Coping Strategies in Physical Therapy Students.
Purpose/Hypothesis: The academic rigor and intensity of coursework inherent to medical education exposes students to a significant amount of stressors and stress that can lead to anxiety and depression. High stakes assessments also induces stress and anxiety responses related to a fear of failure. This stress can be managed to varying degrees of success with coping strategies, but not all students are able to employ effective strategies. The purpose of this study was to analyze the coping strategies that students in a physical therapy education program employ with the goal of informing the development of interventional strategies that enhance academic resilience and success. It was hypothesized that the original factor structure of the original survey would be confirmed and that a new model of underlying constructs of coping strategies would be identified within this sample Number of Subjects: A total of 156 out of 243 students enrolled in the professional phase of a 6 year doctorate in physical therapy (DPT) program completed an anonymous electronic survey (61% response rate). Materials and Methods: The survey included basic demographic information and the Brief COPE Inventory (BCI). The BCI is a 28 item 4-point Likert scale instrument that identifies 14 coping styles/strategies and has been used frequently in the literature with students in higher education. Principal component analysis with varimax rotation and Kaiser normalization was performed using SPSS in order to explore underlying factor structure or constructs within the data. Results: Principal component analysis produced 6 factors (eigen values >1) or constructs that explained a total of 61.9% of the variation of the sample. Multiple BCI items/coping strategies loaded on each of the 6 factors and were consistent with original survey validation. The 6 factors/constructs were (original BCI strategies): 1) Social support (use of emotional support, instrumental support, and venting); (2) Avoidance (denial, behavioral disengagement, and self-blame); (3) Active problem solving (planning and active coping); (4) Positive thinking (acceptance, positive reframing, humor); (5) Religion (religion); and (6) Substance abuse (substance abuse). Conclusions: The results of this survey are consistent with previous findings of the existence of a multi-factor model of coping. A new 6-factor model identified in this study suggests that students utilize a variety of positive and active coping mechanisms (Social support, Active problem solving, Positive thinking and Religion) as well as negative and less appropriate strategies (Avoidance and Substance abuse) in coping with academic stressors and stress. Clinical Relevance: Interventional strategies aimed at developing students' ability to recognize negative strategies and modify their chosen strategies toward positive or productive strategies may result in reduced stress and anxiety and increased levels of resiliency both during the educational process and in clinical practice. Further investigations into potential correlations between perceived stress, resilience and coping mechanisms as well as the effectiveness of interventional strategies are recommended.