Reliability Generalization of the Medical Student Stressor Questionnaire
DOI:
https://doi.org/10.5195/ijms.2021.1141Keywords:
medical students, stress, medical education, physician burnout, reliability generalizationAbstract
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.
Metrics
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
Versions
- 2022-04-13 (4)
- 2022-04-13 (3)
- 2022-04-05 (2)
How to Cite
License
Copyright (c) 2020 Mason A. Montano, Samuel A. Montano, Jennifer L. Harrison, Trisha M. Kivisalu
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org
Infringing material
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org