Assessment of Stress in Physician Assistant Students
Kuhn, Lisa, Kranz, Peter L., Koo, Felix, Cossio, Griselda, Lund, Nick L., Journal of Instructional Psychology
Twenty-seven full-time students within the Physician Assistant Studies Program at The University of Texas--Pan American were anonymously surveyed to determine their levels of stress while enrolled in their first semester. The majority of respondents reported that their stress levels at this point in the program tell within the moderate to considerable range. Most indicated that their stress was induced by the academic demands of the program and their financial obligations. In an attempt to manage their stress, the majority of those surveyed indicated they employed passive techniques.
An under-recognized variable to academic success within physician assistant training programs is the student's ability to manage stress. The faculty of The Physician Assistant Studies Program (PASP) at The University of Texas--Pan American (UTPA), looking to enhance student academic performance, recognized that stress levels tend to be heightened while in the program. Consequently, they were concerned about the impact of stress upon the student's physical, emotional, and academic well being. Within the program, the faculty has become aware of the fact that several students have sought medical treatment for stress-induced or stress-related health conditions. In order for the student to adequately cope with these stress-related conditions, the authors felt that the sources of stress must first be identified, followed by the development of an intervention plan that could be successfully implemented.
Review of Literature
A review of literature indicated a dearth of material as to stress related factors associated with physician assistant training. However, the academic demands of physician assistant programs are closely related to medical school and residency programs. In this regard, there is a significant amount of information on the effects of stress associated with the training of medical students and residents (Lee & Graham, 2001; Levey, 2001; Michels, Probst, Godenick, & Palesch, 2003; Rosenthal, Rosenthal, & Edwards, 1990: Shapiro, Shapiro, & Schwartz, 2000; Stewart, Lam, Betson, Wong, & Wong, 1999: Vitaliano, Maiuro, Russo, Mitchell, Carr, & Van Citters, 1988). Medical education necessitates its students perform well under stressful conditions. While espousing strength and self-sufficiency, medical training programs consequently cultivate cynicism and depersonalization among its medical trainees. This behavior further compounds an increased feeling of both powerlessness and helplessness (Michaels et al.). Consequently, medical education does not adequately prepare its students or professionals to manage and cope with the effects of stress. Thus the medical field is afflicted with fi-equent burnout of its professionals (Michaels et al.).
Medical students are inundated with stress from the start of their medical training as they attempt to adjust to lifestyle changes and increasing hassles incurred by the demands of medical education (Lee et al., 2001 : Rosenthal et al., 1990). Characteristics commonly associated with medical training and identified as situational or professional stressors include: variable hour shifts, sleep deprivation, cumbersome administrative responsibilities, poor administrative support, and curriculum overload (Lee et al.; Levey, 2001 : Enns, Cox, Sareen, & Freeman, 2001). Additional characteristics are: perceived lack of professional knowledge and skills (Sheu & Hwang, 2002), health care policy changes, difficult patients, patient care, life and death situations, and unexpected shill in academic performance (Lee; Levey; Enns). Further stressors mentioned in the literature include family responsibilities, incurring financial debt, decreased chances for social, leisure, or physical activities, decreased support network due to relocation, cultural and minority issues, and inadequate coping skills (Lee, Michels et al.2003; Enns, 2001). …