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      Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study

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          Abstract

          Background

          Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the “Perceived Medical School Stress Instrument” (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance.

          Methods

          We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students ( n = 456).

          Results

          PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students’ M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance.

          Conclusions

          PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students’ M1 grade. More research is needed to identify potential confounders.

          Electronic supplementary material

          The online version of this article (doi: 10.1186/s12909-017-1091-0) contains supplementary material, which is available to authorized users.

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          Most cited references24

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          Statistical Power Analysis for the Behavioral Sciences

          <i>Statistical Power Analysis</i> is a nontechnical guide to power analysis in research planning that provides users of applied statistics with the tools they need for more effective analysis. The Second Edition includes: <br> * a chapter covering power analysis in set correlation and multivariate methods;<br> * a chapter considering effect size, psychometric reliability, and the efficacy of "qualifying" dependent variables and;<br> * expanded power and sample size tables for multiple regression/correlation.<br>
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            How effective are selection methods in medical education? A systematic review.

            Selection methods used by medical schools should reliably identify whether candidates are likely to be successful in medical training and ultimately become competent clinicians. However, there is little consensus regarding methods that reliably evaluate non-academic attributes, and longitudinal studies examining predictors of success after qualification are insufficient. This systematic review synthesises the extant research evidence on the relative strengths of various selection methods. We offer a research agenda and identify key considerations to inform policy and practice in the next 50 years.
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              A conceptual model of medical student well-being: promoting resilience and preventing burnout.

              This article proposes and illustrates a conceptual model of medical student well-being. The authors reviewed the literature on medical student stress, coping, and well-being and developed a model of medical student coping termed the "coping reservoir." The reservoir can be replenished or drained by various aspects of medical students' experiences. The reservoir itself has an internal structure, conceptualized as consisting of the individual's personal traits, temperament, and coping style. The coping reservoir metaphor is used to highlight the dynamic nature of students' experiences, with potential outcomes including enhanced resilience and mental health versus distress and burnout. Medical student well-being is affected by multiple stressors as well as positive aspects of medical training. Attention to individual students' coping reservoirs can help promote well-being and minimize burnout; formal and informal offerings within medical schools can help fill the reservoir. Helping students cultivate the skills to sustain their well-being throughout their careers has important payoffs for the overall medical education enterprise, for promotion of physician resilience and personal fulfillment, and for enhancement of professionalism and patient care. This and other models of coping should be empirically validated.
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                Author and article information

                Contributors
                thomas.koetter@uni-luebeck.de
                josefin.wagner@uni-luebeck.de
                linda.brueheim@uni-luebeck.de
                edgar.voltmer@thh-friedensau.de
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                16 December 2017
                16 December 2017
                2017
                : 17
                : 256
                Affiliations
                [1 ]ISNI 0000 0001 0057 2672, GRID grid.4562.5, Institute of Social Medicine and Epidemiology, , University of Lübeck, ; Ratzeburger Allee 160, 23562 Lübeck, Germany
                [2 ]ISNI 0000 0001 0057 2672, GRID grid.4562.5, Division of Teaching and Learning, Lübeck Medical School, , University of Lübeck, ; Ratzeburger Allee 160, 23562 Lübeck, Germany
                [3 ]ISNI 0000 0001 0057 2672, GRID grid.4562.5, Department of Quality Management and Organizational Development, , University of Lübeck, ; Ratzeburger Allee 160, 23562 Lübeck, Germany
                [4 ]GRID grid.448820.2, Chair of Health Sciences, Friedensau Adventist University, ; An der Ihle 19, 39291 Möckern-Friedensau, Germany
                Author information
                http://orcid.org/0000-0001-8534-2103
                Article
                1091
                10.1186/s12909-017-1091-0
                5732510
                29246231
                0ee23fbf-635a-4318-9c3f-f9f1a82e3856
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 August 2016
                : 4 December 2017
                Funding
                Funded by: University of Lübeck
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Education
                education,medical,undergraduate; students,medical; stress,psychological,questionnaires and surveys,assessment,educational

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