Stress provoking factors in dental education

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Stress provoking factors in dental education

• K. Divaris, A. Polychronopoulou
• Dept. of Preventive Community Dentistry Athens
  University Dental School

29th ADEE Annual Meeting, 3-6 September 2003,
Dresden, Germany
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IntroductionThe educational environment

• Dental school is renowned for being a highly
  pressurized, demanding and stressful environment

• Students within a 5-year curriculum are supposed
  to attain diverse proficiencies
• Academic
• Manual
• Interpersonal

skills

• Additionally, during clinical training, students
  are exposed to analogous occupational stressors,
  as qualified practitioners

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Introduction

• Related research has examined the following
  aspects in dental students

• Commonly reported stressors
• Examinations, time constraints, work overload,
  faculty-student relations, financial pressures

• Perceived sources of stress
• Concerns of entering dental students
• Interpersonal support coping
• Stress symptoms reported distress

• Commonly reported symptoms
• Anxiety, depression, hostility, tension,
  depersonalization, other psychological and
  somatic symptoms signs of distress

• Stress mediating factors
• Type A behavior/personality
• Career commitment
• Available coping resources

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Aim Methods

• Identify stress provoking factors in the Dental
  School environment
• Explore the role of study level gender on
  perceived sources of stress

• AIM

• 30-item modified DES questionnaire (4-point
  Likert scale)
• Distributed to all students physically present at
  classes (n605) officially registered in Athens
  Dental School
• Stata 6.0 was used for the data analysis.
  Nonparametric analyses were conducted due of the
  ordinal nature of the measurements

METHODS
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RESULTS

• RESPONSE
• 571 questionnaires were returned and analyzed.

• Sample description
• 346 female (60.6) 225 male (39.4) students
• Common pre-professional educational background

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DES(modified) mean scores Univariate analysis
by gender and by year of study
1 Wilcoxon test 2Kruskall-Wallis test (
denotes plt0.05, plt10-3)
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DES(modified) mean scores Univariate analysis
by gender and by year of study
1 Wilcoxon test 2Kruskall-Wallis test (
denotes plt0.05, plt10-3)
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ResultsFactors significantly increased in
female students

• Self-efficacy beliefs
• Lack of confidence in self to become a
  successful dentist
• Lack of confidence in self to be a successful
  student
• Fear of failing course or year

plt10-3

• Examinations and grades
• Financial responsibilities
• Lack of home atmosphere in the living quarters

plt0.05
Two-sample Wilcoxon test
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Results
Wilcoxon test plt10-3
Wilcoxon test plt0.05
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ResultsMultivariate analysis (ordinal logistic
regression)
Reference categories 1 Female 2 1st year
( denotes plt0.05, plt10-3)
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Results
Amount of assigned class work
Difficulty of class work
Kruskal-Wallis test plt10-3
Kruskal-Wallis test plt10-3
Two-sample Wilcoxon test N.S
Two-sample Wilcoxon test plt0.05
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Results
Multivariate analysis (ordinal logistic
regression)
Reference categories 1 Female 2 1st year
( denotes plt0.05, plt10-3)
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ResultsMultivariate analysis (ordinal logistic
regression)
( denotes plt0.05, plt10-3)
Reference categories 1 Female 2 1st year
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ResultsMultivariate analysis (ordinal logistic
regression)
Kruskal-Wallis test plt10-3
Two-sample Wilcoxon test plt10-3
Reference categories 1 Female 2 1st year
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Discussion

• Cross-sectional
• Conclusions may not be applicable to other
  institutions
• Interaction among students from different classes
  may be influencing perceived stressors

• Stress provoking factors in the specific dental
  School were examined for the first time.
• To confirm the tentative finding that stress
  levels are dependent on specific curriculum
  issues of the specific institution, or on factors
  closely relevant to student life, further
  assessment of dental student stress from a number
  of schools in different countries is warranted.
  (Yap et al., Humphris et al.)

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Conclusions/Implications

• Self-efficacy beliefs assigned workload were
  perceived as the most stress provoking factors.
• Further research is needed to explore the
  transitional stage (preclinical to clinical
  education).
• Female students seem to be more sensitive in some
  aspects of dental education when compared to male
  peers.

• Dental educators should acknowledge that the
  educational process is not uniformly perceived by
  students.
• Student-centered, balanced flexible curriculum.
• Counseling continuous self-assessment.
• Early clinical exposure is suggested to reduce or
  eliminate certain inherent stress sources.

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• Thank you
• for your attention