Basheer Rehman  ( Department of Oral & Maxillofacial Surgery, Khyber College of Dentistry, Peshawar, Pakistan )
Brekhna Jamil  ( Institute of Health Professions Education & Research, Khyber Medical University, Peshawar, Pakistan. )

Objective:  To determine correlation between emotional intelligence and academic stress.

Method: The quantitative correlational study was conducted in 2016 at the Khyber College of Dentistry, Peshawar, Pakistan, and comprised undergraduate dental students in the 2015-16 session regardless of age, gender and the academic year. Emotional intelligence and dental environmental stress were calculated and compared. Data was analysed using SPSS 20.

Results: Of the 298 students, 98(32.89%) were males and 200(67.11%) were females. The overall mean emotional intelligence score was 81.23±22.8, while the overall mean dental environmental stress score was 109.54±19.5 with a trend of decreasing stress levels from first to final year. A Pearson correlation test was run. Significant negative relationship was found between emotional intelligence and academic stress (p<0.05).

Conclusion: The gradual increase of emotional intelligence from first to final year showed the importance of teaching and learning methods that incorporate certain emotional intelligence trends.

Keywords: Emotional intelligence, Coping skills, Undergraduate dental students. (JPMA 71: 806; 2021)

DOI: https://doi.org/10.47391/JPMA.069

 

Introduction

 

Stress is a pressure or worry caused by problems in one’s life the perception of which is based on personal beliefs and attitudes.¹ Stress can manifest in different forms depending on the situation. Academic stress among college and university students has become a topic of interest during the last couple of decades. Manifestations of academic stress include abnormal sleep and eating behaviour as well as episodes of headache or stomach ache one or several times a week.²

Development of effective strategies is important to cope with stressful situations, and their absence can lead to ill health, negative emotional state and poor performance during active academic years.³ The academic environment of many medical schools itself is a pressure situation in the form of an authoritative rigid system where the primary stress is on competition rather than cooperation among learners. Such type of stressors not only affect undergraduate studies, but may continue during the future postgraduate study period, and later into practical life.⁴ Increased self-efficacy and control can improve academic performance by lowering the stress levels among students.⁵

Dental students encounter certain stressors during their training life, including time and scheduling pressures, managing uncooperative patients, and the highly technical and intensive nature of work.⁶ Dentistry students need to achieve certain competency level through contemporary curricula. These competencies include theoretical knowledge, and clinical and interpersonal skills. Unlike their first two years of academic studies, the third and final years are relatively stressful because of the incorporation of considerable amount of clinical work. Periodic assessment tests, accomplishment of mandatory clinical cases and case presentations add to the existing stressful life. The resulting stress can lead to a variety of psychological morbidities, including anxiety, substance abuse, low work output and burnout.⁷

Individual responses to stress vary and are affected by their cognitive appraisal of the stressful situation. Certain personality traits can affect an individual’s ability to cope with a stressful situation encountered during clinical tasks and is related to hidden curriculum rather than the taught courses. One of these personality traits is emotional intelligence (EI) that has a profound effect on the perception of emotional and stressful situations.⁸

The concept of EI used to be referred to as soft skills or communication skills, and is the ability to recognise one’s own feelings and those of others and manage those emotions to create strong relationships. It has been shown that EI affects academic and professional success and contributes to individual performance over and above the level attributable to general intelligence. Individuals with higher EI show more positive social functioning in interpersonal relationship compared to those with low EI levels. In clinical practice, EI has been found to be related to performance, higher academic achievement, empathy in medical consultation, doctor-patient relationships, clinical performance and patient satisfaction.⁹

Studies examining the relationship between EI and stress-coping ability have been rare. The current study was planned to fill the gap by trying to establish link between EI and academic stress.

 

Subjects and Methods

 

The quantitative correlational study was conducted in 2016 at the public-sector Khyber College of Dentistry, Peshawar, Pakistan, After approval from the institutional ethics review board, undergraduate dental students from first to final year in the 2015-16 session regardless of age and gender were included. Those not willing to participate and those with any known psychological morbidities were excluded.

After getting informed consent from the subjects, EI score of each student was obtained using the Emotional Quotient Self-Assessment Checklist.¹⁰ They were then given the dental environmental stress (DES) questionnaire.¹¹

Data was analysed using SPSS 20.  EI and stress levels of the students were expressed as mean and standard deviation (SD). One-way analysis of variance (ANOVA) and Tukey Post-hoc tests were performed for EI and academic stress separately to compare the mean difference among the groups.

Spearman correlation coefficient was used to check relationship between EI and academic stress at different academic levels. EI and academic stress were correlated using Pearson correlation. P<0.05 was considered statistically significant.

