Perceived sources of stress amongst Chilean and Argentinean dental students

Contrasting student and staff perceptions of preclinical-to-clinical transition at a Chilean dental school

INTRODUCTION

Dental education is a challenging and demanding field of study as students are expected to acquire various competencies to fulfil their professional requirements after graduation. The objective of this study was to investigate and compare dental students' and clinical staff instructors' perceptions of the preclinical-to-clinical transition training at a Dental School in Santiago, Chile.

MATERIAL AND METHODS

Two questionnaires containing 11 quantitative and one qualitative item were developed to assess our year three, four and five (n = 244) dental undergraduate students' challenges when they begin treating patients, and clinical staff (n = 78) perceptions of the preparedness to treat patients of the same students. Both questionnaires were voluntarily and anonymously implemented eight weeks after the beginning of the 2019 academic year. Responses were analysed using a Chi-squared test for each quantitative question, while qualitative comments were studied to form themes and dimensions.

RESULTS

A total of 234 (96%) students and 60 (77%) instructors completed their respective questionnaire. There were considerable variations between students in the different years of the programme, as well as between students and staff members. Students and instructors felt the former had enough knowledge to treat patients though it was difficult for them to apply it in clinical practice. Again, both believed they could communicate with patients, but third year students asked for more training on this. Regarding practical skills, fourth- and fifth-year students felt prepared but not third year students, who preferred to work in pairs with senior students, a preference that was shared by the instructors. All student groups asked clinical staff to provide more frequent, constructive and consistent feedback and felt that the difference between simulation and clinical environments and the amount of clinical work to fulfil clinical requirements made them feel stressed. Another mentioned stressor was students' low self-confidence when working with patients. Among the requested improvements, students requested better training on how the dental clinic works to save time.

CONCLUSIONS

Preclinical-to-clinical transition training presents several challenges. Some of the problems highlighted by both students and clinical staff members persisted with the transition after three, four and even five years of training, which needs to be addressed.

Method 300: a complementary teaching methodology in Dentistry

This study evaluated Method 300, a complementary teaching methodology in Dentistry. Thirty participants were divided into 6 groups according to the scores obtained in a placement test ranging from 0 to 10. Students with scores lower than 6 were classified as having poor academic performance; students with scores equal to or greater than 6 were considered as having good academic performance. Each group included at least one student with good performance. Our methodology consisted of two application cycles, each including one different test; however, only students with low performance could undergo the second testing. Students held meetings twice a week for one hour and thirty minutes. Of the 54 students initially enrolled in the subject, 24 dropped out, leaving 30 students who completed all the proposed activities. In cycle 1, 24 (80%) students showed poor academic performance and 6 (20%) good. Students with poor performance in P1 significantly improved after P1 300 test application (P < 0.001). After cycle 1 activities, all 30 participants showed significant improvement. In cycle 2, the number of students with good performance tripled when compared to cycle 1, resulting in a decrease in the number of students with poor performance (P = 0.205). Results show that the Method 300 is an important teaching-learning resource in Dentistry, to be used as a complementary methodology to lectures.

Occupational Stress among Dental Professionals

Stress at the work place was declared by the World Health Organization as a worldwide epidemic. The stress caused by work appears when the balance between one’s own possibilities and the environment demands is disturbed, which leads to a poor mental state. The fact is that the majority of dentists find they are under constant stress, which is caused by the nature of dental work. Literature describes dentistry as an extremely stressful profession. The main stressors include the tendency toward technical perfection, the causation of pain in patients, the lack of patient cooperation during dental treatment, the failure to maintain the given appointments. Adequate education and preparation, even during dental studies, non-neglect of symptoms and difficulties at the work place, adequate and timely response to the identification of the cause and its elimination or balancing, have a key role in solving this great problem in modern dentistry.

Stress and Basic Need Satisfaction of First-Year Healthcare Professional Students

PURPOSE

Transitioning to graduate-level professional school can trigger stressful feelings for many students. The purpose of this study was to determine the stress levels and unmet basic needs of first-year graduate healthcare students during their transition from undergraduate institutions to professional school.

