Tori Thorpe, SPT; Madison Hayenga, SPT; Daniel Patterson, SPT; Austin Brown, SPT

Research Advisor:   Dr. Joy Karges-Brown, PT, EdD, MS

36 Comments on “Impacts of perfectionism, stress, anxiety, and coping strategies in student physical therapists and student physical therapist assistants

  1. Great job you guys! I like how you did the formatting of your poster, it is simple and to the point but it conveys your research and results in a professional manner. Also, I thought it was a nice touch to color code your variables throughout your poster. From your limitations section, I saw that your group was only able to recieve surveys from schools in the midwest. Do you think different geographic regions (or even different countries for that matter) would have different stress levels of their SPTA and SPT students when compared to the midwest? Also, was your group able to determine a reason for why so few males participated compared to females? Good job guys!

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    • We do believe different geographic regions (or countries) would have different stress levels for SPTA and SPT students compared to the midwest. PTA and PT programs differ in their course work requirements, which may play a part in varying stress levels. Also, there may be more activities offered in certain regions compared to others, therefore, students may find better coping strategies to deal with their stress in one area versus another. A further study would need to be conducted to determine this. We believe the reason that so few males participated in this study compared to females is because the PTA and PT professions are mainly female dominated. Great questions Nick!

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  2. Why do you think females showed significant difference in multiple categories compared to males? Similarly, how do you think male and female perception of stress, perfectionism, anxiety, and coping differs?

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    • Thanks for your questions Rachel. When we developed our hypotheses, our group came to the consensus that males and females would report equal levels of stress. The analysis of differences paints an interesting picture on how the each gender handles the same variables.

      My impression from our data as to why females showed significant differences in categories compared to males is the idea that females tend to be more emotionally intelligent/reflective than males. This is not to say that males have no feelings or ability to self-reflect. However, I think this idea nicely explains how our analysis of differences identifies increased point differentials in instrument measures such as the PSS-10, both Y-Forms of the STAI, and the P-value differences between genders who used emotion-focused coping strategies.

      On the contrary, I do think as a collective group DPT students have a perfectionist tendency regardless of gender. Although I am not a PTA/PTA student, I’d believe the same can be said about that profession as well. I think it’s fair to assume there is a “common ground” that all participants in the study share–which our first conclusion nicely summarizes as, “Students in health-related fields, particularly SPTs, have been found to experience
      increasing levels of stress, anxiety, and perfectionism, which can have negative effects on their mental and physical health.”

      One of the future implications we had for this study was to establish normative data in DPT and PTA programs for future comparisons–and your questions point out why future research in this area would be beneficial for further analysis between the genders amongst both professions!

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  3. You all did a great job of conveying your research in a clear, linear manner! Your topic was also interesting and relevant for SPTs. What would be an example of a problem-focused coping strategy or an emotion-focused coping strategy?

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    • Hi Hailey, thanks for you interest in coping strategies as they can be highly important for many students who are undergoing schooling for physical therapy with its curriculum. There are many different examples that could be fitted for each strategy. A few emotion-focused strategies include meditation and breathing techniques with the goal in mind of regulating our emotions. A problem-focused coping strategy have the goal of reducing or eliminating the problem/cause of stress which are based on the scenario but could be setting boundaries, or completing your assignment/test.

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  4. You all did an amazing job! The information was well organized and easy to understand. Do you believe other students in different areas of healthcare would experience the same rates of stress and anxiety? In addition, why do you think there is a significant difference between the amount of students with high stress levels compared to those with high anxiety levels?

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    • Hi Mikhayla. Thank you so much for your feedback on our poster and for your interest in this topic. We do believe that students in similar healthcare fields, such as medical and chiropractor to name a few, would experience similar trends with higher stress and anxiety levels due to the higher level of educational demand. To answer your last question regarding the difference between students who experience high levels of stress versus high levels of anxiety, I believe there are a lot of factors that play into these results such as the different coping mechanisms that students may use. It may be due to the fact that some students may have a better coping strategy to help them cope with anxiety versus stress and visa versa. It would be interesting to look more into this specific area. Thank you for the great questions and for taking time to explore our poster.

