The objective of this study was to investigate any differences between female undergraduate medical and non-medical students for: 1) prevalence and causes of perceived academic stress, and 2) changes in physical, mental, psychological and emotional health as well as life-style since starting college studies.
A cross-sectional study was conducted at Dammam University, Dammam, Saudi Arabia, in January 2008. All 319 pre-clinical female medical students were included in the study and 297 non-medical students from the College of Applied Studies and Community Services (CASCS) were selected by stratified random sampling. The study instrument was a questionnaire on the “Influence of Studying on Students’ Health”.
More medical students (48.6%) reported being frequently stressed due to studies than CASCS students (38.7%, P <0.01). Unsuitable teaching methods, an unsatisfactory study environment, and fear of failure in examinations were more frequently mentioned by medical than non-medical students (P <0.05). While underlying social problems were significantly more common in medical students, economic problems were more prevalent among CASCS students (P <0.05, P <0.05). More medical than non-medical students reported a worse status of physical and mental health, anxiety and depression and negative life-style changes since initiation of the college programme.
Medical students were at higher risk of physical and mental health problems than non-medical students due to academic stress. Since a substantial proportion of CASCS students also experienced academic stress, we recommend that a student support committee be established for both colleges to provide counselling and guidance in healthy ways to cope with stress.
Stress; Psychology; Education; Epidemiology
This study was undertaken to determine the prevalence of psychological stress among Isfahan medical sciences students.
Cross-sectional, questionnaire-based survey was carried out among the 387 medical sciences students (medicine, pharmacy, and dentistry) of Isfahan, Iran through census. In academic year 2010-2011, Kessler-10 questionnaire was given to the students a month before semester examinations. Scores ≥20 were considered as indicative of positive stress symptoms.
The overall prevalence of stress among medical sciences students was found to be about 76.1%. The prevalence of stress among medicine students was 22.7% mild, 23% moderate and 21.4% severe while 32.8% showed no stress. The prevalence of stress among pharmacy students was 22.22%, 22.22%, 26.19%, and 29.36% mild, moderate, and severe and no stress, respectively. The prevalence of stress among dentistry students was 25% mild, 27% moderate, and 10% severe while 37.5% showed no stress. The prevalence of stress was higher (70.6%) in pharmacy students when compared with medicine (66.1%) and dentistry (62.5%) students. The odds of student having stress is higher in dentistry students (OR: 1.44, P= 0.33), where as the odds are decreasing in pharmacy student (OR: 1.16, P=0.66). There is no statistically significant association between gender, ages, and term and having stress symptoms.
The high level of stress necessitates interventions like social and psychological support to improve the student's well-being. A prospective study is needed to study the association of psychological morbidity with sources of stress and coping strategies.
Isfahan; Kessler; medical sciences students; stress; student support
To study the reported practices of knowledge about and attitude towards smoking among nursing and medical laboratory technology (MLT) students, College of Medicine, King Faisal University at Dammam and Al-Khobar.
College of Medicine, Dammam and King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
A cross-sectional approach involving a sample of 266 students and interns (152 nursing and 114 MLT), which included all enrolled students in the academic year (1998/1999). A self-administered questionnaire was used to collect data covering knowledge, practice and attitude to smoking. SPSS was used for statistical analysis.
The overall smoking prevalence was low (5.6%), slightly higher among nursing (6.6%) versus MLT (4.4%) students. Knowledge of and attitude towards smoking was generally satisfactory in both groups, although deficient in some key areas, such as the addictive nature of smoking, some of its consequences on health, and difficulty of quitting.
Conclusion and Recommendations:
The prevalence of smoking among nursing and MLT students is generally low but their knowledge and attitude need improvement. Health education on facts, dangers and consequences of smoking should start as early as the primary school, and should continue throughout the education of future health professionals (role models for the community).
Smoking; tobacco consumption; university students; nursing; laboratory technology; knowledge/attitudes/practice (KAP); Saudi Arabia
In recent years there has been a growing appreciation of the issues of quality of life and stresses involved medical training as this may affect their learning and academic performance. However, such studies are lacking in medical schools of Nepal. Therefore, we carried out this study to assess the prevalence of psychological morbidity, sources and severity of stress and coping strategies among medical students in our integrated problem-stimulated undergraduate medical curriculum.
