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      Sources of Stress and Coping Strategies among Undergraduate Medical Students Enrolled in a Problem-Based Learning Curriculum

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          Abstract

          Background. Medical education is rated as one of the most difficult trainings to endure. Throughout their undergraduate years, medical students face numerous stressors. Coping with these stressors requires access to a variety of resources, varying from personal strengths to social support. We aimed to explore the perceived stress, stressors, and coping strategies employed by medical students studying in a problem-based learning curriculum. Methodology. This is a cross-sectional study of randomly selected medical students that explored demographics, perceived stress scale, sources of stress, and coping strategies. Results. Of the 378 medical students that participated in the study, males were 59.3% and females 40.7%. Nearly 53% of the students often felt stressed, and a third felt that they could not cope with stress. Over 82% found studying stressful and 64.3% were not sleeping well. Half of the students reported low self-esteem. Perceived stress scores were statistically significantly high for specific stressors of studying in general, worrying about future, interpersonal conflict, and having low self-esteem. Coping strategies that were statistically significantly applied more often were blaming oneself and being self-critical, seeking advice and help from others, and finding comfort in religion. Female students were more stressed than males but they employ more coping strategies as well. Conclusions. Stress is very common among medical students. Most of the stressors are from coursework and interpersonal relationships. Low self-esteem coupled with self-blame and self-criticism is quite common.

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          Most cited references23

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          Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

          To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
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            Embarking upon a medical career: psychological morbidity in first year medical students.

            This study was undertaken to measure the prevalence of psychological morbidity, and the nature and source of stress, in first year medical students. Two hundred and four first year medical students at a university in the north of England were sent a postal, self-report questionnaire. They were asked to complete the General Health Questionnaire (GHQ), the Stress Incident Record and to give details of their alcohol consumption. A total of 172 students (84.3%) replied. Thirty-six per cent of the students scored above the threshold of the GHQ, indicating probable psychological disturbance. There was no difference between men and women. Approximately half of the students described a stressful incident, the majority of which were related to medical training rather than to personal problems. Male students reported drinking significantly more alcohol than female students, but there was no relationship between levels of alcohol consumption and either psychological disturbance or reporting of stress. The findings suggest that even at the preliminary stages of medical training, many students find aspects of the medical course very stressful. The psychological well-being of medical students needs to be more carefully addressed, and closer attention paid to the styles of medical teaching that may provoke avoidable distress.
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              Medical students' distress--quality, continuity and gender differences during a six-year medical programme.

              Research observations suggest an increase in distress during the course of medical education, but it is not known whether this distress is chronic and persistent or episodic because follow-ups covering the whole training programme are lacking. We explored stress symptoms among undergraduate medical students (n = 110) at five points during the six-year medical training programme. The quality and continuity of symptoms and gender differences in stress reports were analysed. Questionnaire and interviews were used to assess stress symptoms, perceived health and severity of distress. Stress symptoms, such as fatigue, sleeping problems, anxiety, irritability and depression, were common. No significant gender differences were seen, but there was a consistent increase of stress reports throughout the medical programme in both sexes. Those who were most distressed at the beginning of training also reported more stress later. To conclude, we need interventions that help students to cope with stress, to make a smooth transition from school to medical school, and also to adjust to different learning environments during the different phases of medical education.
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                Author and article information

                Journal
                Journal of Biomedical Education
                Journal of Biomedical Education
                Hindawi Limited
                2314-5021
                2314-503X
                2015
                2015
                : 2015
                :
                : 1-8
                Article
                10.1155/2015/575139
                21067392-47ce-412b-91f5-14ac02bbbe23
                © 2015

                http://creativecommons.org/licenses/by/3.0/

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