Adversity Intelligence (AI) and Level of Stress among Young

Doctors (Co-Assistants) in Pirngadi General Hospital Medan

Bania Maulina

, Saiful Batubara

and Gita Kurnia Sari

Psychology (Departement of Behavioral Science),Faculty of Medicine, UISU, Medan

Department of medical education, Faculty of Medicine, UISU, Medan

Keywords: Adversity Intelligence (AI), Level of Stress, Medical Student, Co-Assistants

Abstract: The role of AI as intelligence is related to coping, after turning out, not only appearance in business/

organization, but also in educational institutions (Stoltz, 2004, Alka, 2012). In education, AI plays

significant role when individuals are faced with various challenges, such as learning process (Matore, 2015).

The various studies have shown that medical students experienced stress higher than those of non-medical

students. Furthermore, the previous research showed that stress level of co-assistants were higher than that

of preclinical student. The stressful events were also related to individual responses to adversity

encountered. Some individuals became discouraged, but others felt excited and assumed the event as a

challenge. Stoltz (2004) states that each individual has a different response when faced with hardship.

Basically, it was closely related to AI’s concept. This study involved thirty co-assistants, conducted to find

out the relationship between AI and stress level. The AI-scale adopted from Arisandi (2011) and Depression

Anxiety Stress Scale 42 (DAS-42) were used to collect relevant data. Data were analyzed by using Pearson

Product Moment correlation test. The results showed that there was significant negative correlation between

AIand stress level with p value of 0.002 (p <0.05) and r value of -0.543.

1 INTRODUCTION

Medical education consists of two stages, namely

academic stage (preclinic) and profession stage (co-

assistant), meaning that at the first stage, medical

students must lead a preclinical study in the

university before becoming co-assistants in the

hospital. Preclinical studies are relatively more

stagnant in the hospitals asthey will be taken for

approximately seven semesters. After that, the

students will enter co-assistant stage. In this stage,

the students will be directly faced with patients and

have an opportunity to take medical action, to apply

their knowledge during study as preclinical students.

Co-assistant stage will be taken for four semesters

and Pirngadi General Hospital Medan is one of the

educational hospitals in North Sumatera, Medan

(Anonymous, 2013).

Furthermore, medical education processes often

cause students lost a lot of time. This makes them

difficult to manage their time. Moreover, they are

also required to have strong biomedical science,

clinical science and ability to deal with patients

directly. All of these cause medical students to

experience stress (Suhoyo, 2006; Putri, 2015). In

Hochiminch City, Vietnam, the research on 315

medical students showed that 39.6 percent of

students were depressed. The intrapersonal,

academic and environmental problems were viewed

as stressors (Putri, 2015).

Many researches about level of stress had also

been done. Abdulghani (2008) studied medical

students in Saudi Arabia and found that 21.5 percent

of students had mild stress, 15.8 percent had

moderate stress and 19.16 percent had high stress.

Furthermore, Widosari (2010) also conducted

research on preclinical students and co-assistants in

faculty of medicine at SebelasMaret University. She

found that level of stress among co-assistants was

higher than that of preclinical students. Co-assistants

experience more anxious and depressed situations

than preclinical students.

The recent phenomenon also showed that many

students had low fighting power, especially when

they had academic difficulties. Many of them felt

desperate instantly, and would not fight anymore

and some of them felt great suffering and tended to

compensate for feelings of depression with ending

118

Maulina, B., Batubara, S. and Sari, G.

Adversity Intelligence (AI) and Level of Stress among Young Doctors (Co-Assistants) in Pirngadi General Hospital Medan.

DOI: 10.5220/0008882801180122

In Proceedings of the 7th International Conference on Multidisciplinary Research (ICMR 2018) - , pages 118-122

ISBN: 978-989-758-437-4

up their living (Sukojo and Yuniati, 2016).

Similarly, the previous studies conducted on medical

students of the United States and Europe showed

that one third of students had poor mental health and

the prevalence increased in students of advanced

stage, which was 25 to 52 percent.

