of educational programme was a significant stress predictor for Japanese students whilst the clinical practicum was a significant stress predictor for Vietnamese students. Previous academic performance was not a significant stress predictor for students at either dental school. Dental students of an integrated, active-learning curriculum reported lower stress levels than students of a traditional, discipline-based curriculum.

An analysis of clinical transition stresses experienced by dental students: A qualitative methods approach

INTRODUCTION

Stress in dental students is well established with potential psychological distress, emotional exhaustion and burnout-related symptoms. Little attention has been given to the problems encountered by dental students during the transition from theoretical or paraclinical training to the clinical environment. The aim of this study was to adopt a qualitative research methods approach to understand the perceived stressors during students' clinical transition and provide insights for curriculum planners to enhance learning.

METHODS

This study analysed four groups of 2nd- and 3rd-year BDS students' experiences in focus group interviews relating to their pre-clinical and clinical transitions. The interviews were recorded and transcribed verbatim, and a thematic analysis was performed using an inductive qualitative approach.

RESULTS

Key overlapping domains identified were the transition gap and stresses. The transition gap was subclassified into knowledge and skill (hard and soft), and stresses was subcategorised into internal and external stresses. On first coming to clinics, students experienced knowledge gaps of unfamiliar clinical treatments with mismatches between knowledge acquisition and clinical exposure. Students felt incompetent owing to the stresses attributable to curriculum design, staff and the patient. This negatively affected their confidence and clinical performance.

CONCLUSION

A range of challenges have been identified that will allow curriculum designer's to plan a more supportive learning experience to help students during their transition to clinical practice giving them timely knowledge, confidence and clinical performance to better prepare them for entering clinics.

Comparing student and staff perceptions of the "Educational Climate" in Spanish Dental Schools using the Dundee Ready Education Environment Measure

OBJECTIVE

To compare the perceptions of students and teachers of the "Educational Climate" (EC) in Spanish public dental schools.

METHODS

A group of 1064 students and 354 teachers from six Spanish public dental schools responded to the DREEM questionnaire. This has 50 items grouped into five subscales: perception of learning (Learning); perception of teachers (Teachers); academic self-perceptions (Academic); perception of the atmosphere in the faculty (Atmosphere); and social self-perceptions (Social). The DREEM scale provides results for each item, each subscale and the overall EC.

RESULTS

The EC scores were 123.2 (61.6%) for the students and 134.1 (67.0%) for the teachers (P<.001). The scores of the students and teachers for the subscales were, respectively: 27.9 (58.1%) and 30.2 (63.0 %) for Learning (P<.001); 26.8 (60.9%) and 32.6 (74.1%) for Teachers (P<.001); 20.7 (64.7%) and 20.5 (64.0%) for Academic (P=.333); 29.9 (62.3%) and 33.7 (70.3%) for Atmosphere (P<.001); and 17.9 (64.0%) and 16.9 (60.5%) for Social (P<.001). The students identified six problematic items (12.0 %) compared to only two (4.0 %) highlighted by the teachers.

CONCLUSION

The students and teachers considered the EC to be "more positive than negative" in Spanish public dental schools; and the different subscales to be "positive and acceptable." The teachers did, however, evaluate the EC, and specifically the learning-teaching process, more positively than their students, identifying fewer problematic educational aspects. Both groups agreed on the need to: improve support systems for students who suffer from stress and reduce teaching based on "factual learning."

A longitudinal study on stress sources perceived by Chilean dental students

Introducción. La percepción de los estudiantes universitarios sobre el estrés académico es fundamental, ya que proporciona información valiosa sobre la eficiencia y aceptabilidad de los métodos educativos.Objetivo. Evaluar las diferencias en los factores de estrés percibidos por los estudiantes de primer año de odontología durante el primer y segundo semestre según género.Materiales y método. Estudio descriptivo exploratorio, longitudinal y no experimental. En mayo y octubre de 2016 se aplicó la versión en español del Dental Environment Stressors (DES), adaptado y validado para estudiantes de odontología en la Universidad San Sebastián (Concepción, Chile). La muestra consistió en 83 estudiantes de primer año. La comparación de las variables en estudio (stress y sus dimensiones) entre los dos períodos comparados, en general y considerando los géneros, se realizaron mediante la prueba t-Student, previa estimación de existencia o no de igualdad de varianzas entre los grupos mediante la prueba F de Fisher.Resultados. En la segunda medición, la dimensión “Formación clínica” en mujeres fue el único componente que mostró diferencias significativas con valores superiores de la media.Conclusión. Existe una percepción de estrés para todos los ítems del cuestionario DES; las mujeres tuvieron una mayor puntuación en la dimensión “Formación clínica”.