A cross-sectional, questionnaire-based survey was carried out among the undergraduate medical students of Manipal College of Medical Sciences, Pokhara, Nepal during the time period August, 2005 to December, 2006. The psychological morbidity was assessed using General Health Questionnaire. A 24-item questionnaire was used to assess sources of stress and their severity. Coping strategies adopted was assessed using brief COPE inventory.
The overall response rate was 75.8% (407 out of 525 students). The overall prevalence of psychological morbidity was 20.9% and was higher among students of basic sciences, Indian nationality and whose parents were medical doctors. By logistic regression analysis, GHQ-caseness was associated with occurrence of academic and health-related stressors. The most common sources of stress were related to academic and psychosocial concerns. The most important and severe sources of stress were staying in hostel, high parental expectations, vastness of syllabus, tests/exams, lack of time and facilities for entertainment. The students generally used active coping strategies and alcohol/drug was a least used coping strategy. The coping strategies commonly used by students in our institution were positive reframing, planning, acceptance, active coping, self-distraction and emotional support. The coping strategies showed variation by GHQ-caseness, year of study, gender and parents' occupation.
The higher level of psychological morbidity warrants need for interventions like social and psychological support to improve the quality of life for these medical students. Student advisors and counselors may train students about stress management. There is also need to bring about academic changes in quality of teaching and evaluation system. A prospective study is necessary to study the association of psychological morbidity with demographic variables, sources of stress and coping strategies.
BACKGROUND AND OBJECTIVES:
The inclusion of detailed basic science courses in medical school curricula has been a concern of students. The main objective of this study was to explore the attitudes of medical students towards basic sciences courses taught to them in the preclinical years and the applicability of these courses to current clinical practice.
DESIGN AND SETTING:
A cross-sectional survey was conducted during 2008-2009 among medical students in their clinical years at King Saud University, Riyadh, Saudi Arabia.
Thirty percent of all students (n=314) were randomly selected to receive a questionnaire designed to evaluate their opinions about course load, ability to recall information, value of practical sessions, availability of references and course guidelines, and the applicability of individual courses to clinical practice.
Students identified anatomy and pathology as the courses most overloaded with content (76% and 70%, respectively). Half of the students felt they retained the most knowledge of physiology (50%), while less than a quarter of students (19%) felt they retained the most information from biochemistry coursework. The role of practical sessions in facilitating theoretical understanding was more evident in anatomy (69%). Physiology was perceived as the subject with the highest applicability to clinical practice (66%), while pathology (29%) was identified as the subject with the least practical application. Students became increasingly negative in their opinions about basic science courses as they progressed through their medical education.
Current attitudes of medical students towards their basic science courses indicate a need to reform the curricula so as to maximize the benefit of these courses.
Student admission into the College of Medicine at King Saud University (KSU) is dependent on the achievement of a grade point average (GPA) of ≥3.5 /5 by the end of the premedical year. This study was undertaken to ascertain whether pre-selected medical students who achieve a relatively low GPA (≤3.75/5) in the premedical year are at risk of having academic difficulties in subsequent years.
A cross-sectional study of all students admitted to the College of Medicine at KSU during 5 academic years (1994 to 1998) was conducted in 2004. The likelihood of completing the program by 2004 and the dropout frequency were compared in the two groups based on their GPA in the premedical year: High GPA (>3.75) and Low GPA (≤3.75).
During the study period, 739 students were admitted to the college. Of these, 619 (84%) were in High GPA group, and 120 (16%) in the Low GPA group. Of the students with High GPA, 545 (88%) out of 619 graduated compared with 79 (66%) of 120 in the Low GPA group (OR 3.822 [95% CI: 2.44, 5.99]: P<0.0001). Overall, 28 students (3.8%) dropped out, but there was a significantly greater frequency of dropping out in the Low GPA group (10/120; 8.3%) compared with the High GPA group (18/619; 2.9%: OR 3.035 [95% CI: 1.37, 6.75], P=0.01).
Our results support the prerequisite of a minimum GPA in the premedical year before proceeding to the higher levels. The GPA of premedical year is a useful predictor of students who need close monitoring and academic support. The use of GPA in the premedical year for admission into medical colleges should help optimize the use of resources and reduce student wastage.
Medical student selection; GPA; Pre-medical year; drop-out; academic performance
Over the last years, details regarding levels of stress and sources of stress have emerged in studies of nursing students in Western population To date, there only few similar reports on clinical stress, anxiety, depression among the Arab population .This study was conducted to examine the level of perceived stress among baccalaureate Mansoura nursing students and to highlight the possible predicting factors.
