Anxiety in Clinical Settings: Constructing a Scale for Medical Students

Abstract

Introduction: The Scale of Anxiety in Clinical Setting (SACS) was constructed to assess the level of anxiety of medical students when exposed to the clinical setting and also to identify what situations are more likely to trigger higher levels of anxiety in that context.
Material and Methods: This instrument consists of 12 items and was constructed on the basis of the review of the literature on the topic of anxiety in clinical setting, and data from a focus group conducted with students between the 1st and the 5th year of the Medical course at University of Beira Interior (n = 10). The Scale of Anxiety in Clinical Setting psychometric properties were tested through a study with 557 medical students of four Portuguese universities, between the 1st and the 6th year.
Results: The Scale of Anxiety in Clinical Setting validation included the analysis of three key parameters: sensitivity, reliability and factorial validity, the last resulting in four factors: ‘displeasure before invasive procedures’, ‘anxiety toward the sick’, ‘anxiety about performance’ and ‘anxiety toward the human dimension’ with 70.6% of the variance explained.
Discussion: Total Scale of Anxiety in Clinical Setting shows a good internal consistency (Cronbach’s Alpha = 0.84) and a good discriminatory ability, presenting as a consistent and reliable instrument for the assessment of anxiety in medical students when exposed to the clinical setting.
Conclusion: The Scale of Anxiety in Clinical Setting evaluates the anxiety in medical students when exposed to the clinical setting and may be useful in the delineation of teaching strategies for the preparation of future doctors.
Keywords: Anxiety; Education, Medical, Undergraduate; Students, Medical; Stress, Physiological; Questionnaires.