Based on the previous data, wecould conclude

that co-assistants’ activities were viewed difficult,

ultimately affecting the emergence of behaviors

related to stress. Stressful events with varying

degrees are also related to the individual’s responses

with hardship encountered. Some people become

discouraged, but others feel excited by the

challenges.

As said by Stoltz (2004) that basically, everyone

has a different response when faced with hardship.

Some of them seem to be able to get out of the

adversity, while the others feel embarrassed, inferior

until psychological trauma. Basically, this

phenomenon cannot be separated from the concept

of AI. The medical students must have AI to become

intellectual candidates who can survive when faced

with problems or pressure. Strength or power is

needed to solve it (Laura and Sunjoyo, 2009). When

individuals are able to survive and overcome

difficulties, they will achieve success in life.

Achieving success in life is determined by level of

AI.

First, AI was developed by Paul G. Stoltz. Stoltz

(2004) stating that AI is also an individual's ability

to move life’s goal in the future, and also as a

measurement of how to respond to difficulties. He

divided the dimensions of AI into four parts, namely

RE. The CO

RE dimensions will determine

level of individual’s AI usually expressed in the

form of adversity quotient, that is a coefficient

which explains individual's ability to respond

difficulties.

The role of AI as intelligence is related to coping

ability after turning out, not only appearance in the

business or organization, but also in educational

institutions (Stoltz, 2004, Alka, 2012). In education,

the concept of AI plays a significant role when

individual are faced with various challenges, such as

learning process (Matore, 2015). In addition,

research related to AI and stress levels, particularly

among co-assistants has never been done. Therefore,

the reseachers would like to see the correlation

between AI and level of stress among co-assistants

in Pirngadi General Hospital Medan.

The data obtained from this research, will also be

used as basis for planning the right method to

develop the psychological readiness of co-assistants.

So, they can exhibit maximum performance and

make them have good preparation and confidence

when undergoing the profession on the actual

conditions later.

2 METHOD

2.1 Research Design

This study used quantitative research in which the

correlation approach was selected to determine

relationship between AI and level of stress among

co-assistants in Pirngadi General Hospital Medan.

The data were analyzed statistically by using

computer program.

2.2 Variables

There are two variables, namely (1) AI, which is

defined as the total score obtained from the sum of

four dimensions (CO

RE) score, measured by AI

scale, adopted from Ariasandi (2011). AI is

described as the ability of the individual to survive

and overcome all the hardship, with tough and

diligent manners to achieve goals and; (2) the level

of stress is a feeling of tension experienced by the

individual due to internal or external pressure,

characterized by psychological reactions, as

measured through Depression Anxiety Stress Scale

42 (DAS-42).

2.3 Sample

This research involved thirty co-assistants which

were selected through purposive sampling

technique. They were taking part in professional

education at Pirngadi General Hospital Medan,

starting from May 2016 until February 2017. The

study was conducted at the hospital located at Jalan

prof. H.M. Yamin, SH No. 47, Medan.

2.4 Instrument

The researcher used psychological scale to collect

relevant data. First, the AI scale, adopted from

Ariasandi (2011), consisting of sixteen statements

and was arranged by the dimensions of CO

RE-AI,

including control, origin-ownership, reach and

endurance. This scale had tested the reliability by

using cronbach alpha and obtained reliability index

of 0.902. Test validity with 5 percent significance

level has also been done and obtained coefficients

ranged from 0.398-0.798. Thus, it can be said that

Adversity Intelligence (AI) and Level of Stress among Young Doctors (Co-Assistants) in Pirngadi General Hospital Medan

119

the scale was valid and reliable to measure co-

assistants’ level of AI.

Second, DAS-42 was developed byLovibond and

Lovibond, consisting of forty two items. The scale

has also been internationally validated with validity

and reliability value of 0.91, by using Cronbach's

Alpha (Lovibond, 1995).

3 RESULTS AND DISCUSSION

This is to determine correlation between AI and

level of stress among co-assistants in Pirngadi

General Hospital Medan. The correlation test results

can be seen in the table below:

Table 1: AI and Level of Stress among Young Doctors

(Co-Assistants) in Pirngadi General Hospital, Medan.

