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cademic stress may lead to reduced or com- The way students cope with academic-related
promised performance for students. Previous stress and their examination-related self-efficacy may
research has found that greater academic affect the association between stress experienced
stress is associated with lower grades1 and student during the exam period and academic achievement.
burnout and is negatively associated with academic The strategies individuals select to cope with prob-
achievement.2 A longitudinal study of medical stu- lematic events affect levels of perceived stress, with
dents concluded that reported levels of stress were stress persisting if the way of coping is ineffective.8,9
negatively related to their academic performance be- Self-efficacy, which is one’s perception of his or her
fore and during medical school.3 Research with dental capacity to successfully carry out a course of action
students has yielded comparable findings. Silverstein that leads to a desired outcome,10-12 may also affect
and Kritz-Silverstein, for example, found that stress achievement in educational contexts. Students re-
increased over time for first-year dental students, porting higher exam-related self-efficacy have been
with negative effects on academic performance and found to attain better academic achievement.13-20
health.4 While stress-provoking events are common Interestingly, self-efficacy expectations appear
throughout dental education, examinations are often connected with both coping strategies and stress
perceived by students as particularly stressful.5,6 Hav- perceptions. For instance, previous research has
ing some degree of test anxiety appears as a wide- found that active-coping efforts are linked to higher
spread emotion among university students as well.7 self-efficacy scores and good dissertation grades.21
significant gender differences were found. However, strategies. The use of coping strategies was associ-
females compared to males reported significantly ated with the students’ levels of stress during the
higher perceived stress scores, lower exam-related exam period after controlling for gender and age
self-efficacy, and greater use of emotional coping (Table 2). Using emotional coping strategies was
positively associated with perceived stress, whereas
a negative relation was found between using rational
Table 2. Perceived stress regressed on gender, age, and coping strategies and stress scores.
coping strategies
In support of our first hypothesis, coping
B S.E. b strategies were associated with the students’ exam-
Gender -0.21 0.08 -0.16* related self-efficacy after controlling for gender and
Age 0.09 0.04 0.14* age (Table 3, Model 1). Both rational and emotional
Rational coping -0.15 0.04 -0.25** coping strategies were significant predictors of the
Emotional coping 0.21 0.04 0.34** students’ self-efficacy assessments. The more the
Note: Dependent variable was perceived stress. Gender was students reported the use of rational strategies, the
coded as 0 (female) and 1 (male) and used as a control vari- greater exam-related self-efficacy expectancies they
able; beta for this variable was not interpreted; R2=0.25.
reported, whereas using emotional strategies to cope
*p<0.05, **p<0.01
with academic stressful events was associated with
lower perceptions of self-efficacy. The students’
perceived stress was included in Model 2 of the
Table 3. Exam-related self-efficacy regressed on gen- regression model, yielding a significant beta coeffi-
der, age, coping strategies, and perceived stress
cient. However, both coping strategies (rational and
B S.E. b R2 emotional) were attenuated and no longer statistically
Model 1 0.15 significant when the stress scores were added to the
Gender 0.42 0.13 0.22** model. A statistically significant negative associa-
Age -0.07 0.06 -0.07 tion between students’ stress and self-efficacy was
Rational coping 0.14 0.06 0.16* found, with higher perceived stress during the exam
Emotional coping -0.19 0.06 -0.22** period associated with lower reported exam-related
Model 2 0.22 self-efficacy (Table 3, Model 2).
Gender 0.33 0.12 0.18** Consistent with our second hypothesis, cop-
Age -0.03 0.06 -0.03 ing strategies were associated with exam-related
Rational coping 0.07 0.06 0.09 self-efficacy beliefs, at least to some extent, through
Emotional coping -0.10 0.06 -0.12
the students’ stress-related perceptions. The indirect
Perceived stress -0.26 0.06 -0.30**
path involving rational coping, perceived stress, and
Note: Dependent variable was exam-related self-efficacy.
Gender was coded as 0 (female) and 1 (male) and used as a self-efficacy accounted for 46% of total effects in this
control variable; beta for this variable was not interpreted. mediation, whereas the indirect path for emotional
Model 1 and Model 2 were run separately (method: forced
entry). coping strategies represented 45.4% of the total ef-
fects (Figure 1).
*p<0.05, **p<0.01