Stress Level of Dental and Medical Students: Comparison of Effects of a Subject-Based Curriculum versus a Case-Based Integrated Curriculum

The aim of this study was to investigate the stress level of medical and dental students at Kuwait University after a case-based integrated curriculum replaced the former subject-based curriculum. A modified version of the Dental Environment Stress questionnaire was used to measure possible stressors for both medical and dental students. The investigators administered the questionnaire for the first time in 2008, when Kuwait University medical and dental schools followed a subject-based curriculum (group A). The same questionnaire was administered for a second time in 2014, when both medical and dental schools had adopted a case-based integrated curriculum (group B). A total of 345 fifth- and sixth-year medical and dental students responded to the questionnaire (group A=187, group B=158), with an overall 83% response rate. The results showed that, for both the dental and medical students, changing to a case-based integrated curriculum raised the stress level for most of the stressors evaluated. "Inconsistency of feedback on work between different instructors," "difficulties in communicating with teaching staff," "amount of assigned class work," and "examinations and grades" were some of the statistically significant stressors for group B students. Female students reported higher levels of stress than male students in both groups. These results suggest that introducing stress management education into the case-based integrated dental and medical curricula could enhance students' psychological well-being.

Health professions' students have an alarming prevalence of depressive symptoms: exploration of the associated factors

BACKGROUND

There is a need to better understand the depression phenomenon and to clarify why some students become depressed and others don't. The purpose of this study was to compare the prevalence of depressive symptoms among health professions' (HP) students, and to explore the association between socio-demographic factors (e.g. year of study, discipline, gender) and depressive symptoms.

METHODS

In this descriptive-analytic, cross-sectional study, stratified proportionate sampling strategy was used to select the study sample during the academic year 2012-2013. The students from four health professions' schools situated within a large, public university located in Riyadh, Saudi Arabia were screened for depressive symptoms using the 21-item Beck Depression Inventory (BDI II). Chi-square test, student t-test and ANOVA were used to compare different categorical variables.

RESULTS

The overall response rate was 79.0 %, the highest among dental students 86.1 %, and lowest among nursing (49.7 %). The overall prevalence rate of depressive symptoms was 47.0 %; it was highest among dentistry students (51.6 %), followed by medicine (46.2 %), applied medical sciences (AMS) (45.7 %) and lowest among nursing students (44.2 %). A statistically significant association was found between the presence and severity of depressive symptoms on one hand and the female gender (p = 0.000) and year of study on the other hand.

CONCLUSION

This study seems to indicate an alarming rate of depressive symptoms. Female gender, dentistry, the third year for all schools and fifth year for medicine and dentistry have the highest association with depressive symptoms. Future studies may be needed to explore further the reasons and explanations for the variation in the prevalence of depressive symptoms among these groups. The factors that deserve exploration include curricular variables and personal factors such as the students' study skills.

Dentists' experiences of dentally anxious patients in a specialist setting: An interpretative phenomenological analysis

Since dentists play an important role in the emergence and maintenance of dental anxiety in patients, it is imperative to understand how dentists themselves evaluate their work with anxious patients and how they perceive their environment. Semi-structured interviews explored the working lives of six dentists. Interpretative phenomenological analysis revealed four superordinate themes: Negotiating identities, Control, Perceptions of dentistry and being a dentist and Stress related to treating dentally anxious patients. Warranting investigation in other settings, specialist dentists experienced conflicts between being a helper and inflictor of pain, as well as dealing with conflicting views concerning their status as a dentist.

A longitudinal study of psychological stress among undergraduate dental students at the University of Jordan

BACKGROUND

The purpose of this study was to identify whether psychological stress increased as undergraduate dental students progressed through their studies from first to fifth year. Another objective was to determine if the perceived sources of stress have changed along the years.

