A survey study to assess stress and coping during medical education in a Jordanian university

Medical education's rigorous demands are known to cause significant stress among students. The study investigated how students evaluate stressors and apply coping strategies to handle perceived stress and examined how these processes relate to sociodemographic and lifestyle characteristics. The study was guided by the Transactional Model of Stress and Coping (TMSC), and employed an online cross-sectional survey targeting medical students at a Jordanian university (Yarmouk University). The questionnaire covered mental health, including perceived stress, stressors, and coping mechanisms, and also included measures of sociodemographic and lifestyle factors. Based on the TMSC, stressors were considered external demands evaluated through primary appraisal, whereas secondary appraisal involved assessing available resources and options for coping, which then informed the strategies students employed. Bivariate tests evaluated associations between the measured factors and stress. Exploratory factor analysis identified the underlying factor structure of 31 stressors and 28 coping strategies. Multivariable Partial Proportional Odds Models analyzed factors associated with stress levels. About 2/3 of 618 respondents reported elevated stress. Major stressors identified through primary appraisal included frequent exams, extensive learning content, and insufficient study time. During secondary appraisal, students assessed their available coping resources. Those who effectively recognized and utilized adaptive coping strategies, such as seeking emotional or instrumental support, experienced significantly lower stress (odds ratio = 0.58). Examination-related stressors were the only stressors significantly associated with a higher likelihood of increased stress (odds ratio = 2.01). Multivariable analysis demonstrated that females were significantly less likely than males to experience high stress levels (odds ratio = 0.42). Higher stress levels also correlated with greater insomnia scores (odds ratio = 1.13). Stress was prevalent among medical students at Yarmouk University, mainly driven by academic demands appraised as threatening. Secondary appraisal showed that students who identified and used coping resources, such as social or emotional support and faith-based practices, were more successful in managing stress. These findings highlight the need for structured interventions grounded in the TMSC framework to foster adaptive coping. Support programs that propose evidence-based techniques to cope with stress could positively enhance medical students' educational experiences.