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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 2  |  Page : 96-103

Aggravating factor for course requirement stressor among dental students


1 Department of Dental Clinics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
2 Department of Dental Clinics, New Najran General Hospital, Najran, Kingdom of Saudi Arabia
3 Department of Dental Clinics, Najran Specialist Dental Center, Najran, Kingdom of Saudi Arabia
4 Department of Dental Clinics, Primary Health Care Center, Unaizah, Kingdom of Saudi Arabia

Date of Web Publication15-Sep-2017

Correspondence Address:
Fahad Saleh Al Sweleh
Department of Dental Clinics, College of Dentistry, King Saud University, P.O. BOX: 35825, Riyadh 11498
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjhs.sjhs_79_16

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  Abstract 

Objective: To determine the main factor that can aggravate course requirement stressor among dental students at College of Dentistry, King Saud University. Materials and Methods: A cross-sectional study was conducted in College of Dentistry in King Saud University, Riyadh, Saudi Arabia. This study included all undergraduate students, who finished their training in the clinics in 2012–2013. The data were collected using a paper-based questionnaire that utilized a 5-Likert scale. Results: The overall response was 80.4% (283/352). Students perceived that stress scale was more than moderate (6.5–7.6). Third-year students in operative dentistry course reported the aggravating factor (s) of course requirement stressor are “number of clinical requirements” and “availability of suitable patients” (57.5%) and in periodontics is “availability of suitable patients” (50.5%). Fourth-year students in removable prosthodontics reported the aggravating factor(s) is “availability of suitable patients” (56.3%), in fixed prosthodontics are “availability of well-equipped dental clinics” and “fluency of laboratory work” (52.4%), in operative dentistry is “number of clinical requirements” (61.3%), in periodontics are “number of clinical requirements” and “availability of well-equipped dental clinics” (48.5%), and in endodontics is “availability of well-equipped dental clinics” (53.3%). Fifth-year students in removable prosthodontics reported the aggravating factor(s) is fluency of laboratory work (60.9%), in fixed prosthodontics are “availability of well-equipped dental clinics” (60%) and “fluency of laboratory work” (60%), and in comprehensive dental clinic are “availability of suitable patients” and “fluency of laboratory work” (62.7%). Conclusions: Students reported that common aggravating factors for course requirement stressor are “number of clinical requirements,” “availability of suitable patients,” “availability of well-equipped dental clinics,” and “fluency of laboratory work.”

Keywords: Clinical requirements, course requirement, dental students, stress, suitable patients


How to cite this article:
Al Sweleh FS, Aldhili MK, Alyami YA, Alotaibi MK. Aggravating factor for course requirement stressor among dental students. Saudi J Health Sci 2017;6:96-103

How to cite this URL:
Al Sweleh FS, Aldhili MK, Alyami YA, Alotaibi MK. Aggravating factor for course requirement stressor among dental students. Saudi J Health Sci [serial online] 2017 [cited 2021 Jan 21];6:96-103. Available from: https://www.saudijhealthsci.org/text.asp?2017/6/2/96/214856


  Introduction Top


Stress is a common problem in the daily life of people experienced during work, study, and social activities. Stress was defined and described by many authors with different explanations.

Selye is considered the father of stress research. In 1936, he defined stress as “the nonspecific response of the body to any demand made on it;” then, later, in 1976, he modified the definition of stress to be “a state manifested by a specific syndrome which consists of all the nonspecifically induced changes within the biological system.”[1],[2]

Cox (1978) defined stress as “a stimulus, a response, or the result of an interaction between the two, with the interaction described in terms of some imbalance between the person and the environment.”[3] Baum [4] also defined stress “as a negative emotional experience accompanied by predictable biochemical, physiological, and behavioral changes that are directed toward adaptation either by manipulating the situation to alter the stressor or by accommodating its effects.”

The previous different definitions revealed that the stress affects both the body and the mind of human. However, some stress is desirable and can cause positive effect on the individual while chronic and undesirable stress can cause negative effect on the individual.