METHODS

To achieve these aims, a cohort of students at the University of Jordan were followed from first to fifth year of dental school. Fifth year students completed both the General Health Questionnaire 'GHQ-12' which was used to assess psychological stress and the Dental Environment Stress questionnaire 'DES' which was used to examine the perceived sources of stress. The same cohort of students had completed similar questionnaires during their first year of study. Chi-square analysis and independent t-test analysis were performed to compare GHQ-12 and DES scores between first and fifth year.

RESULTS

Results showed that psychological stress increased from first to fifth year of study. Eighty- nine percent of fifth year students scored over the cut-off point of three in the GHQ-12 compared to 58 % in the first year. The difference between the years was statistically significant at p = 0.05. Mean score for DES also increased between first and fifth year of study and the difference was statistically significant at p = 0.05.

CONCLUSIONS

Results of this study demonstrated that stress in dental students at the University of Jordan increased along the years. Fifth year students showed a high level of psychological stress and methods to reduce that stress should be further investigated and utilized.

The impact of a self-development coaching programme on medical and dental students' psychological health and academic performance: a randomised controlled trial

BACKGROUND

Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students' psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia.

METHODS

Four-hundred and twenty-two participants (n = 422, 20-22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students' psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012-2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students' academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ).

RESULTS

Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short-term significant reductions in depression and anxiety in compared to CG from T1 to T2. The short-term changes in stress, GSE and SWLS of the IG were not significantly different from those of the CG. While both groups showed a significant change on most of the psychological variables from T1 to T3, no significant differences were found between the groups in this period. In addition, no significant difference was found in WG between the IG and CG after the intervention. No harms relevant to the intervention were reported.

CONCLUSION

The investigated self-development coaching programme showed only a short-term improvement on depression and anxiety compared with an active control. There was no effect of the intervention on academic performance.

TRIAL REGISTRATION

ACTRN12614000896673.

Examining perceptions of academic stress and its sources among university students: The Perception of Academic Stress Scale

The development of a scale to measure perceived sources of academic stress among university students. Based on empirical evidence and recent literature review, we developed an 18-item scale to measure perceptions of academic stress and its sources. Experts (n = 12) participated in the content validation process of the instrument before it was administered to (n = 100) students. The developed instrument has internal consistency reliability of 0.7 (Cronbach’s alpha), there was evidence for content validity, and factor analysis resulted in four correlated and theoretically meaningful factors. We developed and tested a scale to measure academic stress and its sources. This scale takes 5 minutes to complete.

Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: a cross-sectional study

OBJECTIVES

Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance.

METHODS

In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students' academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data.

RESULTS

High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance.

CONCLUSION

High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.

'Even now it makes me angry': health care students' professionalism dilemma narratives

CONTEXT

Medical students encounter situations during workplace learning in which they witness or participate in something unprofessional (so-called professionalism dilemmas), sometimes having a negative emotional impact on them. Less is known about other health care students' experiences of professionalism dilemmas and the resulting emotional impact.

OBJECTIVES

To examine dental, nursing, pharmacy and physiotherapy students' narratives of professionalism dilemmas: the types of events they encounter ('whats') and the ways in which they narrate those events ('hows').

METHODS

A qualitative cross-sectional study. Sixty-nine health care students (29 dentistry, 13 nursing, 12 pharmacy, 15 physiotherapy) participated in group/individual narrative interviews. Data were analysed using framework analysis (examining the 'whats'), linguistic inquiry and word count software (examining the 'hows' by dilemma type and student group) and narrative analysis (bringing together 'whats' and 'hows').

RESULTS

In total, 226 personal incident narratives (104 dental, 34 nursing, 39 pharmacy and 49 physiotherapy) were coded. Framework analysis identified nine themes, including 'Theme 2: professionalism dilemmas', comprising five sub-themes: 'student abuse', 'patient safety and dignity breaches by health care professionals', 'patient safety and dignity breaches by students', 'whistleblowing and challenging' and 'consent'. Using Linguistic Inquiry and Word Count (liwc) software, significant differences in negative emotion talk were found across student groups and dilemma types (e.g. more anger talk when narrating patient safety and dignity breaches by health care professionals than similar breaches by students). The narrative analysis illustrates how events are constructed and the emotional implications of assigning blame (an ethical dimension) resulting in emotional residue.

