Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. All the medical students from year one to year five levels from the College of Medicine, King Saud University, were enrolled in the study. The study was conducted using Kessler10 psychological distress (K10) inventory, which measures the level of stress according to none, mild, moderate, and severe categories. The prevalence of stress was measured and compared with the five study variables, such as gender, academic year, academic grades, regularity to course attendance, and perceived physical problems. The response rate among the study subjects was 87% (n=892). The total prevalence of stress was 63%, and the prevalence of severe stress was 25%. The prevalence of stress was higher (p<0.5) among females (75.7%) than among males (57%) (odds ratio=2.3, χ2=27.2, p<0.0001). The stress significantly decreased as the year of study increased, except for the final year. The study variables, including being female (p<0.0001), year of study (p<0.001), and presence of perceived physical problems (p<0.0001), were found as independent significant risk factors for the outcome variables of stress. Students' grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress levels. Preventive mental health services, therefore, could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrence.

Purpose The COVID-19 pandemic poses a major challenge for medical students’ learning and has become a potential stressor, with a profound influence on their psychological well-being. We aimed to determine the effect of the current pandemic on undergraduate medical students’ learning. We also explored the association of their stress level with coping strategies, educational, and psychological variables. Materials and Methods This is a cross-sectional design study, and participants were the 1st to 5th year medical students. A self-administered questionnaire (18 items) and a well-known Kessler 10 Psychological Distress questionnaire (10 items) were used to collect the data related to perceived stress with an association of educational, psychological, and coping variables. Results The prevalence of overall stress was significantly higher ( χ 2 = 16.3; P =0.000) in female medical students, ie, (40%) as compared to the male students (16.6%), and was highest (48.8%) during the 3rd medical year. It was also noted that the most effective strategy, embraced by students to cope with the severe stress, was “indulging in religious activities” (OR= 1.08; P =0.81). Furthermore, 22.3% of students had perceived severe stress as they did not prefer online learning. Similarly, those students who have not believed or refused the online learning or disagree in “there is pleasure in the study due to COVID” they have significantly higher stress ( χ 2 =39.7; P =0.000) 21.5% mild, 17.8% of moderate, and 21.2% severe. Conclusion We found that the COVID-19 pandemic has induced stress and changes in medical students’ educational attitudes and strategies. The results exhibited that the predominance of stress is higher in females than males, and also more stress was perceived by the students during their transitional year, ie, 3rd medical year (from pre-clinical to clinical) and also the respondents who regularly did religious meditation were at lower levels of stress. COVID-19’s influence on medical education and students’ well-being will be felt at an extended level, which necessitates an appropriate plan for preparedness.

A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

Addressing these factors, which might be unique for a given student community, in a systematic manner would be helpful to improve students' performance.

The aim of this study was to assess the utility of long term faculty development programs (FDPs) in order to improve the quality of multiple choice questions (MCQs) items' writing. This was a quasi-experimental study, conducted with newly joined faculty members. The MCQ items were analyzed for difficulty index, discriminating index, reliability, Bloom's cognitive levels, item writing flaws (IWFs) and MCQs' nonfunctioning distractors (NFDs) based test courses of respiratory, cardiovascular and renal blocks. Significant improvement was found in the difficulty index values of pre- to post-training (p = 0.003). MCQs with moderate difficulty and higher discrimination were found to be more in the post-training tests in all three courses. Easy questions were decreased from 36.7 to 22.5%. Significant improvement was also reported in the discriminating indices from 92.1 to 95.4% after training (p = 0.132). More number of higher cognitive level of Bloom's taxonomy was reported in the post-training test items (p<0.0001). Also, NFDs and IWFs were reported less in the post-training items (p<0.02). The MCQs written by the faculties without participating in FDPs are usually of low quality. This study suggests that newly joined faculties need active participation in FDPs as these programs are supportive in improving the quality of MCQs' items writing.