PERCEIVED STRESS AND ACADEMIC PERFORMANCE IN MEDICAL STUDENTS
Abstract
The aim of the study was to assess the levels of stress and perceived academic performance in medical students from all study years enrolled at Faculty of Medicine, UKIM, Skopje during the winter semester of the academic year 2022/23. An online survey including the Perceived Stress Questionnaire (PSQ), Perceived Academic Performance Scale (PAPS) and a questionnaire regarding demographic variables (age and gender) was available via Google Forms to a cohort of students at three time points (the beginning, the middle and the end) of the semester. A total of 113 students from all years, aged 18-28, responded. Eighty percent of them were female and 20% were male. The PSQ is self-report questionnaire comprised of 30 questions, which asses the stressful life events during past month. The score can range from 0 to 1, with a higher score indicating a higher level of stress. The PAPS consists of five statements on the experience of one's academic performance, achievement and success. The score can range from 5 to 35, with a higher score indicating a more positively perceived academic performance. The mean value of PSQ score increased (0.55±0.2; 0.58±0.22; 0.63±0.16) (p=0.0286), followed by a decrease in the mean value of PAPS (27.1±6.4; 25.7±7.1; 25.3±7.5) (p=0.1369) from the first to the third time point. A gradual increase in perceived stress and reduced academic performance among medical students during the winter semester are observed.
Key words: PSQ, PAPS, medical students.
References
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21. Gianfredi V, Nucci D, Tonzani A, et al. Sleep disorder, mediterranean diet and learning performance among nursing students: insomnia, a cross-sectional study. Annali di igiene: medicina preventiva e di comunita, 2018; 30(6):470–481. https://doi.org/10.7416/ai.2018.2247
22. Mancevska S, Plincevic Pluncevic J, Todorovska L, Dejanova B, Tecce J. Substance Use and Perceived Hassles among Junior Medical Students with High Anxiety Levels in the Republic of Macedonia. Iran J Public Health. 2014;43(10):1451-3. PMID: 26060708; PMCID: PMC4441899.
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24. Fritz J, Stochl J, Kievit RA et al.Tracking Stress, Mental Health, and Resilience Factors in Medical Students Before, During, and After a Stress-Inducing Exam Period: Protocol and Proof-of-Principle Analyses for the RESIST Cohort Study. JMIR Form Res. 2021; 5(6):e20128. doi: 10.2196/20128. PMID: 34100761; PMCID: PMC8262546.
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27. Stegers-Jager KM, Savas M, van der Waal J, et al. Gender-specific effects of raising year-1 standards on medical students' academic performance and stress levels. Med Educ. 2020;54:538–46. - PMC - PubMed
28. Hyseni Duraku Z, Davis H, Arënliu A, et al. Overcoming mental health challenges in higher education: a narrative review. Front. Psychol. 2024; 15:1466060. doi: 10.3389/fpsyg.2024.1466060
29. Sharma P, Singh P, Kalhan S, et al. Analysis of factors affecting academic performance of MBBS students in pathology. Ann Int Med Dent Res. 2017; 3:9–15.
30. Shafiee A. Fili J, Ghafari S, et al.The prevalence of sleep disturbance and its possible associated factors among iranian medical students: A cross-sectional study with a national meta-analysis. Sleep medicine. 2024; X( 7):100107.
31. Semwal P, Kumari R, Rawat VS, Aravindan N, Dhankar A. Psychological and other Correlates of Academic Performance in Medical Students at a Tertiary Care Hospital: A Cross-Sectional Study. Indian J Community Med. 2022; 47(3):364-68. doi: 10.4103/ijcm.ijcm_1067_21. Epub 2022 Oct 10. PMID: 36438525; PMCID: PMC9693941.VV
32. Levenstein S, Prantera C, Varvo V, et al. Development of the Perceived Stress Questionnaire: a new tool for psychosomatic research. J Psychosom Res. 1993; 37(1):19-32. doi: 10.1016/0022-3999(93)90120-5. PMID: 8421257.
33. Verner-Filion J, Vallerand, RJ. On the differential relationships involving perfectionism and academic adjustment: The mediating role of passion and affect. Learn. Individ. Differ. 2016; 50:103-13.
34. Abdulghani HM, AlKanhal AA, Mahmoud ES, et al. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011; 29(5):516-22. doi: 10.3329/jhpn.v29i5.8906. PMID: 22106758; PMCID: PMC3225114.
35. Voltmer E, Köslich-Strumann S, Voltmer JB, et al. Stress and behavior patterns throughout medical education – a six year longitudinal study. BMC Med Educ. 2021; 21: 454 https://doi.org/10.1186/s12909-021-02862-x
36. Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. Indian J Med Res. 2016;141(3):354-7. doi: 10.4103/0971-5916.156571. PMID: 25963497; PMCID: PMC4442334.
