First year medical student stress and coping in a problem-based learning medical curriculum
First year medical student stress and coping in a problem-based learning medical curriculum
复制标题
DOI：
10.1046/j.1365-2929.2004.01814.x
复制
发表时间：
2004-05-01
影响因子：
6
通讯作者：
Morrison, JM
中科院分区：
文献类型：
--
作者：
Moffat, KJ;McConnachie, A;Morrison, JM
目的了解以问题为基础的本科医学课程一年级学生的心理患病率、压力源和应对机制。设计纵向队列问卷调查，对格拉斯哥大学医学院1997-98学年所有一年级学生(n=275)进行调查。主要调查结果包括12个项目的一般健康问卷(GHQ-12)、压力源和应对策略。主要应激源与医疗培训有关，而不是与个人问题有关，特别是对个人学习行为、进度和能力的不确定性，特别是对评估和学习材料的可用性的关注。小组学习环境，包括导师的表现，以及与同龄人和患者的互动，几乎没有造成压力。学生普遍采用积极的应对策略。压力源小组得分和应对策略均随性别和宿舍情况的不同而有所差异。结论全年增加学生对进展的反馈和指导，提供充足的学习资源可能会减少学生的压力。关于有效应对策略的教育或牧民干预也可能是有益的。对这一群体的持续后续行动可提供信息，为进一步制定课程提供信息，并酌情协助设计预防与压力有关的问题的方案。
OBJECTIVE To examine the prevalence of psychological morbidity, sources of stress and coping mechanisms in first year students in a problem-based learning undergraduate medical curriculum.DESIGN Longitudinal cohort questionnaire survey.SETTING Glasgow University Medical School.PARTICIPANTS All first year students (n = 275) in the 1997-98 intake.MAIN OUTCOME MEASURES Scores on the 12-item General Health Questionnaire (GHQ-12), sources of stress and coping strategies.RESULTS The prevalence of psychological morbidity and mean GHQ-12 scores increased significantly between term 1 and term 3, with no significant gender differences. Principal stressors were related to medical training rather than to personal problems, in particular uncertainty about individual study behaviour, progress and aptitude, with specific concerns about assessment and the availability of learning materials. The group learning environment, including tutor performance, and interactions with peers and patients caused little stress. Students generally used active coping strategies. Both stressor group scoring and coping strategies showed some variation with gender and GHQ caseness.CONCLUSIONS Increased student feedback and guidance about progress throughout the year and the provision of adequate learning resources may reduce student stress. Educational or pastoral intervention regarding effective coping strategies may also be beneficial. Continued follow-up of this cohort could provide information to inform further curriculum development and, if appropriate, aid the design of programmes for the prevention of stress-related problems.