Many physiological, psychological, and behavioral signs and symptoms were mentioned in the literature related to stress. Physiological effects include fatigue, tension, dizziness, sweating, tachycardia, gastrointestinal symptoms, weight loss, and physical complaints. Psychological effects include anxiety, burnout insomnia, depressive symptoms, emotional exhaustion, worry, lack of confidence, unhappiness, and apathy. Behavioral effects include crying, sleeplessness, cynicism, nervousness, hostility, alcohol consumption, and cigarette smoking.[5],[6],[7],[8],[9],[10],[11],[12]

Approximately, 600 articles were published that discussed and investigated medical school stress alone.[13] Alzahem et al.[6] in their systemic review for dental stress reported that there were many indicators of stress such as low grades and marks, low academic achievement, unprofessional attitudes, illicit drug use, cigarettes smoking, lack of social integration, depersonalization, depressed mood, and memory problem.

Many students have experienced some form of stress during their studying. Therefore, signs and symptoms of stress such as anxiety and depressive symptoms can be seen among students.[7] However, there was variation in the literature regarding perceiving stress among gender; female students perceived more stress generally than male students.[7],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23]

Several sources of stress among dental students were identified by studies conducted in different countries. For example, lack of leisure time, procrastination, meeting faculty expectations for workload, and feeling powerless in the system were reported as major concerns in a national survey of Canadian dental students,[24] while examinations and grades were found to be the most potent stressors in an Australian and Jordanian study.[14],[25] In Europe, limited leisure time, examination anxiety, and adapting to the clinical phase of dental education were identified as sources of stress in a study conducted in three European dental schools.[26]

Moreover, the assigned workload, students' self-efficacy beliefs, limited time for working, patient tardiness or no show for appointments, academic overload, completing clinical requirements, and criticism by supervisor and excessive work are considered sources of stress on students.[6],[16],[27]

Al-Saleh et al. investigated the possible stressors faced by dental students in the Kingdom of Saudi Arabia.[28] The authors reported that lack of time for relaxation, amount of study load, and patient being late or not showing were perceived as the major problems among the surveyed dental students.[28] The sources and levels of stress and effective coping strategies for dental students were evaluated by Al-Sowygh.[29] The author concluded that the surveyed dental students displayed relatively high perceived stress scores. Moreover, the perceived stress of female students, married students, and those at a higher level of the study were found to be more as compared to male students, single students, and those at a lower level of study, respectively.[29]

Dental students perceived that they experienced more stress than medical students.[30] Therefore, this problem may negatively affect the academic performance of dental students.[6]

After searching on websites, PubMed, Google Scholar, Yahoo, Elsevier, SAGE Online, Education Resources Information Center, British Medical Journal, Journal of Dentistry, European Journal of Dental Education, and Journal of Dental Education, no studies specifically determine the main factor that can aggravate course requirement stressor in dental education were found. Therefore, there seems to be a distinct lack of information regarding perspectives of dental student regarding clinical course requirement. The aim of this study is to determine the main factor that can aggravate course requirement stressor among dental students at the College of Dentistry of King Saud University.


  Materials and Methods Top


A cross-sectional study design was used in this study to determine factors of aggravating stress of dental students. This study was conducted in College of Dentistry, King Saud University (KSU), in Riyadh, Saudi Arabia, which is the oldest dental college in the Kingdom established in 1957 as public college, graduates approximately 100 students/year, and accommodates approximately 595 students in all levels (300 male and 185 female students). Dental students must complete all clinical course requirements to pass the course.

This study included all undergraduate students, who finished their training in the clinics in 2012–2013 (e.g. 3rd-, 4th-, and 5th-year students). The 1st- and 2nd-year students were excluded from the study because they did not start training in the dental clinics.

Research approval (No. IR0046) was obtained from College of Dentistry, Research Center of King Saud University, before the data were collected.

A pilot test was conducted by distributing the questionnaire to 15 students who finished the previous academic year and were therefore excluded from the study.