 

Results

 

Of the 298 students, 98(32.89%) were males and 200(67.11%) were females. Also, 71(24%) students were from the first year, 74(25%) second year, 76(25%) third year, and 77(26%) were from the final year. The overall mean age of the sample was 20.14±1.521 years.

The overall mean EI score was 81.23±22.8 and mean DES score was 109.54±19.5, showing a gradual increase in total mean EI score and a trend of decreasing stress levels from first to final year (Table 1).

There was a significant difference of academic stress and EI among the four academic groups (Tables 2-5).

There was strong positive relationship between EI and different academic levels (Table 6).

Also, there was a strong negative relationship between academic stress and academic levels (Table 7).

Finally, there was significant negative relationship between EI and academic stress (Table 8).

 

Discussion

 

The current study is the first in Pakistan to explore the correlation between EI and academic stress among dental students.

To reach certain ambitions in life, everyone needs to set certain goals. The effort to achieve these goals has the potential to fill the daily routine into with stresses and emotions. Those who are emotionally stable can handle certain difficult situations associated with stressful life.¹²

In the present study, 67.11% subjects were females. A study¹³ suggested that females outnumber males in university admissions, especially in subjects allied with medicine. In the subject of undergraduate medicine and dentistry studies, the male-to-female ratio worldwide has been reported to be 1:1.31. A Pakistani study¹⁴ carried out in Lahore, strengthened the evidence of female predominance.

In the present study, the class-wise distribution of EI score underwent a gradual increase from the first year to the final year. Srivastava et al.¹⁵ showed similar results. Shetty et al.¹⁶ showed a mean EI score of 102 while evaluating EI of first year medical students. These variations in the mean EI scores may be attributed to the differences in socio-demographic properties, sample size, sampling techniques, and most importantly, the instruments used for determination of EI. In the current study, there was a gradual increase of EI from the first to the final year, showing the importance of teaching and learning methods which incorporate certain EI trends in the students’ overall training. Although not officially implemented, there is a spark of EI training in the institution where there is gradual build-up of soft skills, including communications skills, and, hence, overall EI. In medical education the importance of this hidden curriculum^17,18 is an established fact and is as important as the taught courses. Such components of the hidden curriculum may be missing in any institution, leading to overall lack of improvement in the students’ EI level. These results cannot be wholly attributed to a fault in the teaching system, as a student’s ability to learn and accommodate certain EI traits also need improvement. Saibani et al.¹⁹ evaluated EI scores of engineering students in the first grade and compared them with the EI scores at exit level after 4-5 years. There was no significant change in the overall EI score from first grade to the exit level.

The total mean academic score of all classes in the current study was 109.54±19.5 with a trend of decreasing stress levels from the first to the final year.

A number of studies evaluating stress levels and their effect on the academic life of dental students considered the students as experiencing moderate to severe levels of stress.^20-24 Nearly all studies reported a total mean DES score in the range of 76 to 114 although there is a difference in the total mean score among different studies. The results of these studies^6,20-24 clearly are in accordance with the results of the present study.

A few studies have demonstrated different results. Naidu et al⁶ and Dahan et al.²⁴ showed that there is a variation in the levels of stress among dental students according to their age, gender and, most importantly, academic stage. They showed that dental students report higher levels of stress in the final years compared to the first and second years. Demographic and social variables, methods of teaching and the curriculum structure may vary across the globe and may have an effect on the overall DES score.^6,24

The current study’s findings related to academic stress among undergraduate dental students are similar to those of Saddki et al.²⁵ in Malaysia.

The finding of the current study about a possible a link between EI and academic stress among dental students is in agreement with the results of worldwide studies.^22-25 The ability to recognise one’s own emotions and those of others and to use them to manage emotional problems positively is the key concept of EI. Moreover, timely conflict resolution and the ability to stay calm and focussed in stressful situations are good EI indicators. Theoretically students’ stress levels must rise in response to their study levels and involvement in clinical patient care. But their levels of EI also increase and they perceive less stress.^22,23

It is recommended that EI training programmes must be used in the basic dentistry curriculum. This can be accomplished by recruiting professionals trained in health professional education. The Pakistan Medical and Dental Council (PMDC) can play a key role in designing and implementing strategies to be incorporated into the curriculum to help students in this regard.

 

Conclusion

 

There was a gradual increase in EI from the first year to the final year, showing the importance of teaching and learning methods which incorporate certain EI trends in the overall training of dental students.

 

Disclaimer: The text is based on a Masters-level thesis.

Conflict of Interest: None.

Source of Funding: None.

