Stress among medical students during clinical courses: a longitudinal study using contextual activity sampling system

Nursing students experienced academic emotions during education - a longitudinal descriptive study from a nursing bachelor's program in Sweden

AIM

To explore nursing students' academic emotions during ongoing learning activities focusing on perceived challenge and competence.

BACKGROUND

Emotions plays an important part in learning. Positive emotions can be beneficial while negative emotions can be detrimental to educational outcomes. Optimal experiences are situations when learners simultaneously experience sufficient challenge and competence. Since various learning activities are performed in different learning environments during the nursing program, it is of interest to investigate students' ongoing emotions in the occurring contexts.

DESIGN

A longitudinal descriptive study.

METHODS

By using the Contextual Activity Sampling System, data was collected every third week on a three-year nursing program. From August 2015 to January 2020, a total of 2, 947 questionnaires were answered by 158 students. Experiences of positive and negative academic emotions were calculated for the entire program. Optimal experience was calculated for courses where high discrepancy between positive and negative experiences were identified.

RESULTS

Students self-reported academic emotions varied over time and in relation to learning activities. High ratings of negative emotions were reported during clinical practice in all semesters except the final. Students' positive academic emotions and optimal experience in clinical practice increased after having deepened their academic knowledge.

CONCLUSION

Nursing students had an increased positive experience when they themselves practice a learning activity and it appeared that they benefit from academic preparation prior to entering internship. Nursing students need an academic competence to develop their skills during training in the clinical reality. Increased collaboration between academia and clinic would be beneficial for students' clinical development.

Study protocol for the ETMED-L project: longitudinal study of mental health and interpersonal competence of medical students in a Swiss university using a comprehensive framework of empathy

INTRODUCTION

Physician interpersonal competence is crucial for patient care. How interpersonal competence develops during undergraduate medical education is thus a key issue. Literature on the topic consists predominantly of studies on empathy showing a trend of decline over the course of medical school. However, most existing studies have focused on narrow measures of empathy. The first aim of this project is to study medical students' interpersonal competence with a comprehensive framework of empathy that includes self-reported cognitive and affective empathy, performance-based assessments of emotion recognition accuracy, and a behavioural dimension of empathy. The second aim of the present project is to investigate the evolution of mental health during medical school and its putative link to the studied components of interpersonal competence. Indeed, studies documented a high prevalence of mental health issues among medical students that could potentially impact their interpersonal competence. Finally, this project will enable to test the impact of mental health and interpersonal competence on clinical skills as evaluated by experts and simulated patients.

METHODS AND ANALYSIS

This project consists of an observational longitudinal study with an open cohort design. Each year during the four consecutive years of the project, every medical student (curriculum years 1-6) of the University of Lausanne in Switzerland will be asked to complete an online questionnaire including several interpersonal competence and mental health measures. Clinical skills assessments from examinations and training courses with simulated patients will also be included. Linear mixed models will be used to explore the longitudinal evolutions of the studied components of interpersonal competence and mental health as well as their reciprocal relationship and their link to clinical skills.

ETHICS AND DISSEMINATION

The project has received ethical approval from the competent authorities. Findings will be disseminated through internal, regional, national and international conferences, news and peer-reviewed journals.

Personality and learning styles in relation to attitudes towards interprofessional education: a cross-sectional study on undergraduate medical students during their clinical courses

BACKGROUND

Interprofessional Education (IPE) is now included in curricula in universities worldwide. It is known that there are differences in attitudes towards IPE among students, but less is known regarding how students' personalities and learnings styles correspond with those attitudes. The aim of this study was to investigate whether personality traits and learning styles have any impact on medical students' attitudes towards IPE.

METHODS

Seventy nine medical students in their 9th term (63% females, mean age 29 years) were questioned regarding their attitudes towards IPE according to the Interdisciplinary Education Perception Scale questionnaire, the Kolb's learning style and Big Five Inventory questionnaires. For all three instruments we used the Swedish translated versions.

RESULTS

When investigated with a logistic regression, adjusting for age and gender, there were no significant associations between Big Five inventory, Kolb's learning style and IEPS, except for the Reflective-Pragmatic learning style that was moderately associated with a higher IEPS score.

CONCLUSION

There was no clear correlation between personality, learning style and attitude towards IPE as measured by the IEPS among medical students in our study population. Further investigations would benefit from a combination of qualitative and quantitative design.

Stress among Portuguese Medical Students: A National Cross-Sectional Study

Introduction

The medical course is extremely stimulating but also demanding, and it can interfere with students' mental health. Stress leads to lower life quality, academic performance, and ultimately to a lower quality of patient care delivered.

Objective

To analyse stress levels of sixth-year medical students who attend Portuguese colleges. Methodology. This observational cross-sectional study involved Portuguese medical students attending the sixth year of all Portuguese faculties. We applied an online self-response questionnaire, including the 10 items Perceived Stress Scale (PSS) to assess stress levels and sociodemographic variables. Logistic regression was used to estimate the weight of the studied determinants on stress levels.

Results

A total of 501 participants were included for analysis (69.5% females), with a median age of 24 years old. We found significant levels of stress in 49.9% (95% CI: 45.5–54.3%), with 20.8% of total students presenting extremely high levels, irrespective of age, gender, and faculty. Stress was higher when students presented bad sleeping and eating habits, lack of ability to manage time, dissatisfaction with social life and academic experience, and low family support. Also, these students are more worried about their future and present a higher degree of concern about their graduation test performance.

Conclusion

This study found high stress levels among Portuguese medical students, associated with social determinants and the intrinsic complexity of the course. This is worrying, and it elucidates the importance of coping strategies to make students deal with stress and be healthier, currently and in the future.

Investigating Stress and Sources of Stress Among Female Health Profession Students in a Saudi University

Background

Health profession students experience tremendous levels of stress throughout their education. A high level of stress may have a negative effect on the cognitive functioning and learning of students.

Objective

The study sought to determine the levels and main sources of stress and its possible correlation with academic performance in the preclinical female health profession.

Methods

The cross-sectional design involved the use of self-administered questionnaires. Data were collected from 260 students in health profession programmes in Saudi Arabia. The Medical Student Stressor Questionnaire (MSSQ) was used to collect the data from all second-, third-, and fourth-year undergraduate students.

Results

A high level of stress was observed in 42.7% of the students, and a moderate stress level was observed in 41.5% of the students. The major source of stress experienced by students was related to the academic domain (mean= 2.7±0.73), followed by the group activity domain (mean= 2.1±0.91; p< 0.05). Second-year and third-year students were significantly less likely to show high stress levels compared with fourth-year students (AOR= 0.3; 95% CI: 0.1–0.8; p≤ 0.030 and AOR= 0.4; 95% CI: 0.1–0.5; p≤ 0.001, respectively). High stress levels were not found to be associated with students’ age and academic performance.

Conclusion

Half of the students experienced high and severe levels of stress. Academic and group activity domains were perceived as the major stressors. The year of study was the only significant factor associated with stress levels. Stress among female health profession students should be acknowledged, and efforts should be made to alleviate it. Students should be guided to reduce their stress levels, as this can enhance their quality of life and study experience.