This study used a design to collect numerical data at a point in time at the end of the clinical training. The data were collected using a paper-based questionnaire that utilized a 5-Likert scale from 1 (strongly disagree) to 5 (strongly agree). Researchers distributed the questionnaire to the dental students face-to-face in the classroom. An introductory first page was attached to the questionnaire explaining the purpose of the study and assuring the confidentiality of the participants' information.

The questionnaire had stress scale from 0 (not at all stressful) to 10 (extremely stressful) and nine factors after an initial demographic section. This questionnaire was validated by three experts: two are faculties from the College of Dentistry and one is a psychologist from the College of Education, KSU.

In the questionnaire, students were asked to mark which among the list of nine factors can aggravate clinical course requirement stressor. The factors included number of clinical requirements, number of clinical sessions available to finish requirement, availability of suitable patients, number of instructors in the clinical sessions, number of students in the course, number of assistants in the clinics, availability of well-equipped dental clinics, fluency of laboratory work, and lack of enough time for relaxation between two sessions.

Data were entered into and analyzed using the SPSS software version 20 (IBM, New York, USA). Subgroups were studied based on gender and level of student. Frequency tables were presented for all items. A t-test was used to determine if there is any significant difference in the mean of stress scale between two groups (gender and levels). Proportional t-test was used to determine if there is a significant difference in agreement response between the two groups (gender and level). A P < 0.05 was considered statistically significant for all statistical tests.


  Results Top


The overall response rate for completion of the survey was 80.4% (283/352). Response rate for male students was 66.4% (188/283) and for female students was 33.6% (95/283). The demographic characteristics of the study population are given in [Table 1].
Table 1: Demographic characteristics of the study population

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The mean and standard deviation stress scale according to gender are given in [Table 2]. Generally, students perceived that stress scale was more than moderate which is 6.5–7.6 for all courses, except the periodontics course which had a low mean stress scale of 4.7. The t-test showed statistically significant difference between mean stress scale of male students as compared to that of female students in the 3rd-year periodontics course (male 6.51 and female 4.70, P = 0.005).
Table 2: The mean and standard deviation stress scale according to gender

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[Table 3] shows the percentage of aggravating factors of course requirement stressor for the 3rd-year students according to courses and gender. The majority of 3rd-year male students (54.3%) in the operative dentistry course reported that the “availability of well-equipped dental clinics” is the main aggravating factor for course requirement while the female students (77.4%) reported that the “availability of suitable patients” is the main aggravating factor. The aggravating factors of requirement stressor in operative dentistry course for all 3rd-year students are “number of clinical requirements” and “availability of suitable patients” (57.5%) as shown in [Table 4].
Table 3: Percentage of aggravating factors of course requirement stressor among 3rd-year students

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Table 4: Comparing percentage of aggravating factors of course requirement stressor between 3rd-, 4th-, and 5th-year students

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In the periodontics course, the majority of male students (45.7%) reported that the “number of clinical sessions available to finish requirement” is the main aggravating factor while the female students (71%) reported that the “availability of suitable patients” is the main aggravating factor. The aggravating factor of requirement stressor in periodontics course for all 3rd-year students is “availability of suitable patients” (50.5%) as shown in [Table 4].

[Table 5] shows the percentage of aggravating factors of course requirement stressor for 4th-year students according to courses and gender. The majority of 4th-year male students (72.3%) in removable prosthodontics course reported that the “availability of suitable patients” and “availability of well-equipped dental clinics” are the main aggravating factors for course requirement stressor while female students (80%) reported that the “availability of suitable patients” is the main aggravating factor. The aggravating factor of requirement stressor in removable prosthodontics course for all 4th-year students is “availability of suitable patients” (56.3%) as shown in [Table 4].
Table 5: Percentage of aggravating factors of course requirement stressor among 4th-year students in removable and fixed prosthodontics, operative dentistry, periodontics, endodontics courses

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In the fixed prosthodontics course, the majority of male students (70.2%) reported that the “availability of suitable patients” is the main aggravating factor while female students (76.7%) reported “availability of well-equipped dental clinics.” The aggravating factors of requirement stressor in fixed prosthodontics course for all 4th-year students are “availability of well-equipped dental clinics” and “fluency of laboratory work” (52.4%) as shown in [Table 4].

