Stress in Dpt Students: A Qualitative Study
Purpose
Previous research suggests that healthcare students experience higher levels of stress than the general population. Stress has been linked to burnout, depression, anxiety disorders, substance abuse and suicide in healthcare students. Studies of stress in Doctor of Physical Therapy (DPT) students are limited and almost exclusively quantitative in nature. The purpose of this study was to explore the experience, management and impact of stress on DPT students using qualitative methodology.
Methods/Description:
This research was a qualitative, phenomenological study using a cross-sectional design. Participants included 27 students in years 1, 2 and 3 who were recruited from three physical therapist education programs in the Upper Midwest. After obtaining consent, 60 minute, semi-structured in-person interviews were conducted with each participant. Interviews were digitally recorded, transcribed verbatim and uploaded into NVivo 12 for analysis. Researchers individually coded the data and then collaboratively identified themes and sub-themes using an iterative consensus process.
Results/Outcomes:
Three primary themes emerged from these data. The first theme, sources of stress, reflected stressors that stemmed from academic, personal and financial sources. Participants reported academics related to didactic and clinical curricula as the greatest source of stress. Some academic sources of stress, such as exam schedules, were perceived as externally imposed and others, such as a desire to meet a personal standard of performance, were internally imposed. Stress experienced during clinical education stemmed from adjustment to the clinical site and the relationship with the clinical instructor. Financial sources of stress were perceived as a less immediate concern. The second theme, experience and impacts of stress, reflected studentsÕ immediate physical, emotional and cognitive experience of stress as well as positive and negative behavioral impacts related to motivation, learning, eating, sleeping and socializing. Many participants noted that stress positively impacted motivation and promoted resilience. The final theme, coping strategies and stress modifiers, highlighted coping strategies that included problem-based approaches, social support and self-care activities such as exercise. ParticipantsÕ experience of stress changed over time in relation to transitional points and progression in the program. Relationships with faculty were a programmatic factor that served as a stress modifier. Nearly all participants reported that the stress they experienced as a student was what they expected and was generally acceptable.
Conclusions/Relevance to the conference theme:
As identified in previous research with healthcare students, DPT students in this study experienced high levels of stress. While some stress was perceived to be motivating, distress was associated with high content volumes, multiple exams in compressed time periods and didactic curricular rigor. In contrast to the findings of other researchers, most participants demonstrated positive coping mechanisms and described program cultures in which faculty and other students were supportive and promoted healthy stress management approaches. Financial pressures were described as an anticipated future stressor but not a factor over which participants perceived that they had present control. These results support several recommendations associated with exam scheduling and frequency, content load and faculty support that may reduce unnecessary stress for students and improve learning outcomes. They also highlight critical periods where additional support may be needed.