Reliability Generalization of the Medical Student Stressor Questionnaire

Authors

DOI:

https://doi.org/10.5195/ijms.2021.1141

Keywords:

medical students, stress, medical education, physician burnout, reliability generalization

Abstract

Background: Medical education is known to be stressful. Thus, medical schools have begun amending curricula to incorporate holistic wellness and stress reduction. Assessing medical student stressors is key to curricula development as well as the selection of appropriate reliable measures. This study investigated reliability reporting for studies using the Medical Student Stressor Questionnaire (MSSQ), as no study of this kind currently exists via employing Reliability Generalization (RG).

Methods: A meta-analytic method, RG, was used to analyze the reliability reporting practices and reliability coefficients, in the form of Cronbach’s alpha coefficient, for the MSSQ. While a total of 18 studies were initially isolated related to the MSSQ, only those studies reporting reliability based on their sample (n = 8) were included in the final analysis. Blind coding was utilized and percent agreement among raters was excellent (95.18%).

Results: Reliability estimates reported for the total scale fell within the excellent range (Range alpha coefficient (?) = 0.800 – 0.970; Mean alpha coefficient (M?) = 0.933, Standard Deviation alpha coefficient (SD?) = 0.050). A larger percent of males was negatively correlated to academic stressors while the number of females in studies was negatively correlated with social, drive, group activities and inter/intrapersonal aspects of medical student stressors.

Conclusions: Outcomes provide useful suggestions, implications, and future recommendations regarding the use and application of the MSSQ. Medical student stress is essential to assess via measures which demonstrate robust reliability. Insights into sources of stress can offer important feedback to making specific changes to medical school curricula.

References

Lee J, Graham AV. Students' perception of medical school stress and their evaluation of a wellness elective. Med Educ. 2001 Jul;35(7):652-659.

Dyrbye LN, Harper W, Durning SJ, Moutier C, Thomas MR, Massie FS, et al. Patterns of distress in US medical students. Med Teach. 2011 Oct 1;33(10):834-839.

Maher BM, Hynes H, Sweeney C, Khashan AS, O'Rourke M, Doran K, et al. Medical school attrition-beyond the statistics a ten year retrospective study. BMC Med Educ. 2013 Jan 31;13:13.

Noori S, Blood A, Meleca J, Kennedy V, Sengupta D. Current directions in medical student well-being. Col Med Rev. 2017 Mar 6;(2):10-19.

Strayhorn G. Effect of a major curriculum revision on students’ perceptions of well-being. Acad Med. 1989 Jan;64(1):25-29.

O'Rourke M, Hammond S, O'Flynn S, Boylan G. The Medical Student Stress Profile: a tool for stress audit in medical training. Med Educ. 2010 Apr 8;44(10):1027-1037.

Yusoff MSB, Rahim AFA, Yaacob MJ. The development and validation of the Medical Student Stressor Questionnaire (MSSQ). ASEAN J Psychiat. 2010 Jun 1;11(1):13-24.

Shim EJ, Jeon HJ, Kim H, Lee KM, Jung D, Noh HL, et al. Measuring stress in medical education: validation of the Korean version of the higher education stress inventory with medical students. BMC Med Educ. 2016 Nov 24;16(1):302-310.

Johnson JC, Degenhardt BF, Smith CK, Wolf TM, Peterson DF. Tool for predicting medical student burnout from sustained stress levels: Factor analysis of the Medical Education Hassles Scale-R. J Am Osteopath Assoc. 2018 Mar 1;118(3):170-180.

Jayarajah U, Lakmal K, Athapathu A, Jayawardena AJ, de Silva V. Validating the Medical Students' Stressor Questionnaire (MSSQ) from a Sri Lankan medical faculty. J Taibah Univ Med Sci. 2020 Aug 29;15(5):344-350.

Bob MH, Popescu CA, Pîrlog R, Buzoianu AD. Personality factors associated with academic stress in first year medical students. HVM Bioflux. 2014 Apr 23;6(1):40-44.

Gupta S, Choudhury S, Das M, Mondol A, Pradhan R. Factors causing stress among students of a medical college in Kolkata, India. Educ Health. 2015 Jul 31;28(1):92-95.

Dagani J, Buizza C, Ferrari C, Ghilardi A. Psychometric validation and cultural adaptation of the Italian medical student stressor questionnaire. Curr Psychol. 2020 July 15.

Eva EO, Islam MZ, Mosaddek AS, Rahman MF, Rozario RJ, Iftekhar AF, et al. Prevalence of stress among medical students: A comparative study between public and private medical schools in Bangladesh. BMC Res Notes. 2015 Jul 30;8:327-334.

Melaku L, Mossie A, Negash A. Stress among medical students and its association with substance use and academic performance. J Biomed Educ. 2015 Dec 2;2015(4):1-9.

Vacha-Haase T. Reliability generalization: Exploring variance in measurement error affecting score reliability across studies. Educ Psychol Meas. 1998 Feb 1;58(1):6-20.

Wilkinson L. Statistical methods in psychology journals: Guidelines and explanations. Am Psychol. 1999 Aug 1;54(8):594-604.

Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951 Sep;16:297-334.

Vacha-Haase T, Henson R, Caruso J. Reliability generalization: Moving toward improved understanding and use of score reliability. EPM. 2002 Aug 1;62(4):562-569.

George D, Mallery P. SPSS for Windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon; 2003.

Nunnally JC. Psychometric theory. New York: McGraw-Hill; 1978.

Yusoff MSB. A multicenter study on validity of the Medical Student Stressor Questionnaire (MSSQ). Intl Med J. 2011 Mar 1;18:14-18.

Yusoff MSB. The stability of MSSQ to measure stressors among medical students. Intl Med J. 2013 Apr 21;20(2):250-252.

Yusoff MSB, Fuad AFA, Yaacob, MJ. Prevalence and sources of stress among Universiti Sains Malaysia medical students. The Malaysian J of Med Sci:MJMS. 2010 Jan 1;17(1):30-37.

Gupta S, Choudhury S, Das M, Mondol A, Pradhan R. Factors causing stress among students of a medical college in Kolkata, India. Educ Health (Abingdon). 2015 Aug 11;28(1):92-95.

Othman CJ, Farooqui M, Yusoff MSB, Adawiyah R. Nature of stress among health science students in a Malaysian university. AicEBs London (Asia Pacific International Conference on Environment Beh Studies). 2013 Dec 1;105(3):249-257.

Ravi SP, Balasubramanium R, Ramireddy R, Diamante P, Barton B, Dwivedi N. Stress and coping strategies among premedical and undergraduate basic science medical students in a Caribbean medical school. Ed in Med J. 2014 Dec 1;6(4):48-56.

Yusoff MSB. A confirmatory factor analysis study on the Medical Student Stressor Questionnaire among Malaysian medical students. Ed in Med J. 2011 Jun 1;3(1):44-53.

Steiner-Hofbauer V, Capan Melser M, Holzinger A. Focus gender - medical students' gender-specific perception and attitudes towards the burdens of everyday student life. GMS J Med Educ. 2020 Mar 16;37(2):Doc15.

Published

2021-12-07 — Updated on 2022-04-13

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How to Cite

Montano, M. A., Montano, S. A., Harrison, J. L., & Kivisalu, T. M. (2022). Reliability Generalization of the Medical Student Stressor Questionnaire. International Journal of Medical Students, 10(1), 25–31. https://doi.org/10.5195/ijms.2021.1141 (Original work published April 5, 2022)

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Original Article