Evaluation the validity and reliability of the perceived medical school stress scale in Turkish medical students

Abstract

Medical education can be a challenging and stressful process. Additional stressors can make the medical education process even more complex and impair a student’s attention and concentration. To the authors’ knowledge, there is no valid and reliable scale to measure medical school stress in Turkish medical students. Therefore, this study aimed to determine the validity and reliability of the Perceived Medical School Stress (PMSS) Scale in Turkish medical students. The Perceived Medical School Stress Scale is a self-assessment tool developed to measure medical school-induced stress in medical students. It consists of 13 items divided into two subdimensions. Scale items are answered using a four-point (0–4) Likert system The total score that can be obtained from the PMSS ranges from 0 to 52, with higher scores indicating higher levels of perceived stress. First, the scale was applied as a pilot to 52 students by performing the scale’s back-and-forth translation into Turkish. Then, the scale was applied to 612 volunteer medical students to ensure validity. Convergent validity and confirmatory factor analysis are used to assess the construct validity of a scale. Test-retest, item correlations, and Cronbach’s alpha coefficients are used to evaluate the reliability of a scale. As a result of confirmatory factor analysis, the two-factor structure of the original scale was confirmed. The fit indices of the model obtained showed excellent fit. The Generalized Anxiety Disorder-7 (GAD-7) Scale was used for convergent validity. The GAD-7 is a self-assessment tool that measures the level of generalized anxiety. It is answered with a four-point Likert scale for the last two weeks. The score that can be obtained from the scale is between 0–21. A score of ten or more indicates possible anxiety disorder. The students’ mean perceived medical school stress score was 39.80±8.09, and their GAD-7 score was 11.0±5.5. A significant positive relationship was found between the total scores of the scales (r = .48, P < .001). The Cronbach’s alpha value of the scale was .81, and test-retest reliability was significant for all scale items (P < .001 for all). No item was deleted according to Cronbach’s alpha values and item-total correlations. There was no significant relationship between Turkish version of the PMSS and GAD-7 scores and age, sex, income status, tobacco use, or exercise (P>.05). The Turkish version of the Perceived Medical School Stress Scale is a valid and reliable scale that can be used to investigate the medical school-specific stress of students.