METHODS

The study was conducted at Midwestern University, a private, graduate-level, professional health sciences university located in the Midwest, during the 2018-2019 academic year. The survey was administered to all first-year students within the colleges of dentistry, medicine, optometry, and pharmacy. The Perceived Stress Scale (PSS-10) was used to evaluate participants' stress levels and the Basic Need Satisfaction Inventory (BNSI) was used to evaluate unmet basic needs.

RESULTS

Of the 523 prospective participants, 404 survey responses were included (77.2% response rate). Female students showed higher perceived stress and lower basic need satisfaction. Perceived stress levels did not differ by professional program when taking into consideration the differences in gender distribution by program. A regression model indicated that gender and basic need satisfaction were the main predictors of perceived stress for healthcare professional students.

CONCLUSIONS

Higher basic need satisfaction was predictive of lower perceived stress in healthcare professional students. Perceived stress levels remain higher for female students compared to male students.

Reliability and Validity of the Turkish Adaptation of Dental Environmental Stress Scale: A Methodological Study

Aim:

This paper aims to develop the Turkish version of the dental environmental stress (DES) scale that can evaluate perceived DES in Turkish dental students.

Materials and Methods:

A methodological study was conducted to adapt the DES scale to Turkish language in Gaziantep University, Faculty of Dentistry. The study group consisted of 392 students in the academic year 2018/19. The students were surveyed using the DES scale, translated into Turkish language. The demographic characteristics were analyzed by using descriptive statistical analyses. Kaiser-Meyer-Olkin and Bartlett’s Test of Sphericity were employed to evaluate the suitability of the dataset. Exploratory factor analysis was performed to assess construct validity. Depression Anxiety Stress Scale-21 was used to predict the power of the scale. In reliability analysis, the instrument’s internal consistency and corrected item-total correlation, Cronbach’s α reliability were studied.

Results:

Content Validity Index of the scale items was found to have a high validity range of 0.97. Two items with an estimate value less than 0.4 were excluded and 30 items yielded five factor. Five factors having eigenvalues greater than 1.0 explained 52.299% of the total variance. Each factor showed adequate internal consistency. Factor loadings ranged from 0.46 to 0.77. In the concurrent validity, significant positive relationship was found between DASS-21 and Turkish DES.

Conclusion:

According to psychometric properties, the Turkish version of the DES presented good results, thus it could be a valid instrument to assess the perceived stress in Turkish dental students.

Lifestyle behaviors and mental health in medical students

Purpose

Recently, there has been a renewed interest in medical students’ mental health. The purpose of this paper is to determine factors associated with psychological distress in medical students and to assess the correlation between major lifestyle behaviours and mental health.

Design/methodology/approach

The authors conducted a cross-sectional questionnaire survey among 530 medical students randomized from a faculty of medicine in 2017. The authors used the 12-item General Health Questionnaire (GHQ-12) and the Simple Lifestyle Indicator Questionnaire (SLIQ) to assess mental health and lifestyle, respectively.

Findings

The mean value of GHQ-12 and SLIQ were 4.1±2.8 and 6.2±1.4, respectively. Bivariate correlation analysis showed that SLIQ was significantly correlated to GHQ-12 (r=−0.26; p<0.001). The prevalence of psychological distress (GHQ-12=4) was 50.1%. The authors found that low/middle financial situation of the family (OR=1.5; CI 95%=[1.1–2.3]), internship level, (OR=1.8; CI 95%=[1.1–3.3]), medium/poor perceived academic performance (OR=2.2; CI 95%=[1.5–3.2]) and medium/poor perceived health status (OR=2.3; CI 95%=[1.5–3.6]) were significantly associated with psychological distress. Multivariate analysis performing logistic regression showed that average and unhealthy lifestyle were independently associated with psychological distress, with an adjusted OR of 3.7 (CI 95%=[1.7–7.7]) and 5.8 (CI 95%=[2.4–14.8]), respectively.

Originality/value

The study highlighted the magnitude and the risk factors of psychological distress in medical students. Unhealthy lifestyle was a potential predictive of mental disorders. These findings provide fundamental information for future researches.

Stress predictors in two Asian dental schools with an integrated curriculum and traditional curriculum

INTRODUCTION

This study explored stress predictors and the role of instructional methods and institutional differences in perceived stress levels amongst students at two Asian dental schools.

