Rospenda K M, Halpert J, Richman J A
Department of Psychiatry, University of Illinois College of Medicine at Chicago 60612.
Acad Med. 1994 Jun;69(6):496-500. doi: 10.1097/00001888-199406000-00018.
Stress among medical students has been linked to poor academic performance, while supportive social relationships have been associated with the alleviation of psychological stress. This study examines social support as a potential buffer against stress and hence as a potential strengthener of students' academic performances.
A cohort of 153 third-year students at the University of Illinois College of Medicine at Chicago was asked in the fall of 1990 to complete a questionnaire assessing role stress (stress involving competing demands between school and social and/or family life), social support, and sources of support (outside or inside medical school). Grades for the five major clerkships through which all the students rotated during their third year were collected from student transcripts. Statistical analyses of the relationships among academic performance, stress, and social support included factor analysis, hierarchical multiple-regression analysis, and Pearson correlational analysis.
Data from 120 students (78% of the cohort) were used for correlational analysis. Of these students, 79 (66%) were men and 41 (34%) were women. Because eight of the questionnaires contained incomplete data, 112 questionnaires (73%) were used for multiple-regression analysis. No buffering effect was found for social support. Rather, social support from outside the medical school explained significant variance in academic performances and in role stress. Higher levels of outside support were associated with poorer clerkship grades for women, but with lower levels of stress for men. Also, total support (outside and inside combined) was negatively related to clerkship grades for the entire sample.
The results suggest that contrary to the study's hypotheses, social support in general is related to lower levels of academic performance for both men and women, and that the negative effects of support from outside the medical school context may be particularly salient for women. These results are understandable given the nature of medical training, which places great demands on students' time. Therefore, it may be more appropriate for medical schools to promote time-management strategies than support-building interventions, especially for women.
医学生的压力与学业成绩不佳有关，而支持性的社会关系则与心理压力的缓解相关。本研究考察社会支持作为压力潜在缓冲因素的作用，进而考察其作为学生学业成绩潜在增强因素的作用。
1990年秋季，要求伊利诺伊大学芝加哥医学院的153名三年级学生完成一份问卷，评估角色压力（涉及学校与社会和/或家庭生活之间相互竞争需求的压力）、社会支持以及支持来源（医学院校外部或内部）。从学生成绩单中收集了所有学生在三年级期间轮转的五个主要临床实习的成绩。对学业成绩、压力和社会支持之间关系的统计分析包括因子分析、分层多元回归分析和皮尔逊相关分析。
120名学生（占该队列的78%）的数据用于相关分析。这些学生中，79名（66%）为男性，41名（34%）为女性。由于八份问卷包含不完整数据，112份问卷（73%）用于多元回归分析。未发现社会支持的缓冲作用。相反，医学院校外部的社会支持解释了学业成绩和角色压力的显著差异。较高水平的外部支持与女性较差的临床实习成绩相关，但与男性较低的压力水平相关。此外，总体支持（外部和内部支持之和）与整个样本的临床实习成绩呈负相关。
结果表明，与研究假设相反，总体而言，社会支持与男性和女性较低的学业成绩相关，并且医学院校外部支持的负面影响对女性可能尤为显著。鉴于医学培训的性质对学生时间要求很高，这些结果是可以理解的。因此，医学院校推广时间管理策略可能比支持构建干预措施更为合适，尤其是对女性而言。
