Midwifery is an emotionally challenging profession, and academic education of midwifery especially clinical learning has its own specific challenges. Midwifery students face with stressful experiences, especially related to instructor and characteristics of clinical environment, which can affect their theoretical and practical abilities. There is insufficient evidence in this field. This study aimed to explore (1) the perceived stress and stressors of midwifery students and (2) the relationships between students’ stress and related factors in clinical learning environment. A cross sectional, survey design was conducted at one university in Iran. A sample of 108 students was selected using Krejcie and Morgan table in 2016. Data was collected using Persian version of Cohen’s perceived stress scale, Persian questionnaire of sources of stress and demographic form. Data was analyzed using independent t, ANOVA and correlation coefficient test (α < 0.05). Participants returned 70 surveys (response rate, 64.8%). Approximately 56% of the students perceived a high level of stress. The most common dimensions of stressors were “unpleasant emotions” and “humiliating experiences”. The highest stressors were included “feeling suffering due to seeing for patients with critical situation”, “instructor’s admonition in the presence of clinical staff” and “communication with instructor”. The “interest in the field of study” had a negative impact on perception of stressors in dimensions of “clinical practices” and “interpersonal communication”. The midwifery students reported their stress in severe level, especially in dimensions of “unpleasant emotions” and “humiliating experiences”. The factors associated with the instructors have caused more stress in students. These findings will highlight need for supportive strategies by the clinical instructors. In this regard, the use of experienced instructors, the development of communication skills of the instructors, increasing coping skills of the students and the creation of a supportive environment may be helpful.

中文翻译：

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伊朗助产士学生临床学习中的压力，压力和相关因素：一项横断面研究

助产士是一个在情感上具有挑战性的职业，对助产士的学术教育尤其是临床学习有其自身的特殊挑战。助产士学生面临的压力很大，尤其是与讲师和临床环境特征有关的经历，会影响他们的理论和实践能力。这个领域没有足够的证据。这项研究旨在探讨（1）助产士的感知压力和压力源，以及（2）临床学习环境中学生的压力与相关因素之间的关系。在伊朗的一所大学进行了横截面调查设计。2016年，使用Krejcie和Morgan表选择了108名学生的样本。数据使用波斯版本的科恩感知压力量表收集，波斯人有关压力和人口统计来源的问卷。使用独立的t，ANOVA和相关系数检验分析数据（α<0.05）。参加者返回了70个调查（答复率为64.8％）。大约56％的学生感到压力很大。压力源最常见的维度是“不愉快的情绪”和“侮辱性经历”。压力最大的因素包括“因看病危重病人而感到痛苦”，“在有临床工作人员在场的情况下对教员的训诫”和“与教员沟通”。“对研究领域的兴趣”在“临床实践”和“人际交流”方面对压力源的看法产生了负面影响。助产士学生报告说他们的压力很严重，特别是在“令人不快的情绪”和“侮辱性经历”方面。与导师相关的因素给学生带来了更大的压力。这些发现将突出临床指导者对支持策略的需求。在这方面，使用经验丰富的教师，发展教师的沟通技巧，提高学生的应对能力以及创造支持性环境可能会有所帮助。