The majority of male (80.9%) and female (83.3%) students, as well as all the 4th-year students (61.2%) in operative dentistry course, reported that the “number of clinical requirements” is the main aggravating factor as shown in [Table 4].

In the periodontics course, the majority of male students (66%) reported that the “number of clinical requirements” is the main aggravating factor while female students (73.3%) reported that the “availability of suitable patients” is the main aggravating factor. The aggravating factors of requirement stressor in periodontics course for all 4th-year students are “number of clinical requirements” and “availability of well-equipped dental clinics” (48.5%) as shown in [Table 4].

Furthermore, in the endodontic course, the majority of male students (72.3%) reported that the “availability of well-equipped dental clinics” is the main aggravating factor for course requirement stressor while female students (76.7%) reported that the “availability of well-equipped dental clinics” and (76.6%) “availability of suitable patients” are the main aggravating factors. The aggravating factors of requirement stressor in endodontics course for all 4th-year students are “availability of well-equipped dental clinics” (53.3%).

[Table 6] shows the percentage of aggravating factors of course requirement stressor for 5th-year students according to courses and gender. The majority of male students (54.7%) in removable prosthodontics course reported that the “number of assistants in the clinics” and “availability of well-equipped dental clinics” are the main aggravating factors for course requirement stressor while female students (73%) reported that the “fluency of laboratory work” is the main aggravating factor. The aggravating factor of requirement stressor in removable prosthodontics course for all 5th-year students is fluency of laboratory work (60.9%) as shown in [Table 4].
Table 6: Percentage of aggravating factors of course requirement stressor among 5th-year students in (prosthodontics, comprehensive dental clinic) course

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In the fixed prosthodontics course, the majority of male students (62.7%) reported that the “number of clinical requirements” is the main aggravating factor while female students (64.9%) reported that the “number of clinical sessions available to finish requirement” and “number of instructors in the clinical sessions” are the main aggravating factors. The aggravating factors of requirement stressor in fixed prosthodontics course for all 5th-year students are “availability of well-equipped dental clinics” (60%) and “fluency of laboratory work” (60%) as shown in [Table 4].

In the comprehensive dental clinic course, the majority of male students (58.7%) reported that the “number of clinical requirements” and “availability of suitable patients” are the main aggravating factors for course requirement while female students (70.3%) reported that the “number of instructors in the clinical sessions” and “fluency of laboratory work” are the main aggravating factors. The aggravating factors of requirement stressor in comprehensive dental clinic course for all 5th-year students are “availability of suitable patients” and “fluency of laboratory work” (62.7%).

[Table 4] shows that there were statistically significant differences between 3rd-year and 4th-year students who reported “number of students in the course” as the main aggravating factor of course requirement stressor in the operative dentistry course (3rd year is 50.5% and 4th year is 34.9%, P = 0.024). Furthermore, there were statistically significant differences between 4th-year and 5th-year students who reported that the “number of clinical requirements” in Fixed Prosthodontics course (4th year is 42.7% and 5th is 36.6%, P = 0.002).


  Discussion Top


Many studies found that dental students perceive stress due to difficulty to complete clinical requirements.[6],[29],[30],[31] The current study aimed to determine the main factor that can aggravate course requirement stressor among dental students at the College of Dentistry in KSU in Riyadh, Saudi Arabia according to their level and gender. The result of the current study revealed that the level of stress scale among the surveyed Saudi dental students was more than the middle. The perception of stress scale was influenced by the level and gender. Some studies have reported the existence of gender differences in stress perception among dental students,[14],[20] whereas some other studies did not find any such differences.[8],[17] The mean stress scale in the present study was higher among 3rd-year male students as compared to female students in periodontics course. This partially corroborates with the results of a previous Indian study [23] which reported that males suffered greater stress than females.