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  5. You guys did a really great job with your poster and with presenting the information in an easy-to-understand way! I also think you all picked a very interesting and relevant topic. Reading through the posters, this one instantly caught my eye and I had to know more. Why do you think that females scored higher in both problem-focused and emotion-focused coping strategies? Also, how much do you think that a student’s year in school influenced their stress, anxiety, perfectionism, and coping strategy?

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    • Hi Brianna, thanks for your question and interest in this topic. There are many different examples that could be fitting for each strategy depending on preference of the individual and situation. A few emotion-focused strategies include meditation and breathing techniques with the goal in mind of regulating our emotions. A problem-focused coping strategy have the goal of reducing or eliminating the problem/cause of stress which are based on the scenario but could be setting boundaries, or completing your assignment/test. Avoidant focused coping is not a strategy we suggest using as it is avoiding the situation by distracting yourself or staying occupied doing other things.

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  6. Great job with your research project! I noticed that your second hypothesis (“SPTs will report higher levels of stress and anxiety compared to SPTAs”) was rejected in your discussion. Did the small sample size of SPTA students affect this conclusion, or did you find no difference at all in your data analysis comparing SPTs and SPTAs levels of stress and anxiety?

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    • Great questions Julie! Our results indicated that there were no significant differences in Perceived Stress Scale and State-Trait Anxiety Index scores between SPTs and SPTAs, therefore, our second hypothesis was rejected. The small sample size may have impacted the results of stress and anxiety levels in SPTs compared to SPTAs. Further research needs to be conducted to determine this, which is why we made this topic a point of discussion for future research.

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  7. I think this is a very interesting topic which is relevant to not only SPT and SPTA students, but also for many graduate students who are help to a higher standard than undergraduate students. I am wondering what would some examples of each type of coping strategy be?

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    • Hi Madison, thanks for your interest in our poster. I had a few similar questions above that you can refer to but in general there are many different examples that could be fitting for each strategy depending on the situation and individual.
      A few emotion-focused strategies include meditation and breathing techniques with the goal in mind of regulating our emotions.
      A problem-focused coping strategy have the goal of reducing or eliminating the problem/cause of stress which are based on the scenario but could be setting boundaries, or completing your assignment/test.
      Avoidant focused coping is not a strategy we suggest using as it is avoiding the situation by distracting yourself or staying occupied doing other things.

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  8. Hello, awesome job with this poster! I found it to be very clear and concise which made it easy to understand. I think that stress in the healthcare field is beginning to be more talked about, and I hope that we can continue to find strategies to help lower stress in an effective manner. I am curious if your team has brainstormed any possible procedures to help manage the day-to-day stress of working in healthcare? I am also wondering if you found any information that correlates to the amount of student loan debt that a student has and how that impacts their stress/anxiety levels?

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    • Hi Macy–thanks for your questions. To answer Question #1: I would agree that stress & anxiety are hot topics in the D2D intricacies of healthcare. I believe it’s worth mentioning how many healthcare facilities, locations, providers, etc. of all types are still dealing with the tail-end of COVID and how that essentially changed the world. There are many ‘procedures’ that our research group prospectively formulated but it wasn’t the main purpose of our study. We were trying to think beyond the traditional ideas of Time Management and Self-Care Routines to come up with other ideas. Some of them involved: Professional Development, Taking Regular Vacations, Team Collaboration/Friendships. One of the more important ones I believe to be as helpful for not just DPTs but other professions as well is setting boundaries; establishing clear boundaries between work and personal life to avoid overextending yourself is really important. As happy as we are by nature to say “yes” to many things, we should also learn when to say “no” when necessary. To answer Question #2: We did not inquire about student loans or related topics simply because of time constraints and the lack of data we encountered while developing our Lit Review and similar aspects of our research. Our hope is that our study serves as a foundational research study for future research to build off our data (normative data if you will) so topics such as Student Debt, Relationships, Location, etc. can be studied in depth. With that said, I would certainly like to think student loan debt increases both stress and anxiety levels as much of the literature surrounding DPTs and other fields backs this correlation.
      -Austin

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  9. Hi, I really enjoyed the relevance of your research because it not only effects you but also people you surround yourself with everyday. Do you think the stress and perfectionism of peers can impact the fear/anxiety that is felt while in a graduate program?