CONCLUSION

Professionalism dilemmas experienced by health care students, including issues concerning whistleblowing and challenging, have implications for interprofessional learning. By focusing on common professionalism issues at a conceptual level, health care students can share experiences through narratives. The role-playing of idealised actions (how students wish they had acted) can facilitate synergy between personal moral values and moral action enabling students to commit and re-commit to professionalism values together.

Analysis of the 'Educational Climate' in Spanish Public Schools of Dentistry using the Dundee Ready Education Environment Measure: a multicenter study

AIM

To analyse the 'Educational Climate' (EC) of dental students in Spain.

METHODS

The study group consisted of 1391 students from nine Spanish Public Schools of Dentistry, who responded to the questionnaire based on 'Dundee Ready Education Environment Measure' (DREEM). This questionnaire has 50 items that are grouped into five domains: Learning, Teachers, Academic, Atmosphere and Social.

RESULTS

The global score on the EC was 123.1 (interpretation: 'EC more positive than negative'). The scores obtained in the different domains were: 28.0 in Learning (interpretation: 'a generally positive perception of learning'), 26.8 in Teachers (interpretation: 'teachers are going in the right direction'), 20.8 in Academic (interpretation: 'feeling more on the positive side'), 29.7 in Atmosphere (interpretation: 'a generally positive atmosphere') and 17.7 in Social (interpretation: 'social perception acceptable'). In seven items (14%), an average of <2 was detected, showing that there are some educational problem areas. Regarding the EC in the different Schools of Dentistry, an average of >100 was achieved in all of them, although there were two centres that showed significantly higher values of EC.

CONCLUSIONS

Spanish dental students felt that their EC was more positive than negative and considered that the different domains were positive and acceptable. However, they pointed out the existence of several educational problem areas associated with the development of a traditional curriculum. Accordingly, and in parallel with the implementation of an innovative curriculum in all Spanish Dental Schools in the coming years, immediate educational goals must address the problem areas identified, thereby further promoting a more positive perception of EC.

Maintenance of empathy levels among first and final year medical students: a cross sectional study

OBJECTIVES

The purpose of this study was to quantify the levels of empathy amongst medical students in the first year and final year of the medical curriculum at a medical university in Karachi, Pakistan.

METHODS

A cross-sectional study, comprising of participating students in their first year and final year of the medical curriculum at Ziauddin University Medical College, was carried out, using the Empathy Quotient (EQ) scale consisting of 60 questions through a self-administered questionnaire. The results were collected anonymously over a time period of six months from a sample of 171 participants. Results : According to our analysis, we found 82.67% of fifth year students and 80.21% of first years showing average or above average levels of empathy. Female mean scores were 42±9.60 while males were 38.7±9.358 (P=0.03). No association was found between empathy and age of the participants (p=0.77).

CONCLUSION

We found no significant difference in the levels of empathy between the first and fifth year medical students. However, it was shown that females exhibited higher levels of empathy than males.

Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools

BACKGROUND

Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates.

METHODS

The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics.

RESULTS

A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress.

CONCLUSIONS

Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.

Perceived sources of stress amongst Chilean and Argentinean dental students

INTRODUCTION

The prevalence of high levels of stress as well as its multilevel consequences is well documented amongst students in the health sciences, and particularly in dentistry. However, investigations of perceived stress amongst Spanish-speaking student groups are sparse. This study aimed to (i) describe the translation, adaptation and psychometric properties of a Spanish version of the Dental Environment Stressors questionnaire and (ii) to examine the perceived sources of stress and their associations with the students' study year and gender in two dental schools in Latin America.

MATERIALS AND METHODS

All students officially registered in the dental schools of the University of San Sebastian (USS) in Chile and the Catholic University of Cordoba (CUC) in Argentina were invited to participate in the study. The DES30 questionnaire was adapted in Spanish using translation/back-translation, an expert bilingual committee, and consensus building. Cronbach's alpha was used to measure the instrument's internal consistency, and iterated principal factor analysis with promax rotation was employed to explore its underlying factor structure. Descriptive, bivariate and multivariate methods were used to examine the patterns of association between individual stressors, factor scores and students' characteristics.