The 3rd-year students perceived that “availability of suitable patients” in operative and periodontology course is an aggravating factor; this finding may be due to early clinical exposure to the students and limited suitable patient to their level. Moreover, students in this level are not familiar with new situations and responsibility. Other study refers this stress to the effect of transition from preclinical to clinical level.[29]

Students in 3rd and 4th year perceived that the number of clinical requirements in operative and periodontology courses is the main aggravating factor. This finding is in agreement with the study of Al-Sowygh which found that “clinical requirements” was the greatest stressor for 4th- and 5th-year students.[29] Perceiving this factor may be due to large number of clinical procedures that student should finish to pass the course. Other studies found that completing clinical requirements and workload in clinical years were substantial stressors.[25],[28] Increase number of clinical requirement is type of more workload on students. The Greek dental students reported that one of the sources of stress in dental college is assigned workload.[27] Dodge et al.[32] studied the effect of a clinical program based on patient needs not unit requirements on academic achievement. They found that the nonrequirement group had significantly higher academic achievement and significantly out produced compared to their classmates (requirement group).

The 3rd-year students in operative dentistry and periodontology and 4th year in periodontology, removable prosthodontics, and endodontic course perceived that the “availability of suitable patients” was the main aggravating factor which is in agreement with other studies which found that getting suitable patients cause more stress to the students.[28],[29] Completing treatment plan of the patient is a must to pass the course that is why student wants suitable patient match the criteria of the course level to avoid any delay to the student. Getting suitable patient aggravates requirement stressor because criteria of suitable patient such as having simple procedure for early clinical course and having high level of compliance are not easy for student. For example, if patients being late or not showing for their appointment, this will cause more stress for student as mentioned by other studies.[22],[25],[28] Similar findings were reported with dental student in Jordan,[25] Singapore,[33] United Kingdom,[16] and Australia.[14]

The 4th-year (in fixed prosthodontic) and 5th-year students (in fixed prosthodontics, removable prosthodontics, and comprehensive dental clinic) perceived that the “fluency of laboratory work” was main aggravating factor. These findings attributed to number of cases and clinical requirements of prosthodontics courses which need multiple laboratory procedures and cooperation from laboratory technician. One study found that stress levels increase during the 5th year of the program due to more work during this year.[20]

Generally, perceiving aggravating factor increases from 3rd- to 4th-year students in similar courses such as operative dentistry and periodontology. This finding was attributed to increase the number of clinical requirements in the 4th year compared to the 3rd year.

Commonly reported aggravating factors in 3rd-, 4th-, and 5th-year students were “number of clinical requirements,” “availability of suitable patients,” and “fluency of laboratory work.” These findings were not in accordance with the results of an Indian study conducted by Kumar et al.,[34] which evaluated the perceived sources of stress among dental undergraduate students at a private dental institution. The results showed that the two highest stressors among 3rd- and 4th-year male students were “examination and grades” and “atmosphere created by clinical supervisors.”[34]

Dental students need counseling and help from psychologist provided by the college to overcome any stress source or effect.[6] Furthermore, students need stress management program during their study to prevent and manage the stress early to support students effectively and academically by explaining the expected outcome of stress.[6]

Some limitations of this study need to be considered when interpreting the results. The 4th-year female students did not answer the stress scale question which resulted in lack of data, limit interpretation of the findings for comparison of stress scale of female students at different levels. Another limitation was that it was done in one College of Dentistry that reflects local condition of students which limit generalizability of the findings. Furthermore, this study was conducted in one academic year only which did not reflect how the students perceive over long time to determine the aggravating factor of stressor for many years.

Further, more study is needed to evaluate the effect of modified clinical requirement on students' stress. A prospective longitudinal study might be encouraged to follow and monitor dental student stressors change through students' academic progress.


