Abstract
Objectives Many medical students experience career decision-making stress in the
final phase of training. Yet, the factors that induce or reduce career decision- making
stress and how progression in their clerkships relates to these factors are unknown.
This knowledge gap limits the possibilities for medical schools to develop and implement
interventions targeting students’ career decision-making stress. This study explores
content, process, and context factors that may affect career decision-making
stress.
Methods Using cross-sectional survey data from medical master students (n=
507), we assessed content (future work self ), process (choice irreversibility, time
pressure, career decision-making self-efficacy), and context (supervisory support,
medical school support, study load, competition) factors and their relationships with
career decision-making stress. The hypothesized relationships were tested with
structural equation modelling.
Results A clearer future work self and higher
career decision self-efficacy were associated with lower career decision-making stress,
while experienced time pressure, competition, and study load were associated with higher
career decision-making stress. Choice-irreversibility beliefs, supervisory support, and
medical school support were unrelated to career decision-making stress. As students’
clerkships progressed, they gained a clearer future work self, but also experienced more
time pressure.
Discussion Clinical clerkships help students to form a clearer
future work self, which can diminish career decision-making stress. Yet, students also
experience more time pressure as the period of clerkships lengthens, which can increase
career decision-making stress. A school climate of high competition and study load seems
to foster career decision-making stress, while school support hardly seems effective in
diminishing this stress.
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5 articles.
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