390 © 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education. THE CLINICAL TEACHER 2019; 16: 390–394
Original
Article
… thinking
stress is not
bad has a
protective
effect against
stress and may
enhance well-
being
Student belief about the
value of challenge
JR Rudland
1
, C Golding
2
, C Jaye
3
, M Tweed
4
and TJ Wilkinson
5
1
Division of Health Sciences, Otago Medical School, University of Otago, Wellington, New
Zealand
2
Higher Education Development Centre, Dunedin, New Zealand
3
Department of General Practice and Rural Health, Dunedin School of Medicine, Dunedin,
New Zealand
4
Department of Medicine, University of Otago, Wellington, New Zealand
5
Department of Medicine, University of Otago, Christchurch, New Zealand
SUMMARY
Background: The undergraduate
curriculum tends to focus on
how individuals can cope with
stress especially when transi-
tioning from the classroom to
the clinical workplace environ-
ment. Often this carries the
message that stress is bad, yet
little attention has been paid to
the influence of one’s belief
regarding the value of stress for
learning. Because stress is often
perceived as bad, we chose to
use the term ‘challenge’ in
exploring the associations
amongst belief of the value of
challenge, the challenge
experienced, the perceived
learning, affect and staff
support.
Methods: At the end of each
clinical module within a medical
curriculum, medical students
rated the perceived learning,
degree of challenge, affect,
support and the value of
challenge for learning. The
value and associations amongst
these variables were analysed.
Results: The challenge for
students varied according to the
type of module. Students gener-
ally considered that challenge
promoted rather than hindered
learning. The level of challenge
experienced may influence the
perception of the value of
challenge for learning. However,
when challenge was regarded as
beneficial, this was strongly,
positively associated with
perceived learning, positive
affect and support.
Discussion: Students who believe
challenge is positive also perceive
that such challenges promote
learning. Likewise students who
regard challenge as negative are
less likely to learn from such
challenges. The positive relation-
ship between the belief of the
value of challenge with affect and
support may have positive
implications for well-being. It is
contended that curriculum
planners should acknowledge the
potential positive influence of
stressors in clinical education and
that challenge can be seen as
valuable when there is student
support and measures associated
with maintaining a positive affect.