title: Measuring stress in medical education: validation of the Korean version of the higher education stress inventory with medical students.
abstract: BACKGROUND
  Medical students face a variety of stressors associated with their education; if not promptly identified and adequately dealt with, it may bring about several negative consequences in terms of mental health and academic performance. This study examined psychometric properties of the Korean version of the Higher Education Stress Inventory (K-HESI).
  
  
  METHODS
  The reliability and validity of the K-HESI were examined in a large scale multi-site survey involving 7110 medical students. The K-HESI, Beck Depression Inventory (BDI) and questions regarding quality of life (QOL) and self-rated physical health (SPH) were administered.
  
  
  RESULTS
  Exploratory factor analysis of the K-HESI identified seven factors: Low commitment; financial concerns; teacher-student relationship; worries about future profession; non-supportive climate; workload; and dissatisfaction with education. A subsequent confirmatory factor analysis supported the 7-factor model. Internal consistency of the K-HESI was satisfactory (Cronbach's α = .78). Convergent validity was demonstrated by its positive association with the BDI. Known group validity was supported by the K-HESI's ability to detect significant differences on the overall and subscale scores of K-HESI according to different levels of QOL and SPH.
  
  
  CONCLUSIONS
  The K-HESI is a psychometrically valid tool that comprehensively assesses various relevant stressors related to medical education. Evidence-based stress management in medical education empirically guided by the regular assessment of stress using reliable and valid measure is warranted.
authors.affiliation: Department of Psychology, Pusan National University, Busan, Republic of Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Shim
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Department of Psychology, Ajou University, Suwon, Republic of Korea.
authors.forename: Hana
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.|Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea.
authors.forename: Dooyoung
authors.initials: D
authors.lastname: Jung
authors.affiliation: Department of Psychology, Pusan National University, Busan, Republic of Korea.
authors.forename: Hae-Lim
authors.initials: HL
authors.lastname: Noh
authors.affiliation: Health Service Center, Seoul National University, Seoul, Republic of Korea.
authors.forename: Myoung-Sun
authors.initials: MS
authors.lastname: Roh
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea. hahmbj@gmail.com.|Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea. hahmbj@gmail.com.
authors.forename: Bong-Jin
authors.initials: BJ
authors.lastname: Hahm
mesh_terms: D001007:Anxiety / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis; D004501:Education, Medical; D055317:Evidence-Based Practice; D005163:Factor Analysis, Statistical; D006801:Humans; D007588:Job Satisfaction; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D056910:Republic of Korea; D013315:Stress, Psychological / Q000175:diagnosis*; D013337:Students, Medical / Q000523:psychology*
keywords: Higher education; Measurement; Medical students; Stress