title: Measurement of specific medical school stress: translation of the "Perceived Medical School Stress Instrument" to the German language.
abstract: OBJECTIVE
  Medical students encounter specific stressors during their studies. As a result, they develop anxiety, depression and burnout symptoms more frequently than their similarly aged, but employed counterparts. In 1984, Vitaliano et al. published a 13-item instrument for the measurement of stress specific to medical school: the "Perceived Medical School Stress Instrument" (PMSS). Since then, it has been widely applied and validated in English-speaking countries. No German version of the PMSS exists to date. Thus, our aim was to translate the instrument into the German language in order to be able to measure medical school stress in German-speaking countries.
  
  
  METHODS
  The items of the PMSS were translated into German by three separate researchers. The resulting translations were compared and combined with each other to establish a first German version of each item in the PMSS. These items were then translated back into English by two native English speakers to validate the correct primary translation. Based on a revised German version, a cognitive debriefing with 19 German medical students and a theoretical testing on 169 German medical students, the final German translations for each of the 13 items were determined.
  
  
  RESULTS
  The PMSS was easily translated into German and there was a high congruency between the primary translations into German and the secondary translations back into English. Incongruities between the translations were solved quickly. The assessment of the German equivalent of the PMSS showed good results regarding its reliability (Cronbach's Alpha 0.81).
  
  
  CONCLUSIONS
  A German version of the PMSS is now available for measuring the medical school related stress in German-speaking countries.
authors.affiliation: University of Lübeck, Institute for Social Medicine and Epidemiology, Lübeck, Germany. thomas.koetter@uksh.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Kötter
authors.forename: Edgar
authors.initials: E
authors.lastname: Voltmer
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D002055:Burnout, Professional / Q000175:diagnosis / Q000523:psychology; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004501:Education, Medical; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000150:complications*; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014175:Translating
keywords: Medical education; Questionnaire; Stress; Translation