In this cross- sectional study, Data were obtained from 373 students using a self-administered questionnaire, including questions on sociodemographics, list of possible stressors, perceived stress, physical wellbeing factors, anxiety and depressive symptoms.
Prevalence of high stress level, anxiety and depression were 40.2%, 46.6% and 27.9%, respectively. On average each student reported a mean of 4.6 stressors and academic pressures were the most frequent stressors .In regression analysis the number of stressors and global sickness index score were predictors of high stress level.
These findings call for introduction of stress management programs and psychiatric care into nursing health services of the University.
Nursing students; stress; Depression; Anxiety; Arab culture; Egypt
College students are prone to stress due to the transitional nature of college life. High levels of stress are believed to affect students' health and academic functions. If the stress is not dealt with effectively, feelings of loneliness, nervousness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of stress.
This descriptive cross-sectional study was performed to determine sources of stress and coping strategies in nursing students studying at the Iran Faculty of Nursing & Midwifery. All undergraduate nursing students enrolled in years 1-4 during academic year 2004-2005 were included in this study, with a total of 366 questionnaires fully completed by the students. The Student Stress Survey and the Adolescent Coping Orientation for Problem Experiences Inventory (ACOPE) were used for data collection.
Most students reported "finding new friends" (76.2%), "working with people they did not know" (63.4%) as interpersonal sources of stress, "new responsibilities" (72.1%), "started college" (65.8%) as intrapersonal sources of stress more than others. The most frequent academic source of stress was "increased class workload" (66.9%) and the most frequent environmental sources of stress were being "placed in unfamiliar situations" (64.2%) and "waiting in long lines" (60.4%). Interpersonal and environmental sources of stress were reported more frequently than intrapersonal and academic sources. Mean interpersonal (P=0.04) and environmental (P=0.04) sources of stress were significantly greater in first year than in fourth year students. Among coping strategies in 12 areas, the family problem solving strategies, "trying to reason with parents and compromise" (73%) and "going along with family rules" (68%) were used "often or always" by most students. To cope with engaging in demanding activity, students often or always used "trying to figure out how to deal with problems" (66.4%) and "trying to improve themselves" (64.5%). The self-reliance strategy, "trying to make their own decisions" (62%); the social support strategies, "apologizing to people" (59.6%), "trying to help other people solve their problems" (56.3%), and "trying to keep up friendships or make new friends" (54.4%); the spiritual strategy, "praying" (65.8%); the seeking diversions strategy, "listening to music" (57.7%), the relaxing strategy "day dreaming" (52.5%), and the effort to "be close with someone cares about you" (50.5%) were each used "often or always" by a majority of students. Most students reported that the avoiding strategies "smoking" (93.7%) and "drinking beer or wine" (92.9%), the ventilating strategies "saying mean things to people" and "swearing" (85.8%), the professional support strategies "getting professional counseling" (74.6%) and "talking to a teacher or counselor" (67.2%) and the humorous strategy "joking and keeping a sense of humor" (51.9%) were used "seldom or never".
First year nursing students are exposed to a variety of stressors. Establishing a student support system during the first year and improving it throughout nursing school is necessary to equip nursing students with effective coping skills. Efforts should include counseling helpers and their teachers, strategies that can be called upon in these students' future nursing careers.
To investigate psychological well-being and substance abuse among medical students in Pakistan.
A cross-sectional questionnaire-based survey was conducted in six medical colleges across Pakistan. Final-year medical students were interviewed by either a postgraduate trainee in psychiatry or a consultant psychiatrist.
A total of 540 medical students were approached; 342 participated and the response rate was 64.5%. Mean age was 23.73 years (SD 2.45 years); 52.5% were male and 90% single. Two out of every five respondents reported that work/study at medical school affected their personal health and well-being. A considerable proportion of students were aware of alcohol and smoking as coping strategies for stress in medical students. The main factors causing stress were heavy workload (47.4%), relationship with colleagues (13.5%) and staff (11.9%). A total of 30% reported a history of depression and 15% among them had used an antidepressant. More than half were aware of depression in colleagues. The majority of respondents said that teaching provided on substance misuse in the areas of alcohol and illegal drugs, management/treatment of addiction, and models of addiction was poor. There was significant association (p = 0.044) between stress and awareness about alcohol as a coping strategy for stress among medical students. A significant negative association was also found between medical colleges in public sector (p = 0.052), female gender (p = 0.003) and well-being.