Mean

Std

Dev

value

AI 30,77 5,35

0.002 -0.543

Stress Level 16,63 7,17

*Pearson Product Moment correlation Test(p<0,05)

This table showed that p value was 0.002 (p

<0.05) and r value was -0.543. It meant that there

was significant negative relationship between AI

and level of stress among co-assistants in Pirngadi

General Hospital Medan. In other words, it can be

said that height of AI tended to lead to normal stress

level.

But, in this study, the most of AI’s co-assistants

were in the moderate category with normal stress

level. It was related to many factors that affected

individual’s AI level. As said by Stoltz (2004) many

factors could influence AI’s level. First, internal

factors, e.i genetics, belief, talent, desire, character,

performance, health and intelligence.Second,

external factors, e.i education and environment.

Furthermore, most of co-assistants were able to

manage stress appropriately and effectively or they

might not assume the professional education as a

stressful event. Garmezy and Michael (inTaylor,

1999) states that some people develope maladaptive

behavior as a reaction to survive and the others are

able to survive and develop by adaptive behavior.

They would also be better, when they get out of

trouble and live a healthy life. This means that they

use adaptive coping skills. In other words, it can be

said that individuals who develope adaptive coping

skills patterns tend to have resilience, when facing

failure.

Furthermore, the researchers also found an

overview of AI’s co-assistants outlined in the table

2. This table showed that most of co-assistants in

Pirngadi General Hospital, Medan had medium

category of AI.

Table 2: AI among Young Doctors (CoAssistants) in

Pirngadi General Hospital, Medan.

Interval Level

Frequency

(n)

Perscentage

(%)

x > 50 High 0 0

30 ≤ x ≤

Average 17 57

x < 30 Low 13 43

Zhou (2009) states that everyone is born with a

basic drive to move on, moving towards a life goal,

no matter what the purpose of life is. He terms life

like climbing a mountain. There are three individual

types, e.i quitter, camper, and climber.

Related to AI’s theory, it can be said that co-

assistants were included in campers category, a type

characterized by good ability to deal with hardships

or challenges, but unable to endure hardships or

challenges threatening. This type also has limited

ability to deal with change, especially big change

that requires a lot of adaptability. Individuals with

this type feel satisfied and sufficient with the result

already obtained, so that eventually they are less

motivated to develop potential possessed to the

fullest. Growing spirit will have an impact on the

level of AI. It means that co-assistants in Pirngadi

General Hospital Medan had adequate spirit and

confidence when faced the problems related to

academic activities in the hospital.

The study also found several co-assistants with

low level of AI. They were included in quitters, a

type characterized by low ability to deal with

adversity denying the opportunity to view obstacles

as a challenge.

However, this study could not find a co-

assistants’ high level of AI, also known as climbers.

People with this type have the ability to survive

when faced withcute hardships and makeit as an

opportunity to continue to grow. According to Stoltz

(2004), the support from people around, e.g

listening also could make them feel recognized,

strengthened and cared for. Storytelling could be a

ICMR 2018 - International Conference on Multidisciplinary Research

120

tool of expressing one's emotions and thoughts, so

that they feel more comfortable and ready to deal

with the problem. However, support from the others,

e.g solutions could make individual dependent on

theperson who provide the solution. It caused them

to become unfamiliar with their problem.

Overview of stress level among co-asisstants in

Pirngadi General Hospital, Medan was outlined in

the table below:

Table 3: Level of Stress among Young Doctors (Co-

Assistants) in Pirngadi General Hospital, Medan.

Interval Level

Frequency

(n)

Percentage

(%)

x ≤ 14 Normal 15 50

15 ≤ x ≤

Mild 4 13

19 ≤ x ≤

Moderate 6 20

26 ≤ x ≤

Severe 5 17

x ≥ 34 Very Heavy 0 0

The table showed that most of co-assistants had

normal category of stress. Holroyd and Lazarus state

that cognitive point has a significant role to stress

reaction and it is usually conceptualized in two

interaction processes, namely appraisal and coping.

Appraisal determines whether situation is assumed

as stressful and cognitive appraisal would change

individual to reduce stress. So, if the individual feels

that a situation as something stressful, coping is

needed.