MATERIALS AND METHODS

An anonymous questionnaire was distributed to undergraduate dental students at Tokyo Medical and Dental University (TMDU), Japan and the University of Medicine and Pharmacy (UMP), Hochiminh City, Vietnam in 2016. Data concerning the students' demographic information and grades, and responses to the Perceived Stress Scale (PSS) and Dental Environment Stress questionnaire (DES) were collected. The questionnaires were prepared in English and translated into Japanese and Vietnamese following a forward-backward translation process.

RESULTS

Altogether 684 students answered the questionnaire with a response rate of 97% for TMDU and 89% for UMP. The mean DES score of UMP students was significantly higher than TMDU (P < .001). TMDU students with dentistry as their first programme choice had significantly lower PSS and DES scores in several categories than other TMDU students, whilst UMP clinical students reported higher stress scores in several areas than UMP preclinical students.

CONCLUSION

Having dentistry as their first choice of educational programme was a significant stress predictor for Japanese students whilst the clinical practicum was a significant stress predictor for Vietnamese students. Previous academic performance was not a significant stress predictor for students at either dental school. Dental students of an integrated, active-learning curriculum reported lower stress levels than students of a traditional, discipline-based curriculum.

Comparing student and staff perceptions of the "Educational Climate" in Spanish Dental Schools using the Dundee Ready Education Environment Measure

OBJECTIVE

To compare the perceptions of students and teachers of the "Educational Climate" (EC) in Spanish public dental schools.

METHODS

A group of 1064 students and 354 teachers from six Spanish public dental schools responded to the DREEM questionnaire. This has 50 items grouped into five subscales: perception of learning (Learning); perception of teachers (Teachers); academic self-perceptions (Academic); perception of the atmosphere in the faculty (Atmosphere); and social self-perceptions (Social). The DREEM scale provides results for each item, each subscale and the overall EC.

RESULTS

The EC scores were 123.2 (61.6%) for the students and 134.1 (67.0%) for the teachers (P<.001). The scores of the students and teachers for the subscales were, respectively: 27.9 (58.1%) and 30.2 (63.0 %) for Learning (P<.001); 26.8 (60.9%) and 32.6 (74.1%) for Teachers (P<.001); 20.7 (64.7%) and 20.5 (64.0%) for Academic (P=.333); 29.9 (62.3%) and 33.7 (70.3%) for Atmosphere (P<.001); and 17.9 (64.0%) and 16.9 (60.5%) for Social (P<.001). The students identified six problematic items (12.0 %) compared to only two (4.0 %) highlighted by the teachers.

CONCLUSION

The students and teachers considered the EC to be "more positive than negative" in Spanish public dental schools; and the different subscales to be "positive and acceptable." The teachers did, however, evaluate the EC, and specifically the learning-teaching process, more positively than their students, identifying fewer problematic educational aspects. Both groups agreed on the need to: improve support systems for students who suffer from stress and reduce teaching based on "factual learning."

A longitudinal study on stress sources perceived by Chilean dental students

Introducción. La percepción de los estudiantes universitarios sobre el estrés académico es fundamental, ya que proporciona información valiosa sobre la eficiencia y aceptabilidad de los métodos educativos.Objetivo. Evaluar las diferencias en los factores de estrés percibidos por los estudiantes de primer año de odontología durante el primer y segundo semestre según género.Materiales y método. Estudio descriptivo exploratorio, longitudinal y no experimental. En mayo y octubre de 2016 se aplicó la versión en español del Dental Environment Stressors (DES), adaptado y validado para estudiantes de odontología en la Universidad San Sebastián (Concepción, Chile). La muestra consistió en 83 estudiantes de primer año. La comparación de las variables en estudio (stress y sus dimensiones) entre los dos períodos comparados, en general y considerando los géneros, se realizaron mediante la prueba t-Student, previa estimación de existencia o no de igualdad de varianzas entre los grupos mediante la prueba F de Fisher.Resultados. En la segunda medición, la dimensión “Formación clínica” en mujeres fue el único componente que mostró diferencias significativas con valores superiores de la media.Conclusión. Existe una percepción de estrés para todos los ítems del cuestionario DES; las mujeres tuvieron una mayor puntuación en la dimensión “Formación clínica”.

