Physical Therapy Student Stress: A Brief Mindfulness Intervention and Recommendations for Future Stress Reduction Programming
Purpose/Hypothesis: Recent studies show high levels of stress among DPT students. Research suggests that intensive (8-36 weeks, 2-5 hours per week) mindfulness interventions decrease stress in college, medical and nursing students. A recent study suggests less time intensive interventions (e.g. phone meditation apps) decrease stress in college students. There have been no studies to assess the effects of less intensive mindfulness interventions in DPT students. The purpose of this study was to explore changes in stress in DPT students and assess their perception of a weekly 15 minute mindfulness intervention.
Number of Subjects: First year (Y1, n=33) and second year (Y2, n=15) DPT students.
Materials and Methods: This mixed methods longitudinal study monitored stress levels 3 times during Fall Semester 2018 using the Perceived Stress Scale (PSS). Students who scored high stress (PSS>26) met with a faculty member to discuss strategies including mindfulness resources (e.g. websites, meditation apps). The 15 minute intervention (mindfulness education and a guided meditation) was performed in class 1x/week for 8 weeks. Qualitative interviews were performed with Y1 students to explore the origin of stress.
Results: During the semester, average Y1 student PSS changed from 19.3 (baseline) to 14.7 (midterm) to 16.6 (final): baseline-midterm p<.001; midterm-final p=0.06; baseline-final p=0.03. At baseline, Y1 students had higher PSS scores vs Y2 students, 19.3 vs. 11.4 respectively (p<0.001). When asked to list one word that described their stress, 42% (14/33) of Y1 students stated “overwhelming.” Two themes emerged from mid-semester focus groups: 1) the primary source of stress was the high volume of work and uncertainty about how to approach the workload; 2) stress levels fluctuated during the semester based on changes in exam and workload demands. At the end of the semester, most Y1 students reported the 15 minute mindfulness intervention was helpful, but the effects were short term. Of the 7 Y1 students in the high stress category at baseline, only 2 remained high stress at the end of the semester. Of these 7 students, 5 stated is was helpful to meet with faculty to discuss stress and 4 said they benefitted from the recommendation to try phone meditation apps.
Conclusions: Although this brief mindfulness intervention was well received by students, the decrease in stress was short term. Similar to a recent study, Y1 students experience higher stress than Y2 students.
Clinical Relevance: Early interventions in DPT programs may help manage stress. Mentoring from Y2 students regarding how to manage high workload volume during Y1 may be helpful in future programming. Although classic mindfulness programs are effective, PT students are hesitant to commit to these time intensive programs. Future research should focus on interventions that are consistent, accessible and not too time intensive (e.g. daily phone meditation apps).