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      Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study

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          Abstract

          Background

          Prior evidence suggests that medical students’ mental health is poor and deteriorates during the course of academic studies. This qualitative study therefore aims to improve our understanding of medical students’ perceptions of i) stressors related to their academic studies, ii) resources that may facilitate coping with those stressors and iii) suggestions to potentially reduce stress.

          Methods

          Eight focus groups were conducted with medical students enrolled at a medical school in Germany until thematic saturation was reached. A topic guide was used to facilitate the discussion. Subsequently, focus group discussions were transcribed and content-analyzed using MaxQDA.

          Results

          Organizational factors especially related to inadequate information flow as well as exams (e.g. repeat exams, scheduling, perceived unfair grading), poor theoretical and practical teaching quality, time and performance pressure, social interactions and individual characteristics (e.g. self-expectations, fear of failure) emerged as major contributors to stress. Resources perceived to facilitate coping with those stressors pertained to some other organizational aspects (e.g. flexibility, availability of contact persons), career prospects, practical training, social support, personal characteristics (e.g. knowledge base, past experience) and leisure time. Suggestions for improvement related primarily to organizational measures rather than individual-level measures.

          Conclusions

          Besides well-known stressors (e.g. exams and high performance pressure), some new aspects emerged from our study including stress related to organizational factors and repeat exams. Accordingly, students’ wishes for organizational-level interventions, including better information systems and better interweaving of practical and theoretical education, could be first target areas for improvement.

          Electronic supplementary material

          The online version of this article (10.1186/s12909-019-1747-z) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Adverse health effects of high-effort/low-reward conditions.

          J Siegrist (1996)
          In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
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            • Record: found
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            • Article: not found

            Relationships between medical student burnout, empathy, and professionalism climate.

            Medical student burnout is prevalent, and there has been much discussion about burnout and professionalism in medical education and the clinical learning environment. Yet, few studies have attempted to explore relationships between those issues using validated instruments. Medical students were surveyed at the beginning of their fourth year using the Maslach Burnout Inventory, the Jefferson Scale of Physician Empathy-Student Version, and the Professionalism Climate Instrument. The data were analyzed using Statistical Package for the Social Sciences, and Spearman correlation analysis was performed. Scores indicative of higher medical student burnout were associated with lower medical student empathy scores and with lower professionalism climate scores observed in medical students, residents, and faculty. Investigators observed relationships between medical student burnout, empathy, and professionalism climate. These findings may have implications for the design of curriculum interventions to promote student well-being and professionalism.
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              Social and psychological resources and adaptation.

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                Author and article information

                Contributors
                Jeannette.Weber@uni-duesseldorf.de
                StefanieSkodda@gmx.de
                mutht@uni-duesseldorf.de
                Peter.Angerer@uni-duesseldorf.de
                Adrian.Loerbroks@uni-duesseldorf.de
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                20 August 2019
                20 August 2019
                2019
                : 19
                : 312
                Affiliations
                [1 ]ISNI 0000 0001 2176 9917, GRID grid.411327.2, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, , Heinrich-Heine-University of Düsseldorf, ; Moorenstraße 5, 40225 Düsseldorf, Germany
                [2 ]ISNI 0000 0001 2190 4373, GRID grid.7700.0, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, , Heidelberg University, ; Mannheim, Germany
                Author information
                http://orcid.org/0000-0002-9602-7405
                Article
                1747
                10.1186/s12909-019-1747-z
                6701044
                31429744
                954466ad-48b2-4542-8eda-e9b17f03c297
                © The Author(s). 2019

                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
                : 16 January 2019
                : 6 August 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Education
                qualitative research,focus groups,stress, psychological,health resources,education, medical

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