Academic stress among radiography students: Examining the impact of GPA and class level on student well-being and performance

BACKGROUND: Academic stress affects student performance, mental health, and retention, especially in radiography programs where students face demanding coursework and clinical training. These pressures often begin early and intensify with each academic year, yet limited research has examined how stress levels vary by GPA and class level. This gap is more evident in the Middle East and North Africa (MENA) region, where educational systems and student support structures differ across countries. Addressing this gap is necessary to inform targeted interventions and improve student outcomes. This study investigates the influence of GPA and class level on academic stress, well-being, and performance among radiography students in Egypt, the United Arab Emirates (UAE), and Jordan. MATERIALS AND METHODS: A cross-sectional survey was conducted among 608 radiography students using a validated online questionnaire titled “Radiography Academic Stress Questionnaire (RASQ).” The RASQ was developed based on previous academic stress literature and underwent expert review for content validity. Participants were recruited through convenience and snowball sampling. The survey assessed demographics, academic stressors, and subject-specific challenges. Statistical analyses, including Chi-square and Fisher’s exact tests, were performed to explore correlations between GPA, class level, and academic stress. RESULTS: GPA was included as a key variable because it objectively reflects academic performance and is consistently linked to psychological stress. This relationship is evident in the data: Students with lower GPAs reported significantly higher stress across multiple domains, including financial hardship (P = 0.001), examination-related anxiety (P = 0.001), and difficulty balancing academic and personal life (P < 0.001). Stress from specific subjects—such as radiological anatomy, X-ray, and ultrasound—was more common among low-GPA students (P < 0.005). Class level was also a significant factor: freshmen experienced greater financial stress (P = 0.028), while seniors reported elevated stress due to academic workload and graduation projects (P = 0.001). CONCLUSION: Academic stress in radiography students is closely linked to GPA and class level. Lower GPAs and transitional academic stages correspond with heightened stress, particularly in demanding subjects and final-year requirements. Targeted interventions are needed to address financial, examination, and workload-related stressors. Impact on Practice: Institutions should implement academic mentoring, financial aid, and stress management workshops. Faculty training and curriculum adjustments, such as incremental learning modules, may reduce stress in challenging subjects. These measures can enhance student well-being and prepare a resilient healthcare workforce.