2. Slavish DC, Asbee J, Veeramachaneni K, et al. The Cycle of Daily Stress and Sleep: Sleep Measurement Matters. Ann. Behav. Med. 2021; 55(5): 413–23. https://doi.org/10.1093/abm/kaaa053
3. Almojali AI, Almalki SA, Alothman Aset al. (2017). The prevalence and association of stress with sleep quality among medical students. J Epidemiol Glob Health. 2017; 7(3):169–174. https://doi.org/10.1016/j.jegh.2017.04.005
4. Ahrberg K, Dresler M, Niedermaier S, et al.The interaction between sleep quality and academic performance. J. Psychiatr. Res. 2012; 46(12): 1618–22. https://doi.org/10.1016/j.jpsychires.2012.09.008
5. Alotaibi AD, Alosaimi FM, Alajlan AA, et al. (2020). The relationship between sleep quality, stress, and academic performance among medical students. J. Fam. Med. 2020; 27(1):23–8. https://doi.org/10.4103/jfcm.JFCM_132_19
6. Jahrami H, Dewald-Kaufmann J, MeA-I F, et al. Prevalence of sleep problems among medical students: a systematic review and meta-analysis. J Public Health. 2020;28:605–622. doi: 10.1007/s10389-019-01064-6.
7. Almutairi H, Alsubaiei A, Abduljawad S, Alshatti A, Fekih-Romdhane F, Husni M, et al. Prevalence of burnout in medical students: a systematic review and meta-analysis. Int J Soc Psychiatry. 2022;68(6):1157–1170.
8. Yue L, Zhao R, Xiao Q, et al. The effect of mental health on sleep quality of front-line medical staff during the COVID-19 outbreak in China: a cross-sectional study. PLoS ONE. 2021;16(6): e0253753.
9. Minkel J, Moreta M, Muto J, et al. Sleep deprivation potentiates HPA axis stress reactivity in healthy adults. Health Psychology. 2014; 33(11): 1430–34. https://doi.org/10.1037/a0034219
10. Aldridge JM, Fraser BJ, Fozdar F, et al. (2016). Students' perceptions of school climate as determinants of well-being, resilience, and identity. Improving schools. 2016;19(1):5-26.
11. Alipio M. Predicting Academic Performance of College Freshmen in the Philippines Using Psychological Variables and Expectancy -Value Beliefs to Outcomes - based Education: A Path Analysis. IMCC J Sci. 1 (Special), 2020; 77-86. https://doi.org/10.35542/osf.io/pra6z.
12. Suleiman IB, Okunade OA, Dada EG, et al. Key factors influencing students’ academic performance. J. Electr. Syst. Inf. Technol. 2024; 11:41. https://doi.org/10.1186/s43067-024-00166-w.
13. Edgerton E, McKechnie J. The relationship between student’s perceptions of their school environment and academic achievement. Front. Psychol. 2023; 13:959259. doi: 10.3389/fpsyg.2022.959259
14. Brew EA, Nketiah B, Koranteng R. A Literature Review of Academic Performance, an Insight into Factors and their Influences on Academic Outcomes of Students at Senior High Schools. Open Access Library Journal, 2021; 8: 1-14. doi: 10.4236/oalib.1107423.
15. Tadese M, Yeshaneh A, Mulu GB. Determinants of good academic performance among university students in Ethiopia: a cross-sectional study. BMC Med Educ. 2022; 22:395. https://doi.org/10.1186/s12909-022-03461-0.
16. Cruz EJP, Buban CR, Cabullos MAF, et al. The effect of perceived academic performance on positive emotions, engagement, relationships, meaning, and accomplishment (PERMA) among college students in Metro Manila. Puissant. 2024; 5: 2268-94.
17. Izaguirre LA, Rodríguez-Fernández A, Fernández-Zabala A. Perceived academic performance explained by school climate, positive psychological variables and life satisfaction. Br. J. Educ. Psychol. 2023; 93(1):318–32. https://doi.org/10.1111/bjep.12557,
18. Ahmed Y, Taha MH, Al-Neel S, Gaffar AM. Students' perception of the learning environment and its relation to their study year and performance in Sudan. Int J Med Educ. 2018 May 24; 9:145-150. doi: 10.5116/ijme.5af0.1fee. PMID: 29805119; PMCID: PMC6129164.
