Perfectionism, Perceived Stress, Sleep, and the PT Student
Purpose: Doctor of physical therapy students experience increased stress levels due to increased academic workload and performance expectations (Frank & Cassady, 2005; Frazer & Echternach, 1991; Hodselmans et al., 2018; Jacob et al., 2012; O’Meara, Kostas, Markland, & Previty, 1994). There is a limited understanding of how successful these students are at coping with the increased stress, especially in those students who are perfectionists. This is concerning since ineffective stress management may exacerbate depressive symptoms (Pauley & Hesse, 2009) and insufficient sleep (Amaral et al., 2018; Park & Iacocca, 2014) which ultimately adversely impacts academic performance (Palmer et al., 2013; van der Heijden et al., 2018). Additionally, there has been a call to address burnout among health care providers by improving the resiliency of new graduates (Bodenheimer & Sinsky, 2014; Bowles, Adams, Batcheller, Zimmermann, & Pappas, 2018; Morrow, Call, Marcus, & Locke, 2018). The purpose of this study was to examine perfectionism among entry-level Doctor of Physical Therapy students and to assess its relationship to perceived stress and sleep quality. Methods/Description: Researchers conducted a non-experimental study using a single-site, cross-sectional design. A convenience sample of third-year Doctor of Physical Therapy students were invited to complete an online survey that measured perfectionism (Almost Perfect Scale-Revised (APS-R)), perceived stress (Perceived Stress Scale (PSS-10)), and sleep quality (Pittsburg Sleep Quality Index (PSQI)). Participants provided consent via an online informed consent form. This study was approved by the IRB at a public university in Texas. Results/Outcomes: Forty-one 3rd year Doctor of Physical Therapy students (15 male, 26 female) agreed to participate. Using the APS-R, researchers identified 14/41 (34.15%) Adaptive Perfectionists (AP), 12/41 (29.27%) Maladaptive Perfectionists (MP), and 15/41 (36.59%) non-perfectionist (NP). Additionally, the mean PSS-10 score for 3rd year was as follows: overall 16.80 (SD 4.33), female students 17.81 (SD 4.43), male students 15.07 (SD 3.65), AP 16.00 (SD 6.03), MP 17.83 (SD 3.38), and NP 16.73 (SD 3.03). For comparison, PSS-10 normative data for a sample less than 25 years old was 16.78 and for a sample 25-34 years old was 17.46 (Cohen & Janicki-Deverts, 2012). Using the (PSQI) for 3rd year students, researchers identified 25/41 (60.98%) had good sleep quality, and 16/41 (39.02%) had poor sleep quality. More specifically, PSQI scores were as follows: AP 4.43 (SD 2.41), for MP 6.00 (2.30), and for NP 5.33 (SD 3.31). For comparison, a PSQI of 6 or greater indicated significant sleep issues in a college population (Dietch et al., 2016). However, among third year Doctor of Physical Therapy students, no correlations were found between perfectionism, perceived stress, nor sleep quality. Conclusions/Relevance to the conference theme: In conclusion, among this sample of third-year, Doctor of Physical Therapy students, there was a similar distribution of APs, MPs, and NPs. Perceived stress levels were consistent with an age-matched norm sample. More specifically, female students reported higher stress levels than male students. Additionally, among perfectionists, MPs reported the highest stress levels compared to APs who reported the lowest stress levels. Furthermore, MPs had poorer sleep quality than APs. This research is relevant to the conference theme of burnout and empathy since a better understanding of perfectionism and its association with stress perception and sleep quality while in physical therapy school may result in earlier identification of vulnerable students at risk for burnout. Identifying those at risk for burnout prior to becoming novice clinicians may increase the window of opportunity for teaching effective stress management strategies (Bodenheimer & Sinsky, 2014; Bowles et al., 2018; Morrow et al., 2018).