Warnken Iris, Polujanski Sabine, Rotthoff Thomas, Schindler Ann-Kathrin
University of Augsburg, Faculty of Medicine, Medical Didactics and Education Research, DEMEDA, Augsburg, Germany.
GMS J Med Educ. 2025 Feb 17;42(1):Doc6. doi: 10.3205/zma001730. eCollection 2025.
A high level of stress and critical burnout values (27-56%) has been identified among medical students in numerous international research and review studies. The aim of this interview study was to gain insights into students' perspectives on stressors, stress amplifiers and reactions, as well as the coping strategies they applied. The results will be used to discuss preventative measures in higher education.
A total of 22 semi-standardised, semi-narrative interviews were conducted with medical students, students in their practical year and junior doctors to gain retrospective perspectives on their studies. All data were audio-recorded, pseudonymised, fully transcribed as well as structured and analysed using qualitative content analysis, based on Kaluza's stress model.
Study-related causes (e.g. the amount of material), private issues (e.g. social conflicts) and aspects arising during clinical work phases (e.g. complexity of tasks) were named as stressors. Individual stress amplifiers, such as perfectionism, were also described. The respondents showed stress reactions, such as doubts and fears. The coping strategies described were varied, but some were seen to be effective only in the short term.
The ability to cope with stress must be consciously learned and reflected upon across various causative areas. In particular, the discussion of mental strategies for dealing with repeatedly described stress amplifiers, such as one's own perfectionism, appears to be a behavioural prevention measure that is still little used by medical students. In terms of behavioural prevention, discourses on large amounts of learning material, increased support in the transition phase at the start of a degree course and more flexible studying for medical students (e.g. with a family) must be further developed.
众多国际研究和综述研究已确定医学生中存在高水平的压力和严重职业倦怠值(27%-56%)。本访谈研究的目的是深入了解学生对压力源、压力放大器和反应的看法,以及他们所采用的应对策略。研究结果将用于讨论高等教育中的预防措施。
对医学生、实习年级学生和初级医生进行了总共22次半标准化、半叙述性访谈,以获取他们对学习的回顾性看法。所有数据都进行了录音、化名处理、全文转录,并基于卡卢扎的压力模型采用定性内容分析法进行结构化和分析。
与学习相关的原因(如材料数量)、个人问题(如社会冲突)以及临床工作阶段出现的方面(如任务复杂性)被列为压力源。还描述了个人压力放大器,如完美主义。受访者表现出压力反应,如疑虑和恐惧。所描述的应对策略多种多样,但有些仅在短期内有效。
应对压力的能力必须在各个致因领域有意识地学习和反思。特别是,讨论应对反复出现的压力放大器(如自身完美主义)的心理策略,似乎是一项医学生很少采用的行为预防措施。在行为预防方面,必须进一步开展关于大量学习材料、在学位课程开始时的过渡阶段增加支持以及为医学生(如有家庭的学生)提供更灵活学习方式的讨论。