Ahmad Fuad Abdul Rahim

Prevalence and associated factors of stress, anxiety and depression among prospective medical students

Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (p<0.001) and race (p<0.001). Anxiety was associated with extra-curricular activity (p<0.001), race (p<0.001), mother education level (p=0.002) and CGPA group (p=0.034). Depression was associated with academic performance in class (p<0.001) and race (p=0.004). Prevalence of stress and depression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.

The impact of medical education on psychological health of students: a cohort study.

Many studies have shown that the prevalence of psychological distress among medical students during medical training is higher than that in general population. A few studies have shown that the prevalence of psychological distress among medical students before the onset of medical training was similar to general population. This study aimed to investigate psychological health of medical students before and during medical training. A one-year prospective study was done on successful applicants who undergo the first year of medical training for 2010/2011 academic session. The stress, anxiety and depression were measured by the DASS-21 at five intervals; during interview (Time 0), two months (Time 1), four months (Time 2), six months (Time 3) and final examination (Time 4) of the first year medical training. The prevalence of unfavourable stress, anxiety and depression before the onset of medical training was 4.1%, 55.6% and 1.8%, respectively. The prevalence of unfavourable stress during medical training ranged between 11.8% and 19.9%. The prevalence of anxiety during medical training ranged between 41.1% and 56.7%. The prevalence of depression during medical training ranged between 12% and 30%. Mean scores of stress and depression before (Time 0) and during medical training (Time 1–4) were significantly different (p < 0.001). The prevalence and level of unfavourable stress and depression during medical training were significantly higher than before the onset medical training. This study supports views that medical training is not an optimal environment to psychological health of medical students.

A longitudinal study of relationships between previous academic achievement, emotional intelligence and personality traits with psychological health of medical students during stressful periods.

CONTEXT There is considerable evidence that emotional intelligence, previous academic achievement (i.e. cumulative grade point average (GPA)) and personality are associated with success in various occupational settings. This study evaluated the relationships of these variables with psychological health of first year medical students during stressful periods. METHODS A 1-year prospective study was done with students accepted into the School of Medical Sciences, Universiti Sains Malaysia. Information on emotional intelligence, GPA and personality traits were obtained prior to admission. The validated Universiti Sains Malaysia Emotional Quotient Inventory and Universiti Sains Malaysia Personality Inventory were used to measure emotional intelligence and personality traits, respectively. Stress, anxiety and depression were measured by the 21-item Depression Anxiety Stress Scale during the end-of-course (time 1) and final (time 2) examinations. RESULTS At the less stressful period (time 1), stress level was associated with agreeableness and the final GPA, anxiety level was associated with emotional control and emotional conscientiousness and depression level was associated with the final GPA and extraversion. At the more stressful period (time 2), neuroticism associated with stress level, anxiety level was associated with neuroticism and emotional expression, and depression level was associated with neuroticism. CONCLUSIONS This study found that neuroticism was the strongest associated factor of psychological health of medical students during their most stressful testing period. Various personality traits, emotional intelligence and previous academic performance were associated factors of psychological health during a less stressful period. These data suggest that early identification of medical students who are vulnerable to the stressful environment of medical schools might help them maintain psychological well-being during medical training.

The BigSib students' peer group mentoring programme.

SD 0.5). They reported inadequate time to have learners perform EPs, however (mean 2.1, SD 1.3). Inter-rater reliability on the 20 EPs showed substantial agreement for Searching (j = 0.70) and Application of Evidence (j = 0.72); moderate agreement for Overall Competence (j = 0.57) and Evaluation of Evidence (j = 0.44); and fair agreement for Question Formation (j = 0.22). Residents reported that using the EP improved their EBM skills and allowed them to apply previous EBM teaching. Both teaching staff and residents reported lack of time as a barrier to performing EPs in the inpatient setting and recommended online versions of the forms. The EP is feasible to use during inpatient rotations with modest faculty training. Inter-rater reliability was generally good, but requires further assessment. The EP can be a useful method for determining residents’ EBM competence.

Experiences from a medical students' well-being workshop.

medical schools with groups that were heterogeneous for gender and year of medical school in order to obtain data for the development of the questionnaire. Secondly, we designed the first version of the questionnaire, which incorporated 90 items and used a Likert scale-based response format. Thirdly, we administered the questionnaire to 800 medical students in 75 medical schools in Brazil. Fourthly, using these data, we validated the questionnaire and tested internal consistency, discriminant validity, construct validity and factor analysis. Evaluation of results and impact Cronbach’s a for internal consistency of the questionnaire was 0.78. Cronbach’s a was tested for each item and all items with a £ 0.3 (38 items) were eliminated. Two other items were eliminated after semantic analysis, resulting in a questionnaire with 50 items. The results were analysed according to gender and year of medical course. The data showed significant differences between these groups. Total scores from the questionnaire were compared with self-evaluation scores on QoL and showed a significant positive correlation (r = 0.56, Spearman coefficient). Factor analysis (rotated component matrix) showed the presence of 13 domains in the questionnaire, explaining 56.8% of total variation. Grouping domains by similarity of theme resulted in the identification of five main domains: overall QoL; physical QoL; time management; the learning environment, and psychological QoL. The questionnaire analysis showed that 45.4% of the students were not satisfied with their medical courses. Factors that improve the QoL of medical students were good supervision of practical activities, participation in projects of social development, good classes, good teachers and contact with patients. Lack of free time to study, engage in leisure pursuits, maintain relationships and gain enough rest was considered a major factor in decreasing QoL for medical students. Students in Years 3 and 4 showed the lowest QoL scores in relation to the medical course and for the domains of the questionnaire; these values were lower for females. Students in Years 5 and 6 had better relationships with teachers and regarded the medical course as very competitive. We also made a transcultural translation to English. The questionnaire permits analysis of the QoL of medical students and the factors that generate stress in this group. This understanding can help medical schools design appropriate interventions.

Adopting programmatic feedback to enhance the learning of complex skills.

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Empowering students’ minds through a cognitive load theory-based lecture model: A metacognitive approach

ABSTRACT Lecturing is widely considered to be a passive, teacher-centred teaching method that fails to foster learning, yet it remains the most feasible method of teaching among higher institutions. Some modern lectures, aligned with recommendations from published guidelines on effective lecturing, are less didactic and more interactive than others, but little is known about converting the classical knowledge-transfer process of lecturing to actual learning. We introduce a cognitive load theory-based lecture guideline that adopts various types of empirically proven strategies to manage learners’ mental loads during lectures. We conducted a randomised controlled trial to evaluate its effectiveness by determining the between-group difference in cognitive load level, self-perceived learning, knowledge acquisition and knowledge retention. This study discusses the practical application of the guideline and several examples of the principles.