Otherwise, if someone thinks a situation is not

something stressful, coping is not needed. The

stressful situation can also be minimized through

effective coping skills (Lazarus and Folkman, 1984).

In relation to research findings, it can be argued

that most of co-assistants assumed professional

education was not a stressful situations or they

assumed that the situation was as stressful but they

minimized stressful situations by implementing

effective coping skills.

In addition, academic climate factors in Pirngadi

General Hospital Medan which has been well

planned also affected normal category of stress

among co-assistants. The climate includes a

harmonious relationship between senior-juniors,

supervisors and other academic staff. Through

decades Pirngadi General Hospital Medan has

become one of the educational hospitals helping

students to adjust and go through their academic

activities comfortably.

4 CONCLUSIONS

This study shows that there is a significant negative

relationship between AI and stress level among co-

assistants in Pirngadi General Hospital Medan.

Tracking of coping skills types is considered

effective to minimize stressful situations and can be

taken into consideration for further research.

5 RECOMMENDATION

The conclusion of this research shows that AI plays

an important role in one's stressful experience. But

cognitive process also has a significant role to

minimize or reduce the stress level. Practical coping

skills could help people but we do not know which

coping skills are effective. Hopefully, this research

gives contribution to other researchers, especially

those related to coping skills.

REFERENCES

Abdulghani, H. M., 2008. Stress and depression among

medical students: A cross sectional study at a medical

college in Saudi Arabia. Pakistan journal of medical

sciences, 24(1), 12.

Alka, V.R.S., 2012. A Study of secondary school students’

response to adversity in relation to certain

psychological and performance factors; Thesis,

Department of Education University of Mumbai,

Mumbai.

Anonymous, 2013. Undang-Undang Republik Indonesia

Nomor 20 Tahun 2013 Tentang Pendidikan

Kedokteran. Jakarta: Depdiknas.

Ariasandi, E., 2011. Hubungan Antara Kemampuan

Adversitas Dengan Stres Akademik Pada Mahasiswa.

Semarang: Perpustakaan Unikat.

Lovibond P. F and S. H Lovibond., 1995. The Structure of

Negative Emotional States: Comparison of The

Depression Anxiety Stress Scale (DASS) with The

Beck Depression and Anxiety inventories. Australia:

Pergamon.

Lazarus, R.; Folkman, S., 1984. Stress, appraisal and

coping. New York: Springer Publishing Company.

Matore, M.E.E.M.; Khairani, A.Z.; Razak, N.A., 2015.

The influence of AQ on the academic achievement

Adversity Intelligence (AI) and Level of Stress among Young Doctors (Co-Assistants) in Pirngadi General Hospital Medan

121

among Malaysian Polytechnic Students, International

Education Studies, 8 (6): 69-74 .

Putri, S.A., Zulharman., Firdaus., 2015. Hubungan

Adversity Quotient dengan Tingkat Stres Akademik

Pada Dokter Muda Fakultas Kedokteran Universitas

Riau. Riau : FK UNRI.

Stoltz, P.G., 2004.Adversity quotient: Mengubah

hambatan menjadi peluang;adversity quotient: Turning

obstacles into opportunities, Penerjemah: T. Hermaya,

PT Grasindo, Jakarta.

Sujoko; Yuniati, R., 2016.Analisaperilaku striving for

superiority padasiswa yang tidak lulus ujiannasional,

JurnalIlmiahPsikologi, Juli; 8 (2).

Yakoh, M.; Chongrukasa, D.; Prinyapol, P., 2015.

Parenting styles and adversity quotient of youth at

Pattani Foster Home: 282-286. 6

World Conference

on Psychology Counseling and Guidance.

Widosari, Y.W. 2010. Perbedaan Derajat Kecemasan dan

Depresi Mahasiswa Kedokteran Preklinik dan Ko-

asisten di FK UNS Surakarta. Surakarta : FK

Universitas Sebelas Maret.

Zhou, H., 2009. The adversity quotient and academic

performance among college students at ST.Joseph’s

College, Quezon City, Thesis. The Departments of

Arts and Sciences ST.Joseph’s College, Quezon City.

ICMR 2018 - International Conference on Multidisciplinary Research

122