Inventory of Sources of Stress During Medical Education - Further Validation

ABSTRACT

Introduction: The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA. Objective(s) To further validate the ISSME using Confirmatory Factor Analysis and to analyze[ATP1] the psychometric properties of a new version including additional sources of stress. Method(s) Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls);they answered an online survey including the ISSME and other validated questionnaires Maslach Burnout Inventory - Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS). Result(s) Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (chi2 /df=3.274;RMSEA=.0581, p<.001;CFI=.917;TLI=.904, GFI=.919). The Cronbach's alfas were alpha=.897 for the total and from alpha=.669 (F2-HD) to alpha=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, alpha=.543) and two additional COVID-19 stress-related-items (F7, alpha=.744) also showed acceptable fit indexes (chi2 /df=3.513;RMSEA=.061, p<.001;CFI=.88.;TLI=.866, GFI=.892). This new version's alpha was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students. Conclusion(s) This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.