  Conclusions Top


Students perceived that stress scale is more than moderate in many courses. The present study showed that common aggravating factors for course requirement stressor are as follows:

  • ”Number of clinical requirements” with 3rd- and 4th-year students (in operative dentistry) and with 4th-year students (in periodontology)
  • ”Availability of suitable patients” with 3rd-year students (in operative dentistry and periodontology) and with 4th-year students (in removable prosthodontics)
  • ”Availability of well-equipped dental clinics” with 4th-year students (in periodontics and fixed prosthodontics) and with 5th-year students (in fixed prosthodontics)
  • ”Fluency of laboratory work” with 4th-year students (in fixed prosthodontics) and with 5th-year students (in removable prosthodontics and fixed prosthodontics).


Modifying course requirement is necessary for learning not for performing. Competency-based learning is the trend of education in the world. Implementing stress management programs in the college is important to reduce the complication of stress.

Acknowledgments

We wish to thank the College of Dentistry Research Center at the King Saud University and Mr. Nassr Al-Maflehi for his guidance in statistical analysis. We also wish to thank the students for their participation in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
The American Institute of Stress. What is Stress?; 2014. Available from: http://www.stress.org/what-is-stress/. [Last cited on 2014 Feb 01].  Back to cited text no. 1
    
2.
Selye H. Wikipedia; 2014. Available from: http://www.en.wikipedia.org/wiki/Hans_Selye. [Last cited on 2014 Feb 01].  Back to cited text no. 2
    
3.
Mackay C, Cox T, Burrows G, Lazzerini T. An inventory for the measurement of self-reported stress and arousal. Br J Soc Clin Psychol 1978;17:283-4.  Back to cited text no. 3
[PUBMED]    
4.
Baum A. Stress, intrusive imagery, and chronic distress. Health Psychol 1990;9:653-75.  Back to cited text no. 4
[PUBMED]    
5.
Wexler M. Mental health and dental education. J Dent Educ 1978;42:74-7.  Back to cited text no. 5
[PUBMED]    
6.
Alzahem AM, van der Molen HT, Alaujan AH, Schmidt HG, Zamakhshary MH. Stress amongst dental students: A systematic review. Eur J Dent Educ 2011;15:8-18.  Back to cited text no. 6
[PUBMED]    
7.
Peterlini M, Tibério IF, Saadeh A, Pereira JC, Martins MA. Anxiety and depression in the first year of medical residency training. Med Educ 2002;36:66-72.  Back to cited text no. 7
    