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    • Hi Tessa–I absolutely think the stress and perfectionism of peers can impact the fear/anxiety felt in a graduate program. I would say an aspect of our study that we weren’t able to assess was the peer-to-peer interaction aspect. I’ve always expressed how hard it is even as a Year 1 to drop the “competitive attitude” towards your peers because that was the mentality most of us lived during our undergraduate times when applying to programs. So by nature we see that carry-over into our cohorts for many students unfortunately. Sprinkle in some stress, anxiety, and perfectionistic tendencies and it is fairly easy to connect the dots on how things could “snowball”. I would love if future research tracks prospective DPT students from their time in undergrad studies all the way through graduate school (DPT) to see how their perspective changes on the variables we used and more. Thanks for your question Tessa!

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  10. Great poster! I love how easy the poster is to read and the use of different colors to help organize your variables. I think it is extremely important to talk about mental health, as everyone may deal with troubling times in any degree at some point in their lives. Because graduate school does demand a higher level of commitment, intellectual thinking, and time, stress and anxiety are almost inevitable. Have you done any research on methods of relieving stress, anxiety, and perfectionism or effective copying strategies in graduate students to address these factors?

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    • Peyton–thank you for your kind words on our work. I completely agree about what you said regarding mental health and believe our research does a solid job highlighting it’s clinical relevance to our field. The brief answer to your question is yes, research was done on our 4 established variables. You may have already noticed that there are three “parts” to the variables: [1] Definition, [2] Identify/Measure, and [3] Analysis.

      If our study had a “fourth part,” I think it would fall under a term along the lines of, “[4] Application.” This is what I thought your question alluded to. Because the research in this particular population & interest is rather limited, the studies purpose was to examine the 4 variables and provide implications for future research (ie. application) based on our findings. In a perfect world, future research would utilize our data to dive deeper in the specific methods DPT students used, which could ultimately open new doors to methods we haven’t been made aware of yet.

      However, we did *indirectly* encounter a few broad methods to our variables, such as determining if a perfectionist was adaptive or maladaptive. The same could be said about coping methods, where Problem, Avoidant, or Emotion-Focused strategies could be determined. We essentially have a “general” idea of what these methods are but not enough detail to directly determine what specific methods our participants utilized. Hopefully that makes sense.

      For what it’s worth, the methods to relieving stress, anxiety, and perfectionism in the literature across various medical professions appear to have a common ground of shared methods such as: meditation, exercise, time management, etc. The same could be said regarding maladaptive methods such as: pulling “all nighters”, excessive alcohol consumption, drug abuse, etc.

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  11. Great poster guys, the information was clear and the outline very reader friendly. Given the data here shows that most SPTs and SPTAs experience moderate levels of stress and anxiety. Was there any information on how this affected their academic or clinical performances as compared to those who had lower levels of such experienced states. We know currently that burnout within the field is very much prevalent, so curious if this has any relation or transfer to the workforce and what might be ways to mend this.

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    • Hi Kino.

      Thank you for your question and for taking time to explore our poster. In our research, we didn’t look at the longer term affect of the stress and anxiety felt throughout the schooling process for SPTs and SPTAs. However, that would be interesting to see how the anxiety and stress that was high throughout school effected clinical performance on a more long term basis.

      Thanks for the question.

