Date of Award

5-22-2024

Degree Type

Thesis

Degree Name

Master of Health Professions Education

First Advisor

Dr Rahila Ali

Second Advisor

Dr Sara Shakil

Third Advisor

Dr Tabassum Zehra

Department

Community Health Sciences

Abstract

Objective: The aim of this study is to determine the mediating role of educational environment in selection of coping strategies to reduce academic stress.
Methods: A cross sectional study was performed on 189 medical undergraduates of first, third and fifth years at Hamdard university. The study was conducted in the year 2023 and data was collected in the month of October. Purposive sampling technique was used. To collect data perceived stress scale, brief COPE and DREEM were employed. The Mann-Whitney U test was utilized to compare stress levels between males and females. The one-way ANOVA was used to determine the relationship between parametric variable (comparison of coping strategies used by three cohorts).
Results: From a total of 300 students enrolled in first, third and fifth Year, 189 students participated in the study. From first year 87 students, 52 from third year & 50 from fifth year. Among them 96 students were male and 93 were female. Mean age of participating students ranged from 18 to 26 years. Students of all three years reported moderate stress. The overall DREEM score achieved by students of first year was (69%), third year was (82.7%) and fifth year was (72%). The highest score percentage was noted in the domain of student’s perception of teachers SPoT & the lowest was observed for students’ academic self-perception SASP in all three years. A difference was found in SASP in fifth year that about half of the students “felt confident” (48%) while first year (48.3%) & third year (63.5%) were “feeling more on positive side”. The most common coping strategies used by the first and third-year participants was seeking solace in religion or spiritual beliefs. However, for fifth year participants, majority of the students reported that they have been accepting the reality The mean Perceived Stress Scale (PSS) scores were 2.06 ± 0.65 for males and 2.31 ± 0.61 for females, with a p-value of 0.008 indicating a statistically significant difference in average stress between the two genders. Results indicate a significant difference for coping strategies (P-value: 0.008). The post-hoc test (Tukey Kramer) was used to precisely identify which groups differ from each other. Results of Tukey Kramer test showed that there is a significant difference (P-value: 0.010) in coping strategies between first and fifth-Year students. The results of mediation analysis indicate that variable X (stress) has a significant total effect on Y (coping strategies), with a coefficient of 0.1605 (p < .001), implying that as X (stress) increases, Y (coping) tends to increase. However, when considering the direct effect of X (stress) on Y (coping) after accounting for a potential mediator (DREEM), the coefficient slightly increases to 0.1732 (p < .001), maintaining significance. The indirect effect via the mediator (DREEM) is insignificant, suggesting that the mediator does not significantly explain the relationship between X (stress) and Y (coping). Therefore, the direct effect of X on Y remains the primary driver of their relationship.
Conclusion: A positive and supportive educational environment has a direct influence on reducing the psychological stress of medical students. Medical students' psychological discomfort is directly lowered in a supportive learning environment. Our findings suggest that the quality of the educational environment may influence the coping strategies adopted by students in managing academic stress. Establishing a conducive learning environment will benefit their mental well-being during the course of undergraduate medical education help students effectively cope with the challenges in medical school.

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1

Last Page

115

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