Structured approaches to improving outcomes of oral exam in medical and paramedical education: A systematic review and evidence-based framework.

Stress experienced during childhood can leave biological imprints that persist across the lifespan. Stress is conceptualized as a process in which environmental demands are appraised as exceeding an individual’s coping resources, eliciting physiological, emotional, and behavioural responses, consistent with the transactional model of stress and coping []. Although stress responses serve important adaptive functions [], difficulties in regulating or recovering from stress may contribute to adverse developmental and health outcomes with long-term implications. Several complementary frameworks provide insight into why early stress exposure may have lasting consequences. The Developmental Origins of Health and Disease (DoHaD) and adverse childhood experiences (ACEs) frameworks highlight how early-life environmental conditions and cumulative adversity shape biological systems and developmental pathways [–]. Complementing these perspectives, the concept of allostatic load explains the physiological mechanisms through which repeated stress may accumulate as biological wear and tear, ultimately affecting adaptation and health []. Together, these frameworks underscore the significance of childhood stress as a key factor associated with later developmental outcomes []. Most previous studies on childhood stress have focused on severe stress associated with major life events such as parental divorce, disasters, and abuse. In contrast, comparatively less attention has been given to children’s daily stress experiences []. Daily stress refers to frustration-inducing environmental demands encountered in everyday contexts []. Although these stressors are generally less severe than major adverse experiences, everyday stressors can still disrupt emotional and physiological regulation [,]. Empirical evidence suggests that high levels of family conflict in daily life can disrupt young children’s physiological stress-regulation systems [], and that elevated daily stress during elementary school predicts increased internalizing and externalizing problems in adolescence []. Despite growing evidence that everyday stress experiences have been associated with children’s developmental functioning, research on daily stress in typically developing children remains relatively limited [].