19. Habashi K, Simanton E. Wellness Activities, Stress, and Academic Performance in Medical Students. Cureus. 2024; 16(6): e62704. https://doi.org/10.7759/cureus.62704
20. Wunsch K, Fiedler J, Bachert P, et al. The Tridirectional Relationship among Physical Activity, Stress, and Academic Performance in University Students: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health. 2021; 18(2): 739. https://doi.org/10.3390/ijerph18020739
21. Gianfredi V, Nucci D, Tonzani A, et al. Sleep disorder, mediterranean diet and learning performance among nursing students: insomnia, a cross-sectional study. Annali di igiene: medicina preventiva e di comunita, 2018; 30(6):470–481. https://doi.org/10.7416/ai.2018.2247
22. Mancevska S, Plincevic Pluncevic J, Todorovska L, Dejanova B, Tecce J. Substance Use and Perceived Hassles among Junior Medical Students with High Anxiety Levels in the Republic of Macedonia. Iran J Public Health. 2014;43(10):1451-3. PMID: 26060708; PMCID: PMC4441899.
23. Bruffaerts R, Mortier P, Kiekens G, et al. Mental health problems in college freshmen: Prevalence and academic functioning. J. Affect. Disord. 2018; 225: 97–103. https://doi.org/10.1016/j.jad.2017.07.044
24. Fritz J, Stochl J, Kievit RA et al.Tracking Stress, Mental Health, and Resilience Factors in Medical Students Before, During, and After a Stress-Inducing Exam Period: Protocol and Proof-of-Principle Analyses for the RESIST Cohort Study. JMIR Form Res. 2021; 5(6):e20128. doi: 10.2196/20128. PMID: 34100761; PMCID: PMC8262546.
25. Di Vincenzo M, Arsenio E, Della Rocca B,et al. Is There a Burnout Epidemic among Medical Students? Results from a Systematic Review. Medicina. 2024; 60(4):575. https://doi.org/10.3390/medicina60040575
26. Wu H, Li S, Zheng J, et al. Medical students’ motivation and academic performance: the mediating roles of self-efficacy and learning engagement. Med. Educ. Online. 2020; 25(1). https://doi.org/10.1080/10872981.2020.1742964
27. Stegers-Jager KM, Savas M, van der Waal J, et al. Gender-specific effects of raising year-1 standards on medical students' academic performance and stress levels. Med Educ. 2020;54:538–46. - PMC - PubMed
28. Hyseni Duraku Z, Davis H, Arënliu A, et al. Overcoming mental health challenges in higher education: a narrative review. Front. Psychol. 2024; 15:1466060. doi: 10.3389/fpsyg.2024.1466060
29. Sharma P, Singh P, Kalhan S, et al. Analysis of factors affecting academic performance of MBBS students in pathology. Ann Int Med Dent Res. 2017; 3:9–15.
30. Shafiee A. Fili J, Ghafari S, et al.The prevalence of sleep disturbance and its possible associated factors among iranian medical students: A cross-sectional study with a national meta-analysis. Sleep medicine. 2024; X( 7):100107.
31. Semwal P, Kumari R, Rawat VS, Aravindan N, Dhankar A. Psychological and other Correlates of Academic Performance in Medical Students at a Tertiary Care Hospital: A Cross-Sectional Study. Indian J Community Med. 2022; 47(3):364-68. doi: 10.4103/ijcm.ijcm_1067_21. Epub 2022 Oct 10. PMID: 36438525; PMCID: PMC9693941.VV
32. Levenstein S, Prantera C, Varvo V, et al. Development of the Perceived Stress Questionnaire: a new tool for psychosomatic research. J Psychosom Res. 1993; 37(1):19-32. doi: 10.1016/0022-3999(93)90120-5. PMID: 8421257.
33. Verner-Filion J, Vallerand, RJ. On the differential relationships involving perfectionism and academic adjustment: The mediating role of passion and affect. Learn. Individ. Differ. 2016; 50:103-13.
34. Abdulghani HM, AlKanhal AA, Mahmoud ES, et al. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011; 29(5):516-22. doi: 10.3329/jhpn.v29i5.8906. PMID: 22106758; PMCID: PMC3225114.
35. Voltmer E, Köslich-Strumann S, Voltmer JB, et al. Stress and behavior patterns throughout medical education – a six year longitudinal study. BMC Med Educ. 2021; 21: 454 https://doi.org/10.1186/s12909-021-02862-x
36. Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. Indian J Med Res. 2016;141(3):354-7. doi: 10.4103/0971-5916.156571. PMID: 25963497; PMCID: PMC4442334.
Published
2024-12-30
How to Cite
MANCEVSKA, Sanja; PISLEVSKI, Matej; PLUNCEVIC GLIGOROSKA, Jasmina.
PERCEIVED STRESS AND ACADEMIC PERFORMANCE IN MEDICAL STUDENTS.
Journal of Morphological Sciences, [S.l.], v. 7, n. 3, p. 95-103, dec. 2024.
ISSN 2545-4706.
Available at: <http://jms.mk/jms/article/view/vol7no3-12>. Date accessed: 26 mar. 2025.
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