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   <subfield code="a">Dionzon-Serra, Cherry Ann E.</subfield>
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   <subfield code="a">Relationship of perceived stress and grit to academic performance of medical students</subfield>
   <subfield code="c">Cherry Ann E. Dionzon-Serra; Maria Elizabeth M. Grageda, PhD, MHPEd, adviser.</subfield>
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   <subfield code="b">National Teacher Training Center for the Health Professions, University of the Philippines Manila</subfield>
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   <subfield code="a">Background of the study. Grit as a positive psychology construct has been robustly studied in the field of education and recently has been of interest in the field of medical education. It has been linked with academic success and achievements and academic performance in different university courses from different countries. Several studies linked grit to academic performance of nonmedical courses but only a few among medical students and with conflicting results. Studies have shown that medical education is highly stressful compared to other fields of education and may affect students’ academic performance. Its attrition rate is high compared to other fields. Particularly in this time of COVID-19 pandemic, the unprecedented shifts in the landscape of medical education and clinical training impacted medical students’ learning and clinical experiences. This pandemic causes additional perceived stress on medical students. Do perceived stress and grit affect academic performance of medical students? &#13;
&#13;
Objectives. This study aimed to determine the relationship of perceived stress and grit to academic performance and the difference of the perceived level of stress and grit of medical students by year level and sex. It also determined the relationship of grit and perceived stress of medical students with age. Furthermore, this study also determined the effect of COVID-19 to the medical students’ perceived stress and their coping mechanisms. &#13;
&#13;
Methodology. This study is a correlational research design which utilized two validated questionnaires, the 8-item Short Grit Scale (Grit-S) and the Medical Student Stressor Questionnaire (MSSQ), to evaluate the grit and stress levels and stressors, respectively. Total enumeration of all the medical students in 3 medical colleges in Luzon was done but only 242 medical students (30.06%) from first year to fourth year responded. Data were analyzed using descriptive statistics, t-test, ANOVA and correlation.&#13;
&#13;
Results. Grit and overall perceived level of stress do not have a strong statistically significant relationship to Academic performance. However, when the 6 domains of stress were analyzed individually, domain 5 (Drive and desirerelated stressors) showed a negative but weak relationship to academic performance. COVID-19 pandemic is an additional source of stress to medical students. Grit when grouped by year level and sex do not have significant differences. The explanation for this may be because medical students in general are grittier than the rest of the general population thus their grittiness may not differ significantly among themselves. Medical education is tedious and demanding let alone stressful and it takes one to persevere and be consistent with the goal of finishing the program. Perceived stress when analyzed by age does not have a significant relationship to academic performance. Lower year levels have significant high level of perceived stress compared to fourth year&#13;
medical students with females having high level of stress than males. Reasons for the lower year levels’ higher level of perceived stress compared to fourth year level based on their answers on the MSSQ include falling behind reading schedule, not enough medical skill practice, having difficulty understanding the lesson, unable to answer questions from teachers, unjustified grading process, unable to answer questions from patients, participation in class discussion and need to do well in group activities. There is a scientific and physiologic explanation on why females perceived stress higher than males. Females have higher stress-related neurochemicals and corticosteroids making them more&#13;
responsive to acute stressors than males. The main source of perceived stress are the academic related stressors.&#13;
&#13;
Conclusion. Although medical education is known to be stressful and demanding, this study showed that over-all perceived level of stress does not affect academic performance, however, drive and desire related stressor has a negative relationship to academic performance. The higher the drive and desire related stressors the poorer the academic performance will be. Lower year levels have significant high perceived level of stress with females having higher level of perceived stress than males and the majority of the stress comes from academic related stressors. Medical students in this study are somewhat gritty. Grit and its subthemes do not have a significant relationship to academic performance and do not differ significantly among medical students when compared according to year level and sex.</subfield>
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   <subfield code="a">Grageda, Maria Elizabeth M.</subfield>
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