Medical undergraduates experience many challenges in their academic, social as well as financial aspects in present day circumstances. All these challenges make them vulnerable if they can’t withstand it. Resilience is the ability to withstand adversities an individual faces. If they lack resilience, they are likely to face many negative consequences. Objective of the study was to assess the resilience level and associated factors among medical undergraduates in a selected university in Sri Lanka. A descriptive cross-sectional study was conducted among all the medical undergraduates (n= 578) studying in the medical faculty during April to September 2023 in Wayamba medical faculty. Study instruments consist of the 14-Item Resilience Scale, to assess the level of resilience and a self-administered questionnaire to inquire the associated factors. The levels of resilience were expressed as percentages with 95% CI. Bivariate and multivariate logistic regression is used to assess the associated factors of low resilience. Probability < 0.05 was selected as the significance level. The results were expressed as odds ratios (OR) and 95% CI. The response rate was 85.3% (n= 492). Mean age was 22 years (SD =1.2) and majority were females (69.3%). Low, moderate, and high levels of resilience of medical undergraduates were 51% (n = 251), 30% (n = 148) and 18.9% (n =93) respectively. In each academic year, half of the undergraduates had low level of resilience. Male sex (AOR = 2.4; 95% CI =1.2 – 4.8), getting angry frequently (AOR = 3.0; 95% CI = 1.5 -6.0) and not engage in extracurricular activities (AOR = 2.2; 95% CI = 1.2 - 4.2) were significantly associated with low resilience level among medical undergraduates.  Except the sex, other two are modifiable factors and need to take necessary interventions to rectify it. Recommend resilience enhancing interventions among medical undergraduates. Needs to explore the research area with qualitative studies to get highest yield.


Resilience, Medical undergraduates, Associated factors, Sri Lanka,


Metrics Loading ...


  1. Aboalshamat, K.T., Alsiyud, A.O., Al‑Sayed, R.A., Alreddadi, R.S., Faqiehi, S.S., Almehmadi, S.A. (2018). The relationship between resilience, happiness, and life satisfaction in dental and medical students in Jeddah, Saudi Arabia. Nigerian Journal of Clinical Practice, 21(8), 1038-1043. https://doi.org/10.4103/njcp.njcp_278_17
  2. Aiena, B.J., Baczwaski, B.J., Schulenberg, S.E., Buchanan, E.M. (2015). Measuring resilience with the RS-14: a tale of two samples. Journal of Personality Assessment, 97(3), 291-300. https://doi.org/10.1080/00223891.2014.951445
  3. Al Omari, O., Al Yahyaei, A., Wynaden, D., Damra, J., Aljezawi, M., Al Qaderi, M., Al Ruqaishi, H., Abu Shahrour, L., ALBashtawy, M. (2023). Correlates of resilience among university students in Oman: a cross-sectional study. BMC psychology, 11(1), 2. https://doi.org/10.1186/s40359-022-01035-9
  4. American Psychological Association, (2014). The Road to Resilience. American Psychological Association, Washinton DC. USA. http://www.apa.org/helpcenter/road-resilience.aspx
  5. Arastaman, G., Balci, A. (2013). Investigation of High School Students' Resiliency Perception in terms of Some Variables. Educational Sciences: Theory and Practice, 13(2), 922-928.
  6. Bahadir-Yilmaz, E., Fatma Oz, R.N. (2015). The resilience levels of first-year medical, dentistry, pharmacy and health sciences students. International Journal of Caring Sciences, 8(2), 385.