The majority of the medical students reported a negative impact of heavy workload on their psychological well-being. Significant numbers of medical students think that substance misuse is a coping strategy for stress. Teaching on addiction/addictive substances is poor at undergraduate level in Pakistani medical colleges.
Being in medical school has always been regarded as highly stressful. Excessive stress causes physical and mental health problems. Persistent stress can impair students’ academic achievement and personal or professional development. The aim of this study is to explore the nature of stress among medical students by determining the prevalence, sources and pattern of stress and the factors affecting it.
We chose a cross-sectional study design utilizing validated questionnaires, the 12 items General Health Questionnaire (GHQ-12) and Medical Student Stressor Questionnaire (MSSQ), to evaluate stress levels and stressors. School and ethical committee clearance were obtained prior to the study. Data were analysed using SPSS version 12.
Of the medical students who were administered the questionnaire, 761 (72%) respondents participated in this study. The prevalence of stress among the medical students was 29.6%. The top 10 stressors were academic-related. Prevalence of stress for the first, second, third, fourth and fifth year students was 26.3%, 36.5 %, 31.4%, 35.3% and 21.9%, respectively. Year of study was the only significant factor affecting stress among medical students (P-value < 0.05).
The prevalence of stress among medical students in USM is high. Academic-related problems were the major stressor among medical students. Year of study was the factor most significantly associated with medical students’ stress. There was a bimodal pattern of the stress level throughout the year of study.
medical students; mental health; stress; medical sciences
Stress may affect students’ health and their academic performance. Coping strategies are specific efforts that individuals employ to manage stress. This study aimed to assess the perception of stress among medical students and their coping strategies.
A cross-sectional study was conducted among 376 medical and medical sciences undergraduates in Management and Science University in Malaysia. Stress was assessed by a global rating of stress. Sources of stress were assessed using a 17-item questionnaire. The validated Brief COPE inventory was used to assess coping strategies.
The majority of respondents were females (64.4%), aged 21 years or older (63.0%), and were Malays (68.9%). Forty-six percent felt stress. The most common stressor was worries of the future (71.0%), followed by financial difficulties (68.6%). Significant predictors of stress were smoking (OR = 2.9, 95% CI 1.3–6.8, P = 0.009), worries of the future (OR = 2.1, 95% CI 1.3–3.4, P = 0.005), self-blame (OR = 1.3, 95% CI 1.1–1.5, P = 0.001), lack of emotional support (OR = 0.8, 95% CI 0.7–0.9, P = 0.017), and lack of acceptance (OR = 0.8, 95% CI 0.6–0.9, P = 0.010). Students used active coping, religious coping reframing, planning, and acceptance to cope with stress.
Stressors reported by the students were mainly financial and academic issues. Students adopted active coping strategies rather than avoidance. Students should receive consultation on how to manage and cope with stress.
coping skills; Malaysia; medical school; social support; stress; students
"Examinations drive students' learning." This statement refers to what is assumed to be one of the strongest relationships in education. We explored in this research how and why students differ in their approaches to learning, how assessment affects deep learning, and which barriers stand in the way of good assessment and learning in the clinical years of a Problem Based Learning (PBL) graduate entry medical curriculum.
Method: We conducted a qualitative, phenomenological study using semi-structured group interviews with students and semi-structured individual interviews with teachers and students. The transcripts were analyzed, and themes were identified.
Setting: The research was conducted at the King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia from November 2007 to March 2008.
Results: A total of 28 students participated in 7 focus group interviews. Semi-structured individual interviews were conducted with 12 teachers and 12 students. The analysis yielded four themes: summative assessment, formative assessment, continuous assessment of clinical attachments, and learning objectives.
The results of this study confirm that assessment affects students' perceptions of learning and how they learn. These effects are not uniformly positive. According to the students, the predominantly summative assessment program offers little inducement to engage in deep learning. They express a clear preference for formative assessment, which may foster a deeper approach to learning. Efforts to achieve more clinically relevant assessment with adequate balance between the various types of assessment are required. Research is needed to decide this balance.
Although nursing students experience a high level of stress during their training, there has been limited research on stress and its impact on the student's physical responses, such as gastrointestinal symptoms. The aims of this study are to assess the prevalence of GI symptoms in nursing students in Korea and to examine the association between the perceived stress and GI symptoms.
