During the proceedings of the 31st EDSA meeting of Belgrade, 1-3 April 2003, the EDSA General Assembly approved unanimously the initiation of the “Stress provoking factors in dental education” project. A joint EDSA-ADEE workshop with this topic was organized in the ADEE Congress of Dresden (3-6 September 2003) with the participation of many representatives from both associations. During the works of the congress a preliminary report was given as a paper presentation and included results from Athens Dental School, where the idea of the project was originally conceived, under the scientific mentoring of the Ass. Professor Argyro Polychronopoulou.
The aim of the study was to identify the stress provoking factors in the dental school environment and examine the effect of gender, year of study and educational system on the perceived sources of stress. The tool used for the survey, a modified IDES (Inventory of Dental Environment Stressors) questionnaire was developed in English, Greek, Spanish, Croatian and Romanian. The distribution took place in 11 countries and up to now, results are available from Croatia, Greece, Ireland, Slovenia, Spain, Sweden and the UK, totaling a sample of 1610 students who responded.
Preliminary results from the data analysis are in concordance with existing evidence in the literature, indicating that dental students are subject to numerous work-related and academic stressors that may adversely affect their physical and psychological health. The primary sources of stress seem to be related with assigned workload, performance pressure, self-efficacy beliefs, student-faculty relations and clinical training. Significant by gender and by year of study differentiations have been observed. Female students appear more concerned than their male peers in certain areas of dental education, however, socio-cultural factors may be influencing this finding. Moreover, the transition from preclinical to clinical training seems to be a critical phase for dental students; the existence of anticipatory stress has been documented during the preclinical stage, and this may precipitate burnout symptoms that affect negatively both clinical training and future professional well-being.
Further, the impact of these factors seems to be related to the educational system implemented in different dental schools. Indeed, the diversity of the educational philosophies represented in the sampled student body entails dental students trained within PBL-driven curricula, 5-year and 6-year lecture-based curricula. It is therefore, of great educational significance to assess the differences in the concerns of student cohorts with different attending systems.
This EDSA project reiterates that educational interventions may help reduce stress by eliminating inherent stress sources in the dental school environment. The reconsideration of traditional educational systems towards a more balanced, flexible and student-centred orientation should be a main priority. Balance should be sought in the curriculum designation: optimal workload must be addressed to each study level, so contextual and cognitive learning are achieved. Educational flexibility should be facilitated in such a way, so that studies are adjustable to students’ individualities, coping style and progress. A student-centred orientation will facilitate collaborative learning and interpersonal support among students, rather than competitiveness and depersonalization.
Equally significant is the acquisition by students of such skills, which would enable them to identify sources of stress, recognize personal stress reactions and learn to cope with stressful events. It should be noted that investigators have evaluated stress reduction programs for dental students, including specific courses, stress-reduction sessions, introduction to behavioural sciences, faculty-incorporated advising systems
Although some of the high-rated stresses appear to be inherent in professional education and prevalent to diverse dental educational settings, a contemporary dental school should address potential stress sources effectively. Multi-level interventions include the reconsideration of traditional curricula in the era of new pedagogical approaches and teaching methods that place students at the epicentre of the educational process. The establishment of counselling, the practical implementation of behavioural sciences and the introduction of stress management modules will facilitate the maximization of students’ coping resources, and thus, will contribute to the educational and professional well-being of dental undergraduates.

» Preliminary results, from Athens University School of Dentistry- 29th ADEE Annual Meeting, 3-6 September 2003, Dresden, Germany	Download Now (1MB)
»A multi-centre study of dental students’ perceived sources of stress- 30th ADEE Congress, 1-4 September 2004, Cardiff, Wales, UK	Download Now (43KB)