  7. Bataineh, M.Z. (2013). Academic Stress among Undergraduate Students: The Case of Education Faculty at King Saud University. International Interdisciplinary Journal of Education, 2, 82-88. https://doi.org/10.12816/0002919
  8. Bittmann, F. (2021). When problems just bounce back: About the relation between resilience and academic success in German tertiary education. SN Social Sciences, 1(2), 65. https://doi.org/10.1007/s43545-021-00060-6
  9. Bunevicius, A., Katkute, A., Bunevicius, R. (2008). Symptoms of anxiety and depression in medical students and in humanities students: relationship with big-five personality dimensions and vulnerability to stress. The International journal of social psychiatry, 54(6), 494-501. https://doi.org/10.1177/0020764008090843
  10. Callegari, C., Bertù, L., Lucano, M., Ielmini, M., Braggio, E., Vender, S. (2016). Reliability and validity of the Italian version of the 14-item Resilience Scale. Psychology Research and Behavior Management, 277-284. https://doi.org/10.2147/PRBM.S115657
  11. Coşkun, Y.D., Garipağaoğlu, Ç., Tosun, Ü. (2014). Analysis of the relationship between the resiliency level and problemsolving skills of university students. Procedia-Social and Behavioral Sciences, 114, 673-680. https://doi.org/10.1016/j.sbspro.2013.12.766
  12. Daining, C., & DePanfilis, D. (2007). Resilience of youth in transition from out-of-home care to adulthood. Children and Youth Services Review, 29(9), 1158-1178. https://doi.org/10.1016/j.childyouth.2007.04.006
  13. Damásio, B.F., Borsa, J.C., da Silva, J.P. (2011). 14-item resilience scale (RS-14): psychometric properties of the Brazilian version. Journal of Nursing Measurement, 19(3), 131-145. https://doi.org/10.1891/1061-3749.19.3.131
  14. de Oliveira, A.C.P., Machado, A.P.G., Aranha, R.N. (2017). Identification of factors associated with resilience in medical students through a cross-sectional census. BMJ open, 7(11), e017189. http://dx.doi.org/10.1136/bmjopen-2017-017189
  15. Dyrbye, L.N., Power, D.V., Massie, F.S., Eacker, A., Harper, W., Thomas, M.R., Szydlo, D.W., Sloan, J.A., Shanafelt, T.D. (2010). Factors associated with resilience to and recovery from burnout: a prospective, multi‐institutional study of US medical students. Medical education, 44(10), 1016-1026. https://doi.org/10.1111/j.1365-2923.2010.03754.x
  16. Fergus, S., Zimmerman, M.A. (2005). Adolescent resilience: a framework for understanding healthy development in the face of risk. Annual review of public health, 26, 399-419. https://doi.org/10.1146/annurev.publhealth.26.021304.144357
  17. Gordon, K.A. (1995). Self-concept and motivational patterns of resilient African American high school students. Journal of Black Psychology, 21(3), 239-255. https://doi.org/10.1177/00957984950213003
  18. Han, S., Lee, J., Park, K.G. (2017). The impact of extracurricular activities participation on youth delinquent behaviors: An instrumental variables approach. Journal of Adolescence, 58, 84-95. https://doi.org/10.1016/j.adolescence.2017.05.006
  19. Lau, P. L., Muhamad, A.S.B., Shaharom, M.S.N.B., San Teh, Y. (2021). A preliminary study of resilience among students in a malaysia public university. Jurnal Kurikulum & Pengajaran Asia Pasifik, 9(4), 32-38. https://juku.um.edu.my/index.php/JUKU/article/view/34090
  20. Manori S., Godamunne, P., Jayawardana, P. (2021). Resilience among grade 10 adolescents in the Gampaha District; level, risk factors and intervention for its enhancement. Thesis, Post Graduate Institute of Medicine, Combo, Sri Lanka.
  21. Mestre, J.M., Núñez-Lozano, J.M., Gómez-Molinero, R., Zayas, A., Guil, R. (2017). Emotion Regulation Ability and Resilience in a Sample of Adolescents from a Suburban Area. Frontiers in psychology, 8, 1980. https://doi.org/10.3389/fpsyg.2017.01980
  22. Mukherjee, A., Som, T. K., Ghosh, S., Mondal, R., Saha, I., Ghose, G. (2021). Resilience among undergraduate medical students of a medical college of Eastern India. Journal of Comprehensive Health, 9, 18-22. https://doi.org/10.53553/JCH.v09i01.005
  23. Murry, V. M., Bynum, M. S., Brody, G. H., Willert, A., Stephens, D. (2001). African American single mothers and children in context: A review of studies on risk and resilience. Clinical Child and Family Psychology Review, 4, 133-155. https://doi.org/10.1023/A:1011381114782
  24. Nair, B., Otaki, F., Nair, A.F., Ho, S.B. (2023). Medical students’ perception of resilience and of an innovative curriculum-based resilience skills building course: A participant-focused qualitative analysis. PLOS one, 18(3), e0280417. https://doi.org/10.1371/journal.pone.0280417
  25. Nishi, D., Uehara, R., Kondo, M., Matsuoka, Y. (2010). Reliability and validity of the Japanese version of the Resilience Scale and its short version. BMC Research Notes, 3, 1-6. https://doi.org/10.1186/1756-0500-3-310
  26. Ononye, U., Ndudi, F., Bereprebofa, D., Maduemezia, I. (2022). Academic resilience, emotional intelligence, and academic performance among undergraduate students. Knowledge and Performance Management, 6(1), 1-10. http://dx.doi.org/10.21511/kpm.06(1).2022.01
  27. Oz, F., Inci, F. Bahadır-Yılmaz, E. (2012). The death anxiety and resilience levels of nursing students and relevance between these levels. New Symposium Journal, 50, 229-236.