A cross-sectional descriptive study design was used. A total of 715 students of a three-year associate degree nursing program in a Korean college participated. The Perceived Stress Scale and a GI Symptoms Questionnaire were administered through a self-reported system. Chi-square tests, Fisher's exact test, and logistic regression analysis were performed using SPSS 17.0.
Sixty-five percent of the nursing students experienced more than one GI symptom, with 31.1% of students reporting more than three GI symptoms. Most of the nursing students complained of upper dysmotility and bowel symptoms. In addition, students who reported higher perceived stress were significantly more likely to complain of GI symptoms. Compared to nursing students with the lowest perceived stress level, the adjusted odds ratio (OR) for GI symptoms in students with the highest perceived stress level was 3.52 times higher (95% CI = 2.05-6.06).
GI symptoms that are highly prevalent among nursing students are significantly associated with the perceived stress level. High perceived stress should be considered a risk factor for GI symptoms. To reduce perceived stress, stress management programs including cognitive reappraisal training are needed in nursing curriculum.
The relationship between the sleep/wake habits and the academic performance of medical students is insufficiently addressed in the literature. This study aimed to assess the relationship between sleep habits and sleep duration with academic performance in medical students.
This study was conducted between December 2009 and January 2010 at the College of Medicine, King Saud University, and included a systematic random sample of healthy medical students in the first (L1), second (L2) and third (L3) academic levels. A self-administered questionnaire was distributed to assess demographics, sleep/wake schedule, sleep habits, and sleep duration. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). School performance was stratified as “excellent” (GPA ≥3.75/5) or “average” (GPA <3.75/5).
The final analysis included 410 students (males: 67%). One hundred fifteen students (28%) had “excellent” performance, and 295 students (72%) had “average” performance. The “average” group had a higher ESS score and a higher percentage of students who felt sleepy during class. In contrast, the “excellent” group had an earlier bedtime and increased TST during weekdays. Subjective feeling of obtaining sufficient sleep and non-smoking were the only independent predictors of “excellent” performance.
Decreased nocturnal sleep time, late bedtimes during weekdays and weekends and increased daytime sleepiness are negatively associated with academic performance in medical students.
Sleep; Sleep duration; Medical students; Academic performance; School
Medical students report high levels of stress related to their medical training as well as to other personal and financial factors. The aim of this study is to investigate whether there are differences in course-related stressors reported by medical students on undergraduate problem-based learning (PBL) and non-PBL programmes in the UK.
A cross-sectional study of second-year medical students in two UK medical schools (one PBL and one non-PBL programme) was conducted. A 16-question self-report questionnaire, derived from the Perceived Medical Student Stress Scale and the Higher Education Stress Inventory, was used to measure course-related stressors. Following univariate analysis of each stressor between groups, multivariate logistic regression was used to determine which stressors were the best predictors of each course type, while controlling for socio-demographic differences between the groups.
A total of 280 students responded. Compared to the non-PBL students (N = 197), the PBL students (N = 83) were significantly more likely to agree that: they did not know what the faculty expected of them (Odds Ratio (OR) = 0.38, p = 0.03); there were too many small group sessions facilitated only by students resulting in an unclear curriculum (OR = 0.04, p < 0.0001); and that there was a lack of opportunity to explore academic subjects of interest (OR = 0.40, p = 0.02). They were significantly more likely to disagree that: there was a lack of encouragement from teachers (OR = 3.11, p = 0.02); and that the medical course fostered a sense of anonymity and feelings of isolation amongst students (OR = 3.42, p = 0.008).
There are significant differences in the perceived course-related stressors affecting medical students on PBL and non-PBL programmes. Course designers and student support services should therefore tailor their work to minimise, or help students cope with, the specific stressors on each course type to ensure optimum learning and wellbeing among our future doctors.
Sleep is an important physiological process for humans. University students in most resource limited countries often report poor sleep quality due to changing social opportunities and increasing academic demands. However, sleep quality among university students has not been studied in Ethiopia. Thus, this study assessed sleep quality and its demographic and psychological correlates among university students.
