title: A comparison of course-related stressors in undergraduate problem-based learning (PBL) versus non-PBL medical programmes.
abstract: BACKGROUND
  Medical students report high levels of stress related to their medical training as well as to other personal and financial factors. The aim of this study is to investigate whether there are differences in course-related stressors reported by medical students on undergraduate problem-based learning (PBL) and non-PBL programmes in the UK.
  
  
  METHODS
  A cross-sectional study of second-year medical students in two UK medical schools (one PBL and one non-PBL programme) was conducted. A 16-question self-report questionnaire, derived from the Perceived Medical Student Stress Scale and the Higher Education Stress Inventory, was used to measure course-related stressors. Following univariate analysis of each stressor between groups, multivariate logistic regression was used to determine which stressors were the best predictors of each course type, while controlling for socio-demographic differences between the groups.
  
  
  RESULTS
  A total of 280 students responded. Compared to the non-PBL students (N = 197), the PBL students (N = 83) were significantly more likely to agree that: they did not know what the faculty expected of them (Odds Ratio (OR) = 0.38, p = 0.03); there were too many small group sessions facilitated only by students resulting in an unclear curriculum (OR = 0.04, p < 0.0001); and that there was a lack of opportunity to explore academic subjects of interest (OR = 0.40, p = 0.02). They were significantly more likely to disagree that: there was a lack of encouragement from teachers (OR = 3.11, p = 0.02); and that the medical course fostered a sense of anonymity and feelings of isolation amongst students (OR = 3.42, p = 0.008).
  
  
  CONCLUSIONS
  There are significant differences in the perceived course-related stressors affecting medical students on PBL and non-PBL programmes. Course designers and student support services should therefore tailor their work to minimise, or help students cope with, the specific stressors on each course type to ensure optimum learning and wellbeing among our future doctors.
authors.affiliation: Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. ADL548@bham.ac.uk
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Lewis
authors.forename: Darryl A Braganza
authors.initials: DA
authors.lastname: Menezes
authors.forename: Helen E
authors.initials: HE
authors.lastname: McDermott
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Hibbert
authors.forename: Sarah-Louise
authors.initials: SL
authors.lastname: Brennan
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Ross
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jones
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D018794:Problem-Based Learning; D015397:Program Evaluation; D011594:Psychometrics; D012938:Social Perception; D013315:Stress, Psychological; D013337:Students, Medical; D011795:Surveys and Questionnaires; D006113:United Kingdom