title: Stress and Academic Performance in Dental Students: The Role of Coping Strategies and Examination-Related Self-Efficacy.
abstract: Academic stress negatively affects students' performance. However, little is known of the processes that may be involved in this association. This study aimed to analyze how other variables such as coping strategies and exam-related self-efficacy could be related to academic stress and performance for dental students. An online survey, including measures of coping strategies, perceived stress, exam-related self-efficacy, and academic performance, was completed by undergraduate dental students in Madrid, Spain. Of the 275 students invited to take the survey, 201 participated (response rate 73.6%). Rational coping strategies (problem-solving, positive reappraisal, seeking social support) were negatively associated with perceived stress (β=-0.25, p<0.01), whereas emotional coping strategies (venting negative emotions, negative auto-focus) were linked to increased academic stress (β=0.34, p<0.01). Moreover, rational and emotional coping strategies were, respectively, positively (β=0.16, p<0.05) and negatively (β=-0.22, p<0.01) associated with students' exam-related self-efficacy, and this relation was found to be partially mediated by the students' perceived stress (β=-0.30, p<0.01). Experiencing higher levels of stress during the examination period was found to be associated with poorer average grades (β=-0.21, p<0.01), but students' exam-related self-efficacy partially mediated this relation (β=0.23, p<0.01). Those students who perceived themselves as more efficient in completing examinations reported better grades. Using adequate coping strategies (i.e., rational coping) may help to reduce stress for dental students and, through their effect on exam-related self-efficacy appraisals, contribute to improved academic performance.
authors.affiliation: Dr. Crego is Associate Professor, Department of Psychology and Health, Faculty of Health and Education Sciences, Madrid Open University, Collado-Villalba, Spain; Dr. Carrillo-Diaz is Assistant Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain; Dr. Armfield is Associate Professor, Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia; and Dr. Romero is Associate Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain. antonio.crego@udima.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Crego
authors.affiliation: Dr. Crego is Associate Professor, Department of Psychology and Health, Faculty of Health and Education Sciences, Madrid Open University, Collado-Villalba, Spain; Dr. Carrillo-Diaz is Assistant Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain; Dr. Armfield is Associate Professor, Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia; and Dr. Romero is Associate Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Carrillo-Diaz
authors.affiliation: Dr. Crego is Associate Professor, Department of Psychology and Health, Faculty of Health and Education Sciences, Madrid Open University, Collado-Villalba, Spain; Dr. Carrillo-Diaz is Assistant Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain; Dr. Armfield is Associate Professor, Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia; and Dr. Romero is Associate Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Armfield
authors.affiliation: Dr. Crego is Associate Professor, Department of Psychology and Health, Faculty of Health and Education Sciences, Madrid Open University, Collado-Villalba, Spain; Dr. Carrillo-Diaz is Assistant Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain; Dr. Armfield is Associate Professor, Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia; and Dr. Romero is Associate Professor, Department of Pediatric Dentistry, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Martín
authors.initials: M
authors.lastname: Romero
mesh_terms: D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001290:Attitude; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving; D020377:Self Efficacy; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D013335:Students, Dental / Q000523:psychology*; D058013:Test Taking Skills / Q000523:psychology; D055815:Young Adult
keywords: academic performance; coping strategies; dental education; dental students; examinations; self-efficacy; stress