8.
Muirhead V, Locker D. Canadian dental students' perceptions of stress and social support. Eur J Dent Educ 2008;12:144-8.  Back to cited text no. 8
[PUBMED]    
9.
Cecchini JJ, Friedman N. First-year dental students: Relationship between stress and performance. Int J Psychosom 1987;34:17-9.  Back to cited text no. 9
[PUBMED]    
10.
Grandy TG, Westerman GH, Lupo JV, Combs CG. Stress symptoms among third-year dental students. J Dent Educ 1988;52:245-9.  Back to cited text no. 10
[PUBMED]    
11.
Knudsen W. Quality of life of the dental student. Tandlakartidningen 1978;70:183-6.  Back to cited text no. 11
[PUBMED]    
12.
Tedesco LA. A psychosocial perspective on the dental educational experience and student performance. J Dent Educ 1986;50:601-5.  Back to cited text no. 12
[PUBMED]    
13.
Shapiro SL, Shapiro DE, Schwartz GE. Stress management in medical education: A review of the literature. Acad Med 2000;75:748-59.  Back to cited text no. 13
[PUBMED]    
14.
Sanders AE, Lushington K. Sources of stress for Australian dental students. J Dent Educ 1999;63:688-97.  Back to cited text no. 14
[PUBMED]    
15.
Morse Z, Dravo U. Stress levels of dental students at the Fiji School of medicine. Eur J Dent Educ 2007;11:99-103.  Back to cited text no. 15
[PUBMED]    
16.
Heath JR, Macfarlane TV, Umar MS. Perceived sources of stress in dental students. Dent Update 1999;26:94-8, 100.  Back to cited text no. 16
[PUBMED]    
17.
Sofola OO, Jeboda SO. Perceived sources of stress in Nigerian dental students. Eur J Dent Educ 2006;10:20-3.  Back to cited text no. 17
[PUBMED]    
18.
Sugiura G, Shinada K, Kawaguchi Y. Psychological well-being and perceptions of stress amongst Japanese dental students. Eur J Dent Educ 2005;9:17-25.  Back to cited text no. 18
[PUBMED]    
19.
Rosli TI, Abdul Rahman R, Abdul Rahman SR, Ramli R. A survey of perceived stress among undergraduate dental students in Universiti Kebangsaan Malaysia. Singapore Dent J 2005;27:17-22.  Back to cited text no. 19
[PUBMED]    
20.
Naidu RS, Adams JS, Simeon D, Persad S. Sources of stress and psychological disturbance among dental students in the West Indies. J Dent Educ 2002;66:1021-30.  Back to cited text no. 20
[PUBMED]    
21.
Westerman GH, Grandy TG, Ocanto RA, Erskine CG. Perceived sources of stress in the dental school environment. J Dent Educ 1993;57:225-31.  Back to cited text no. 21
[PUBMED]    
22.
Pau AK, Croucher R. Emotional intelligence and perceived stress in dental undergraduates. J Dent Educ 2003;67:1023-8.  Back to cited text no. 22
[PUBMED]    
23.
Acharya S. Factors affecting stress among Indian dental students. J Dent Educ 2003;67:1140-8.  Back to cited text no. 23
[PUBMED]    
24.
Bradley IF, Clark DC, Eisner JE, De Gruchy K, Singer DL, Hinkleman K, et al. The student survey of problems in the academic environment in Canadian dental faculties. J Dent Educ 1989;53:126-31.  Back to cited text no. 24
[PUBMED]    
25.
Rajab LD. Perceived sources of stress among dental students at the University of Jordan. J Dent Educ 2001;65:232-41.  Back to cited text no. 25
[PUBMED]    
26.
Pöhlmann K, Jonas I, Ruf S, Harzer W. Stress, burnout and health in the clinical period of dental education. Eur J Dent Educ 2005;9:78-84.  Back to cited text no. 26
    
27.
Polychronopoulou A, Divaris K. Perceived sources of stress among Greek dental students. J Dent Educ 2005;69:687-92.  Back to cited text no. 27
    
28.
Al-Saleh SA, Al-Madi EM, Al-Angari NS, Al-Shehri HA, Shukri MM. Survey of perceived stress-inducing problems among dental students, Saudi Arabia. Saudi Dent J 2010;22:83-8.  Back to cited text no. 28
    
29.
Al-Sowygh ZH. Academic distress, perceived stress and coping strategies among dental students in Saudi Arabia. Saudi Dent J 2013;25:97-105.  Back to cited text no. 29
    
30.
Murphy RJ, Gray SA, Sterling G, Reeves K, DuCette J. A comparative study of professional student stress. J Dent Educ 2009;73:328-37.  Back to cited text no. 30
    
31.
Muirhead V, Locker D. Canadian dental students' perceptions of stress. J Can Dent Assoc 2007;73:323.  Back to cited text no. 31
    
32.
Dodge WW, Dale RA, Hendricson WD. A preliminary study of the effect of eliminating requirements on clinical performance. J Dent Educ 1993;57:667-72.  Back to cited text no. 32
    
33.
Yap AU, Bhole S, Teo CS. A cross-cultural comparison of perceived sources of stress in the dental school environment. J Dent Educ 1996;60:459-64.  Back to cited text no. 33
    
34.
Kumar S, Dagli RJ, Mathur A, Jain M, Prabu D, Kulkarni S. Perceived sources of stress amongst Indian dental students. Eur J Dent Educ 2009;13:39-45.  Back to cited text no. 34
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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