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. 2022 Feb 23;22(1):122.
doi: 10.1186/s12909-022-03182-4.

Perceived stress and study-related behavior and experience patterns of medical students: a cross-sectional study

Kambiz Afshar  1 , Birgitt Wiese  2 , Stephanie Stiel  2 , Nils Schneider  2 , Bettina Engel  2   3
Affiliations

Perceived stress and study-related behavior and experience patterns of medical students: a cross-sectional study

Kambiz Afshar et al. BMC Med Educ. .

Abstract

Background: Distress and burnout are common in physicians. Both may already arise during medical training and persist throughout residency. An analysis of needs is necessary in order to develop target group specific curricular concepts at medical faculties. Aim of this study was to assess the perceived stress of medical students, to explore study-related behavior and experience patterns, and to investigate associated factors.

Methods: We conducted a cross-sectional survey of medical students at the Hannover Medical School. The web-based questionnaire consisted of 74 items and included two standardized instruments: the "Work-related Behavior and Experience Patterns" (Arbeitsbezogene Verhaltens- und Erlebensmuster, AVEM) and the "Perceived Medical School Stress" scale (PMSS). Students were asked to state their self-perceived actual stress level on a scale from 0% (no stress at all) to 100% (maximum stress). We performed a classification and regression tree (CART) analysis to identify factors that can discriminate between the four different AVEM patterns.

Results: Five hundred ninety-one medical students (female 75.8%, response rate: 34.0%) participated in the survey. The mean sum score of the PMSS was 37.2 (SD 8.3; median score 37, min.-max. = 18-65). Overall, 68.5% of the students showed a risk pattern (risk pattern A "overexertion": 38.9%; risk pattern B "burnout": 29.6%). Pattern G "healthy" was shown in 8.3% and pattern S "protection" in 23.1% of the students. Multilevel analysis revealed that the self-perceived stress level and the PMSS sum score were the most important predictors for the AVEM pattern assignment. Furthermore, academic year, gender, and financial dependency were relevant influencing factors: students in higher academic years with no financial support had a higher probability to be in risk pattern B whereas male students in the first academic year tended to be in pattern G.

Conclusions: The PMSS sum score could objectify medical students' high self-perceived stress level. The majority of participating students showed a risky study-related behavior and experience pattern. Medical faculties should be aware of the still existing and relevant problem of stress and burnout among medical students. Our results lay the groundwork for an evaluation and further development of medical curricula at the own faculty.

Keywords: Burnout; Cross-sectional studies; Medical education; Medical students; Stress.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Medical students’ (n° = °591) subjective stress level (0–100%) * Mean stress level = 61.74%, standard deviation = 26.025
Fig. 2
Fig. 2
Medical students’ study-related behavior and experience pattern assignment (n = 591). Pattern G = “healthy”; Pattern S = “protection”; Risk pattern A = “overexertion”; Risk pattern B = “burnout”
Fig. 3
Fig. 3
Classification and regression tree (CART) analysis. a Multivariate analysis with all parameters including stress level and PMSS-D sum score. b Multivariate analysis without stress level and PMSS-D sum score. G = pattern “healthy”; S = pattern “protection”; Risk A = risk pattern “overexertion”; Risk B = risk pattern “burnout”. Totals may differ from 100% due to rounding imprecision
See this image and copyright information in PMC

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