A cross-sectional survey was conducted in two universities in Ethiopia. Multistage sampling procedures were used to enroll 2,817 students into the study. A self-administered structured questionnaire including the Pittsburgh Sleep Quality Index (PSQI), the Depression Anxiety Stress Scale-21, the Perceived Stress Scale (PSS) and selected modules of the World Health Organization STEPS instrument was used for the study. This research included 2,551 students. Frequency, median, mean with standard deviation and 95% confidence interval were used to characterize sleep quality and other variables. Analysis of variance and binary logistic regression procedures were also used.
The prevalence of poor sleep quality (total PSQI score > 5) was 55.8% (1,424). Female students (adjusted odds ratio (AOR) 1.23; 95% CI: 1.00, 1.57), second year (AOR 2.91; 95% CI: 2.1, 4.02) and third year students (AOR 2.25; 95% CI 1.62, 3.12) had statistically significant higher odds of poor sleep quality. Perceived stress level and symptoms of depression and anxiety were strongly associated with sleep quality.
A substantial proportion of university students are affected by poor sleep quality. If our results are confirmed in prospective studies, health promotion and educational programs for students should emphasize the importance of sleep and mental health.
Pittsburgh sleep quality index; Perceived stress; Anxiety; Depression; Students; Ethiopia
Recently there is a growing concern about stress during undergraduate medical training. However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases.
A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to March 2009. Perceived stress was assessed using the perceived stress scale. A 33-item questionnaire was used to assess sources of stress and their severity.
The overall response rate was 80.5% (161 out of 200 students). The overall mean perceived stress was 30.84 (SD = 7.01) and was significantly higher among female students. By logistic regression analysis, stressed cases were associated with occurrence of psychosocial (OR 5.01, 95% CI 2.44-10.29) and academic related stressors (OR 3.17 95% CI 1.52-6.68). The most common sources of stress were related to academic and psychosocial concerns. 'High parental expectations', 'frequency of examinations', 'vastness of academic curriculum', 'sleeping difficulties', 'worrying about the future', 'loneliness', 'becoming a doctor', 'performance in periodic examinations' were the most frequently and severely occurring sources of stress. There was a negative but insignificant correlation between perceived stress and academic performance (r = -0.099, p > 0.05).
A higher level of perceived stress was reported by the students. The main stressors were related to academic and psychosocial domains. Further studies are required to test the association between stressed cases and gender, academic stressors and psychosocial stressors.
Despite a high prevalence of depressive symptoms among university students, few studies have examined how this mental health problem is associated with perceived stress and perceived burdens related to being a student.
We conducted a cross-sectional study of 2,103 first year students from one western (Germany), one central (Poland), and one south-eastern European country (Bulgaria). The self-administered questionnaires included the modified Beck Depression Inventory and Cohen's Perceived Stress Scale. A 13 item scale measured perceived burdens related to being a student with four subscales: "Course work", "Relationships", "Isolation", and "Future".
Depressive symptoms were highly prevalent in all three countries (M-BDI ≥35: 34% in Poland, 39% in Bulgaria, and 23% in Germany). Students felt more burdened by course work and bad job prospects ("Future") than by relationship problems or by feelings of isolation. The perceived burdens subscales "Future", "Relationship" and "Isolation" remained associated with depressive symptoms after adjusting for perceived stress, which displayed a strong association with depressive symptoms. The association between perceived stress and depressive symptoms differed by gender. These findings were similar in all three countries.
Perceived burdens related to studying are positively associated with higher depression scores among students, not only by mediation through perceived stress but also directly. While the strong association between perceived stress and depressive symptoms suggests the need for interventions that improve stress management, perceived burdens should also be addressed.
Tobacco consumption is associated with considerable negative impact on health. Health professionals, including future doctors, should have a leading role in combating smoking in the community.
The aims of the study were to assess the prevalence of smoking among medical students of newly established medical colleges in Riyadh city, the capital of Saudi Arabia, as well as to assess students' attitude, practice and their knowledge on the risk factors of tobacco consumption.
A cross-sectional, questionnaire-based study of students from two medical colleges in Riyadh, Saudi Arabia was carried out. The questionnaire used was anonymous, self-administered and developed mainly from Global Adult Tobacco Survey (GATS).
A total of 215 students participated in this study. Forty students (19%) indicated that they smoke tobacco at the time of the study. All of them were males, which raise the prevalence among male students to 24%. Tobacco smoking was practiced by males more than females (P value <0.0001) and by senior more than junior students (<0.0001). About 94% of the study sample indicated that smoking could cause serious illnesses. About 90% of the students indicated that they would advice their patients to quit smoking in the future and 88% thought that smoking should be banned in public areas. Forty-four students (20%) thought that smoking has some beneficial effects, mainly as a coping strategy for stress alleviation.
