OBJECTIVES: To assess the perceived stress in 4th year Pharmacy students after the completion rotation course, and to determine its association with the APPE course type, students’ attitude toward APPE, and students’ self-evaluation of their performance, and finally to explore other factors associated with the perceived stress.

METHODS: A cross-sectional survey was administered to students who completed a 6-week rotation during September to November 2018. A previously validated perceived stress scale was used which included 10 items with a 5-point scale. A general life satisfaction score and APPE satisfaction score were measured based on students’ attitude toward various aspects of daily life and toward APPE course, respectively. Correlation analysis was used to evaluate the relationships between perceived stress score (PSS), students’ attitude toward APPE and students’ self-evaluation of performance. Multivariate regression analysis for identifying the predictors associated with PSS was conducted using SAS 9.3.

RESULTS: Response rate of 93.9% (122/130) was obtained. Mean age was 26 ±3 and 60% were females. Respondents reported moderate level of perceived stress score (22.1 ± 4.8, range = 0-34), high APPE satisfaction score (24.7 ±4.8, range = 3-30) and moderate to high self-performance ratings (88.6 ±12.3, range = 20-100). On average, students spent 10.43 ± 13.15 hours offsite working during their APPE, which was positively associated with higher stress scores (p<0.05). Students taking an ambulatory care course were associated with lower stress scores as compared to others (p<0.05). Females were associated with higher stress scores (p<0.05).

CONCLUSIONS: Rotation course type, gender and extent of offsite working hours during their APPE were significant predicators of perceived stress score. Further research could address causes of observed differences in stress among pharmacy students. Stress management and work load workshops before these APPE rotations may be considered by college administrators.