  28. Palagini, L., Moretto, U., Novi, M., Masci, I., Caruso, D., Drake, C.L., Riemann, D. (2018). Lack of resilience is related to stress-related sleep reactivity, hyperarousal, and emotion dysregulation in insomnia disorder. Journal of Clinical Sleep Medicine, 14(5), 759-766. https://doi.org/10.5664/jcsm.7100
  29. Petrowski, K., Brähler, E., Zenger, M. (2014). The relationship of parental rearing behavior and resilience as well as psychological symptoms in a representative sample. Health and quality of life outcomes, 12, 1-9. https://doi.org/10.1186/1477-7525-12-95
  30. Pharasi, S., Patra, S. (2020). Burnout in medical students of a tertiary care Indian medical center: How much protection does resilience confer?. Indian Journal of Psychiatry, 62(4), 407-412. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_681_19
  31. Pokhrel, N. B., Khadayat, R., Tulachan, P. (2020). Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC Psychiatry, 20, 1-18. https://doi.org/10.1186/s12888-020-02645-6
  32. Rodgers, K.B., Rose, H.A. (2002). Risk and resiliency factors among adolescents who experience marital transitions. Journal of Marriage and Family, 64(4), 1024-1037. https://doi.org/10.1111/j.1741-3737.2002.01024.x
  33. Shah, M., Hasan, S., Malik, S., Sreeramareddy, C.T. (2010). Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school. BMC medical education, 10, 1-8. https://doi.org/10.1186/1472-6920-10-2
  34. Shamila Manori, D.M., Pavithra G., Pushpa L.J. (2023). Magnitude of resilience among Grade 10 Adolescents of State Schools in the District of Gampaha, Sri Lanka, Asian Journal of Interdisciplinary Research, 6(1), 9-16. https://doi.org/10.54392/ajir2312
  35. Skinner, E.A., Kindermann, T.A., Furrer, C.J. (2009). A Motivational Perspective on Engagement and Disaffection: Conceptualization and Assessment of Children's Behavioral and Emotional Participation in Academic Activities in the Classroom. Educational and Psychological Measurement, 69, 493-525. https://doi.org/10.1177/0013164408323233
  36. Sreeramareddy, C.T., Shankar, P.R., Binu, V.S., Mukhopadhyay, C., Ray, B., Menezes, R.G. (2007). Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Medical education, 7, 1-8. https://doi.org/10.1186/1472-6920-7-26
  37. Thomas, C., Zolkoski, S. (2020). Preventing stress among undergraduate learners: The Importance of emotional intelligence, resilience, and emotion regulation. Frontiers in Education, 5, 94. https://doi.org/10.3389/feduc.2020.00094
  38. Tian, L., Liu, L., Shan, N. (2018). Parent–child relationships and resilience among Chinese adolescents: The mediating role of self-esteem. Frontiers in psychology, 9, 323904. https://doi.org/10.3389/fpsyg.2018.01030
  39. Ungar M, Resilience across Cultures, The British Journal of Social Work, Volume 38, Issue 2, February 2008, Pages 218–235, https://doi.org/10.1093/bjsw/bcl343
  40. Verma, A.K., Ayub, A., Singh, G.P., Kumar, A. (2022). Resilience related to novel coronavirus among doctors and undergraduate medical students-A study from India. Journal of Education and Health Promotion, 11(1), 350. https://doi.org/10.4103/jehp.jehp_60_22
  41. Voges, M.A., Romney, D.M. (2003). Risk and resiliency factors in posttraumatic stress disorder. Annals of General Hospital Psychiatry, 2, 1-9. https://doi.org/10.1186/1475-2832-2-4
  42. Wagnild, G. (2009). A review of the Resilience Scale. Journal of Nursing Measurement, 17(2), 105-113. https://doi.org/10.1891/1061-3749.17.2.105
  43. Wagnild, G., Young, H. (1993). Development and Psychometric Evaluation of Resilience Scale. Journal of Nursing Measurement, 1, 165-178.
  44. Walpita, Y.N., Arambepola, C. (2022). Assessment of resilience levels among Sri Lankan nurses: Is there room for improvement? The International Journal of Health Planning and Management, 37(6), 3238-3249. https://doi.org/10.1002/hpm.3552
  45. Wasonga, T. (2002). Gender effects on perceptions of external assets, development of resilience and academic achievement: Perpetuation theory approach. Gender Issues, 20(4), 43-54. https://doi.org/10.1007/s12147-002-0022-4
  46. Werner, E., Smith, R. (1982). Vulnerable but invincible: A study of resilient children. McGraw-Hill, New York.