Despite good knowledge about the hazards of tobacco consumption, about 25% of the medical students in this study continue to smoke. The main reported reasons should be addressed urgently by policy-makers. Special efforts should be taken to educate medical students on the effective strategies in managing stress during their study as they thought that tobacco smoking could be used as a coping strategy to face such a stress.
Medical students; Saudi Arabia; smoking
Medical education and training can directly contribute to the development of psychological distress in medical students. This can lead to catastrophic consequences such as impaired academic performance, impaired competency, medical errors and attrition from medical school. This study aimed to assess the prevalence of psychological morbidity among Iranian medical students.
This was a cross-sectional study. Samples of medical students in different levels of training (basic science, clinical clerkship, internship, and residency stage) were entered into the study. The 12-item General Health Questionnaire (GHQ-12) was used to measure psychological morbidity. Both univariate and multivariate analyses were used to report on findings.
In all, 220 medical students were invited to take part in the study. Of these, 192 students agreed to fill in the questionnaire. The mean age of respondents was 25.4 (SD = 5.2) and 53% were female. Overall 49.5% of the students scored above the threshold on the GHQ-12 (score > 3.5). The results obtained from logistic regression analysis indicated that female gender and level of training were the most significant contributing factors to increased psychological distress [OR for female gender = 2.99; OR for the basic science group = 6.73].
Psychological distress appears to be common in medical students and significantly varies by gender and level of training. The psychological well-being of medical students needs to be more carefully addressed, and closer attention to eliminating the risk factors is critical to prevent consequent adverse outcomes.
Mental health; Medical students; GHQ-12
The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia during the period from November 2007 to December 2008. We conducted semi-structured focus groups interviews with students and conducted individual interviews with teachers and students to explore students’ and clinical teachers’ perceptions and interpretations of factors influencing students’ study strategies. Data collection was continued until saturation was reached. We used Atlas-ti Computer Software (Version 5.2) to analyse the data, apply the obtained themes to the whole dataset and rearrange the data according to the themes and sub-themes. Analysis of data from interviews with twenty-eight students and thirteen clinical supervisors yielded three major themes relating to factors affecting students’ study strategies: “clinical supervisors and supervision”, “stress and anxiety” and “assessment”. The three themes we identified played a role in students’ adoption of different study strategies in the “community of clinical practice”. It appeared that teachers played a key role, particularly as assessors, clinical supervisors and as a source of stress to students.
Study strategy; Assessment; Clinical supervisor; Clinical attachment; Anxiety
The objective of the study is the identification of the specialty intentions, the reason behind that choice and the preferred practice location of the study population.
A cross sectional study was conducted using a self administered questionnaire distributed at the end of the academic year 1994. One hundred and forty nine (149) male and 104 female graduating medical students representing the four medical colleges in Saudi Arabia were included
The four major clinical specialties were selected by more than half of the students; Internal Medicine (17%), Surgery(16%), Paediatrics (14%) and Obstetrics (11%). Twenty seven percent were not sure of their future career choice. Primary health care was chosen by only 1.6% of the students. More men chose Surgery but more women chose Obstetrics and Ophthalmology.
“Financial incentives”, “no night duties”, “social reasons” and “less responsibilities” were the less frequently mentioned reasons for career choice. The qualifications in view were mostly Canadian Board for 49% of the students and Arab Board for 48% of them. The most frequently preferred locations for postgraduate training were Saudi Arabia (56%) and Canada (40%). The majority intended to practice in hospitals (90%) and in cities (85%).
The current drastic deficiency of trained Saudi Family Physicians will continue unless targeted strategies to produce more generalists are undertaken.
Specialty choice; Practice location; Medical students; Saudi Arabia
To assess prevalence of anxiety and depression among medical students in a medical college of Saudi Arabia.
A cross-sectional study was done on premedical, 1st, 2nd & 3rd year students of College of Medicine, Qassim University. The instrument used to assess the anxiety and depression was Self administered questionnaire, The Aga Khan University Anxiety and Depression Scale (AKUADS). AKUADS is a screening tool, and at a cut off point of 19, it has a Specificity of 81%, Sensitivity of 74%, a Positive Predictive Value of 63% and Negative Predictive Value of 88%. Data analysis was done on Epi Info version 6.
