Last week, I opened a new newsletter series about stress in graduate medical students and referenced an article I wrote with Dr. Rizzolo about this subject. Today I’d like to share some of the aspects and outcomes of our study to show our foundations for developing stress-management programs for students.  

Parameters of our study

Our study examined fluctuating stress levels in health science students during their first year of graduate school. We reviewed four programs: Doctor of Physical Therapy, Occupational Therapy, Speech-Language Pathology, and Physician Assistant.  We used the BSI (Brief Symptom Inventory), with our subjects completing the test three times:

Time 1: During the first week of graduate school

Time 2: During the last two weeks of Semester 1

Time 3: Mid-semester during Semester 2

The BSI subscales included anxiety, depression, obsessive-compulsive, phobia, and somatization (expressing psychological or emotional symptoms as physical symptoms, such as stress causing headaches, nausea, fatigue, or pain).

Results

Discussion

Notable fluctuations in anxiety levels in health science students indicate it is necessary to assist students in developing effective stress management techniques to help moderate the negative consequences of stress.

Our results supported the hypothesis: academia's pressures and stress are associated with anxiety and depression throughout the first school year. “SLP students experienced increasing anxiety and depression over three semesters, versus other program students who seemed to adjust and experience lower anxiety levels by the third semester.”

It is necessary to assist students in stress management techniques to moderate the negative consequences of stress. Kelly, Bradlyn, Dubbett, and Lawrence studied the effects of a three-week stress management program on student stress levels.  A cohort of 34 medical students served as the treatment group, and another 14 students served as the control group (no treatment). Students in the treatment group attended six 60-to-90-minute stress management sessions (including identifying stressors, stress management, and relaxation techniques).  Students in the treatment group showed significant reductions in the Jenkins Speed and Impatience Scale and the Jenkins Hard-Driving Scale, suggesting several indices of tension and stress behavior patterns improved after training.  Students in the treatment group recognized and coped with stress more efficiently.

In summary, we deduced:

1. Stress fluctuates through the didactic year. Educators should be cognizant of this and intervene before stress becomes overwhelming

2. We should try to recognize students under psychological strain and proactively help them manage their stress

3. Stress can be reduced by simple techniques such as deep breathing, music therapy, reading, and humor, as well as exercise and yoga or meditation can significantly reduce stress, reduce heart rate and blood pressure – and many of these can easily be incorporated into a daily routine.

An interesting side note to our research: other studies noted that stress is perceived differently and thus affects health differently, depending on the subset of the healthcare profession. Briefly, a study measuring differences in medical, physician assistant, nursing, and audiology students measured stress as highest in second-year medical students. At the same time, depression scores were highest in PA students.

Next time…

In our following newsletter, we’ll move from the scientific to the practical as we discuss our culture's double standard of self-care versus workaholism.