RESULTS

Three hundred and four students comprised the study's analytical sample, with two-thirds of those being female. The DES30-Sp demonstrated good internal consistency (Cronbach's α = 0.89). A four-factor solution emerged and included 'academic workload', 'clinical training', 'time constraints' and 'self-efficacy beliefs' factors. 'Fear of failing a course or a year', 'examinations and grades' and 'lack of time for relaxation' were amongst the top individual-item stressors reported by students in both schools. Amongst this group of undergraduate dental students, those in Argentina, in higher study year, and females reported higher perceived stress.

CONCLUSIONS

Increased workload, time constraints and some aspects of clinical training were the top stressors of approximately 300 Chilean and Argentinean dental undergraduates. Some variations between schools, males and females and study years were noted. The Spanish version of the DES30 questionnaire performed well, but future studies should evaluate the instrument's properties in larger and more diverse dental student populations.

The Perception of Stress among Clinical Dental Students

Objective

To determine the prevalence of stress among clinical students from Faculty of Dentistry, King Abdul Aziz University, Jeddah.

Materials and methods

A cross-sectional descriptive study was carried out in May 2012 on fourth, fifth and sixth year clinical dental students from Faculty of Dentistry, King Abdul Aziz University, Jeddah, using a modified form of dental environment stress (DES) questionnaire. A total of 353 questionnaires were distributed and incomplete questionnaires were excluded from the study. SPSS version 15 was used to do statistical analysis.

Results

A total of 353 students were asked to complete the questionnaire and 232 (65.7%) responded; of these 120 (51.7%) were males and remaining 112 (48.3%) were females. More or less all the students were having stress. In male students severe stress was due to difficulty in getting suitable patient (51%) and the patient who were arriving late or not coming on appointment, p = 0.16, whereas in female they were having severe stress due to fear of failure (59%), p = 0.02, examination and grading (57%) and completing examination requirement (52%). In male, amount of academic overload was also main cause of severe stress (p = 0.03). Sixth-year students were having more stress due to amount of overload (59.1%), lack of time to do assigned work (53.4%), difficulty to get suitable patient (71.6%) and patient arriving late or not coming on appointment (64.8%). Fifth-year students were more stressed due to completing examination requirement (65.7%). Fourth-year students were having more stress due to fear of failure (58.4%) and examination and grading (58.4%).

Conclusion

The finding of this study show some considerable degree or severe stress among the students. Longitudinal studies that include preclinical dental students should be carried out to know how the pattern of stress varies during preclinical and clinical training period.

How to cite this article

Al-Samadani KH, Al-Dharrab A. The Perception of Stress among Clinical Dental Students. World J Dent 2013;4(1):24-28.

Students' perceptions of the educational environment in a Greek Dental School, as measured by DREEM

AIM

The aim of this study was to estimate the dental students' perceptions of their educational environment and to identify any differences related both to their gender and semester of studies.

MATERIALS AND METHODS

The translated and validated in Greek Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed to all 2nd- to 5th-year students of the Athens Dental School. The questionnaire consisted of 50 statements organised in five subscales (perceptions of learning, teachers, atmosphere, academic self-perceptions and social self-perceptions). Internal validity was checked with Cronbach alpha. Confirmatory factor analysis (CFA) was performed under the same conditions as the original inventory. Mean statement, subscale and overall scores were calculated and given as percentages.

RESULTS

The response rate was 64%. Overall Cronbach alpha was 0.93 (excellent). CFA produced five meaningful subscales, not matching the original ones. The overall DREEM mean score was 56%. Gender did not influence the findings. The students' perceptions of the educational environment with the exception of the academic self-perceptions were more positive in the pre-clinical years. Statistically significant differences were revealed only for the 'learning' subscale between the 3rd- and the 4th-year students. Seventy-eight percent of the statements were in the positive side. The lowest scores were related to students' stress, tiredness and lack of appropriate feedback from the teachers, and the highest were related to accommodation, school friends and perceptions that they feel socially comfortable in class.

CONCLUSIONS

Students' perceptions of the educational environment were reasonably positive, with no gender difference. However, some weaknesses were identified, particularly in the clinical years. Further research is needed to clarify appropriate interventions.