At the time of the study there were a total of 288 male students and 105 female students enrolled in the college. The overall response rate among the males and females were 68.7% and 99.0% respectively. Overall the prevalence of anxiety and depression in females were 66.6% and males 44.4% (p-value 0.01). In the 1st year the prevalence in females were 89.7% and males 60% (P-Value = 0.006). No suicidal ideation was reported by either males or females.
Almost similar level of anxiety and depression was found in another study using the same instrument in a similar curriculum model medical college in Pakistan. Our findings are also consistent with the findings from other studies from western medical schools as well as other Asian and African medical schools using different screening tools.
The aim of this study is to assess students’ views on student-teacher relationship and its effect on academic grades.
The present cross-sectional study was conducted in the College of Medicine, King Saud University, Riyadh, in 2005. The questionnaires were distributed to 420 students during the examination period in order to obtain a full response. It consisted of items on different aspects of student-teacher relationship for which the responses were measured on a 4-point scale. The response rate was about 83%.
The current relationship between the student and the teacher was evaluated as very good and good by 61% of the study sample. The responses were associated with their grades as (X2=6.25, p=0.012). Eighty-four point one percent of students with higher and above average grades felt that expulsion from class was an appropriate means of controlling the class. Also (78.2%) students felt that the teachers treated them with respect, and their responses were significantly associated with their grades (X2=11.8, p=0.003). Eight-four percent of the students with higher and above average grades strongly agreed that teacher's performance was affected by students’ attendance or absence and the responses were significantly associated with their grades (X2=4.35, p=0.037). The responses to most of the items by the students were independent of their grades.
This study concludes that student-teacher relationship was good in a medical school and the views of students on this relationship were independent with their academic grades. Further study which includes from 1st year to 5th year undergraduate students is required to give a broader view of student-teacher relationship in a medical school.
Student-teacher relationship; Undergraduate medical education; Saudi Arabia
Substance use remains high among Ethiopian youth and young adolescents particularly in high schools and colleges. The use of alcohol, khat and tobacco by college and university students can be harmful; leading to decreased academic performance, increased risk of contracting HIV and other sexually transmitted diseases. However, the magnitude of substance use and the factors associated with it has not been investigated among medical students in the country. This study was conducted to determine the prevalence of substance use and identify factors that influenced the behavior among undergraduate medical students of Addis Ababa University in Ethiopia.
A cross-sectional study using a pre-tested structured self-administered quantitative questionnaire was conducted in June 2009 among 622 medical students (Year I to Internship program) at the School of Medicine. The data were entered into Epi Info version 6.04d and analyzed using SPSS version 15 software program. Descriptive statistics were used for data summarization and presentation. Differences in proportions were compared for significance using Chi Square test, with significance level set at p < 0.05. Multivariate logistic regression analyses were used to assess the magnitude of associations between substance use and socio-demographic and behavioral correlates.
In the last 12 months, alcohol was consumed by 22% (25% males vs. 14% females, p = 0.002) and khat use was reported by 7% (9% males vs. 1.5% females, p < 0.001) of the students. About 9% of the respondents (10.6% males vs. 4.6% females, p = 0.014) reported ever use of cigarette smoking, and 1.8% were found to be current smokers. Using multiple logistic regression models, being male was strongly associated with alcohol use in the last 12 months (adjusted OR = 2.14, 95% CI = 1.22-3.76). Students whose friends currently consume alcohol were more likely to consume alcohol (adjusted OR = 2.47, 95% CI = 1.50-4.08) and whose friends' use tobacco more likely to smoke (adjusted OR = 3.89, 95% CI = 1.83-8.30). Khat use within the past 12 months was strongly and positively associated with alcohol consumption (adjusted OR = 15.11, 95% CI = 4.24-53.91). Similarly, ever use of cigarette was also significantly associated with alcohol consumption (adjusted OR = 8.65, 95% CI = 3.48-21.50).
Concordant use of alcohol, khat and tobacco is observed and exposure to friends' use of substances is often implicated. Alcohol consumption or khat use has been significantly associated with tobacco use. While the findings of this study suggest that substance use among the medical students was not alarming, but its trend increased among students from Year I to Internship program. The university must be vigilant in monitoring and educating the students about the consequences of substance use.