 

References

 

1.      Acharya S. Factors affecting stress among Indian dental students. J Dent Educ 2003;67:1140-8.

2.      Ross SE, Niebling BC, Heckert TM. Sources of stress among college students. Soc Psychol 1999;61:841-6.

3.      Mosley TH Jr, Perrin SG, Neral SM, Dubbert PM, Grothues CA, Pinto BM. Stress, coping, and well-being among third-year medical students. Acad Med 1994;69:765-7. doi: 10.1097/00001888-199409000-00024.

4.      Tyssen R, Vaglum P, Grønvold NT, Ekeberg Ø. The relative importance of individual and organizational factors for the prevention of job stress during internship: a nationwide and prospective study. Med Teach 2005;27:726-31. doi: 10.1080/01421590500314561.

5.      Heath JR, Macfarlane TV, Umar MS. Perceived sources of stress in dental students. Dent Update 1999;26:94-100. Doi: 10.12968/denu.1999.26.3.94

6.      Naidu RS, Adams JS, Simeon D, Persad S. Sources of stress and psychological disturbance among dental students in the West Indies. J Dent Educ 2002;66:1021-30.

7.      Kumar S, Dagli RJ, Mathur A, Jain M, Prabu D, Kulkarni S. Perceived sources of stress amongst Indian dental students. Eur J Dent Educ 2009;13:39-45. doi: 10.1111/j.1600-0579.2008.00535.x.

8.      Harvey A, Nathens AB, Bandiera G, Leblanc VR. Threat and challenge: cognitive appraisal and stress responses in simulated trauma resuscitations. Med Educ 2010;44:587-94. doi: 10.1111/j.1365-2923.2010.03634.x.

9.      Elam CL. Use of "emotional intelligence" as one measure of medical school applicants' noncognitive characteristics. Acad Med 2000;75:445-6. doi: 10.1097/00001888-200005000-00011.

10.    Sterrett EA. Assessing Emotional Intelligence. Braintree, MA: HRD Press, Inc; 2015, pp 1-14.

11.    Garbee WH Jr. Sources of stress in the dental school environment. LDA J. 1981;39:9-14.

12.    Gohm CL, Corser GC, Dalsky DJ. Emotional intelligence under stress: Useful, unnecessary, or irrelevant? Pers Individ Differ 2005;39:1017-28.

13.    Adams R. Gender gap in university admissions rises to record level. News release. The Guardian Media Group. [Online] 2015 [Cited 2017 December 20]. Available from URL: https://www.theguardian.com/education/2015/jan/21/gender-gap-university-admissions-record

14.    Khan JS, Tabasum S, Mukhtar O. Comparison of pre-medical academic achievement, entrance test and aptitude test scores in admission selection process. J Pak Med Assoc 2013;63:552-7.

15.    Srivastava K, Joshi S, Raichaudhuri A, Ryali V, Bhat PS, Shashikumar R, et al. Emotional intelligence scale for medical students. Ind Psychiatry J 2011;20:39-44. doi: 10.4103/0972-6748.98413.

16.    Shetty CS, Venkatappa KG, Parakandy SG, Sparshadeep EM, Das SK. Assessment of emotional intelligence in first year medical students: A questionnaire based study. IOSR J Dent Med Sci 2013;3:23-6.

17.    Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994;69:861-71. doi: 10.1097/00001888-199411000-00001.

18.    Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching. BMJ 2004;329:770-3. doi: 10.1136/bmj.329.7469.770.

19.    Saibani N, Muhamad N, Abd Wahab D, Sahari J. Level of emotional intelligence (EQ) scores among engineering students during course enrollment and course completion. Procedia Soc Behav Sci 2012;60:479-83. doi: 10.1016/j.sbspro.2012.09.410

20.    Sugiura G, Shinada K, Kawaguchi Y. Psychological well-being and perceptions of stress amongst Japanese dental students. Eur J Dent Educ 2005;9:17-25. doi: 10.1111/j.1600-0579.2004.00352.x.

21.    Peker I, Alkurt MT, Usta MG, Turkbay T. The evaluation of perceived sources of stress and stress levels among Turkish dental students. Int Dent J. 2009; 59:103-11.

22.    Pau AK, Croucher R. Emotional intelligence and perceived stress in dental undergraduates. J Dent Educ 2003;67:1023-8.

23.    Pau A, Rowland ML, Naidoo S, AbdulKadir R, Makrynika E, Moraru R, et al. Emotional intelligence and perceived stress in dental undergraduates: a multinational survey. J Dent Educ 2007;71:197-204.

24.    Dahan H, Bedos C. A typology of dental students according to their experience of stress: a qualitative study. J Dent Educ 2010;74:95-103.

25.    Saddki N, Sukerman N, Mohamad D. Association between Emotional Intelligence and Perceived Stress in Undergraduate Dental Students. Malays J Med Sci 2017;24:59-68. doi: 10.21315/mjms2017.24.1.7.