A cross-sectional study of stress and its sources among health professional students at Makerere University, Uganda

Aim

To assess prevalence of stress and its sources among undergraduate health professional students at Makerere University.

Design

This was a descriptive cross-sectional study using quantitative methods of data collection.

Methods

The study was conducted among 258 undergraduate health professional students (Medical, Dental and, Nursing students) at Makerere University. From each programme, students were recruited proportionately, while being selected conveniently from each year of study. Stress was measured using the General Health Questionnaire 12 and stressors assessed using a questionnaire developed from literature. After obtaining ethics approval, data were collected from consenting students. Data collected were analysed using SPSS statistical program.

Results

The prevalence of stress was found to be 57.4% and stressors of academic and psychosocial origin were most frequently reported. The top stressors included; academic curriculum (38%), dissatisfaction with class lectures (30.9%), long distance walk (29.5%), lack of time for recreation (28.9%), performance in examination (28.3%), lack of special guidance from faculty (26.7%) and high parental expectations (26.7%).

The Mediator Role of Perceived Stress in the Relationship between Academic Stress and Depressive Symptoms among E-learning Students with Visual Impairments

Introduction

This study examined a mediator role of perceived stress on the prediction of the effects of academic stress on depressive symptoms among e-learning students with visual impairments.

Methods

A convenience sample for this study was collected for three weeks from November to December in 2012 among students with visual impairments attending a Korean cyberuniversity in Seoul. A total of 103 students with visual impairments completed the survey via e-mail or telephone, with an overall response rate of 72.54%.

Results

The present study demonstrated that perceived stress fully mediated the effect of academic stress on depressive symptoms. Academic stress was significantly associated with perceived stress and depressive symptoms, and perceived stress was significantly associated with depressive symptoms. However, the association between academic stress and depressive symptoms was no longer significant when perceived stress was included as a mediator.

Discussion

This finding supports the full mediation model by demonstrating that academic stress indirectly influences depressive symptoms through perceived stress, and by highlighting the important contribution of perceptions of stressors.

Implications for practitioners

Cyberuniversities, professors, and disability services offices need to identify and assess what academic resources are available. To improve the accessibility of e-learning materials and settings, reasonable accommodations in e-learning settings and special online assistance services should be provided. A precollege orientation program and a training program for better adaptation and usage of the e-learning materials and technologies are needed. Senior students’ successful experiences and know-how should be shared among students with visual impairments. Psychological counseling services for students who have a high level of depressive symptoms should be provided.

Burnout prevalence and correlates amongst Colombian dental students: the STRESSCODE study

INTRODUCTION

Accumulating evidence amongst dental students indicates an alarming prevalence of stress, which can precipitate the development of burnout--a state of mental or physical exhaustion and disengagement. Understanding individual and educational correlates of burnout is necessary for its prevention. The aims of this study were to determine the prevalence of burnout amongst a large sample of Colombian dental undergraduates and investigate its psychosocial and educational correlates.

MATERIALS AND METHODS

Survey data collected from 5647 students participating in the Stress in Colombian Dental Education study were used for this analysis. Burnout was measured using the Maslach Burnout Inventory-Student Survey (MBI-SS). Covariates included participants' socio-demographic characteristics and perceived stress, as well as educational environment factors. Descriptive, bivariate and multivariate methods based on multilevel mixed-effects logistic regression modelling were used for data analysis.

RESULTS

Seven per cent of the students surveyed met the criteria for burnout. The prevalence of burnout was higher amongst upper classes, older and married students, those who reported not having passed all required courses and not having dentistry as their first career choice, as well as students in public institutions and those with large class sizes. Moreover, students' perceived stress in the domains of workload and self-efficacy was significantly and positively associated with burnout.

CONCLUSIONS

Both personal and educational environment characteristics were found to be associated with burnout. Irrespective of these factors, students' perceived stress with regard to workload and self-efficacy was a strong influence on burnout and its alleviation may be a promising avenue to prevent psychological morbidity.

Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools

BACKGROUND

Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates.

METHODS

The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics.

RESULTS

A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress.

CONCLUSIONS

Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.