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  12. Great job with your research and poster! I found extremely easy to follow and included things that I felt were relevant to many of our lives. A question I have for you guys is, would it be advantageous to look into the types stressors that students may report? Such as PTA students may report lower levels of stress due to the fact that school isn’t typically placing as much of a financial hardship on their lives as PT students.

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    • Great question Parker! We do think it would be advantageous to look into the types of stressors students report. Looking into different stressors between PT and PTA programs would be useful in determining what can be done to help students reduce their stress levels while in school. We think some interesting areas to look into would be education requirements, amount of free time, cost of schooling, and being away from family. It would be very interesting to compare the two programs and find the main source of stressors between them.

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  13. Great job presenting these findings! I have a few questions so bear with me! Is there a plan to conduct a repeat of the survey to see if any of these factors change as students progress through their programs? Also, were there any questions related to whether or not participants had previously been diagnosed with anxiety? Lastly, how did you decide upon your definitions for the variables and the outcome measurement tools you utilized (were they similar to what is used in psychological practice with the DSM-5, previous studies in education, etc.)?

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    • Great questions. Thank you for taking the time to explore and learn more about our research. As of today, there isn’t a plan to repeat the survey. However, that would be interesting to see how the factors and results change throughout each year of graduate school. In the survey, there was an optional question where participants could state if they had recently been diagnosed with anxiety or depression. This question was optional and if I remember right, I don’t believe anyone voluntarily answered. We decided each outcome measurement tool based upon what research had to say in regard to the validity and reliability as well as how often that specific tool was utilized with graduate students in other studies. I hope that answers all of your questions. Thank you again for the great questions.

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  14. Great job with your presentation! I appreciated the color coordination and organization as it made the reading much easier. You mentioned how only Midwest schools were used in the study and viewed as a limitation. Do you have any ideas on how to intrigue participation from schools from different regions to participate in your study? How do you think that could affect your data in terms of student stress levels?

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    • Hi Morgan, thanks for your kind words. I think if we wanted to broaden the geographical categories for a study like ours it would have to involve some form of incentive (ie. prizes, $$$, etc.). I tried to think of an example of this and basically came up with: “Imagine you’re going to the University of Southern California DPT and you get this email asking for your participation. You really have no incentive to participate, but your response is more likely to be ‘Yes’ if it means you have a chance at winning a prize/etc.” It’s worth noting that if we received limited participation from a specific region we may not be able to make conclusions about that area based off the data that is accurately reflective of their demographic if the sample size is too small. This is largely why we kept it to the Midwest for more “control” if that makes sense.

      That being said, I think if we did get a larger sample size from various DPT and PTA locations in the United States, I’d like to think it would be reflective of what we found already if not more profound in terms of stress, anxiety, and perfectionism levels. I don’t think this is exclusive to the Midwest.

      I wrote the following quote in a different reply that might be of interest to you: “I think it’s fair to assume there is a “common ground” that all participants in the study share–which our first conclusion nicely summarizes as, ‘Students in health-related fields, particularly SPTs, have been found to experience increasing levels of stress, anxiety, and perfectionism, which can have negative effects on their mental and physical health.'”

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  15. Hi everyone, great poster! This research is very interesting to me, being a first-year SPT. What aspects or characteristics of high anxiety levels do you think lead to an individual becoming a maladaptive perfectionist? Additionally, what actions can students with high anxiety levels take to avoid being a maladaptive perfectionist?

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    • Hi Taylor, great questions. Based on our research, being a maladaptive versus an adaptive perfectionist is all based upon your self critic. Whether you can strive for high achievements and accept when you fall short and continue working towards your goals and be adaptive. Or you fall short and are very self-critical and can not except anything but the highest achievements. When looking at characteristics that may lead to becoming a maladaptive perfectionist, I don’t think there are specific ones. I believe that two individuals could hold the same characteristic, but it is more the coping mechanism they choose to utilize that categorizes them rather than one or multiple characteristics. Two individuals could be highly competitive but one copes by relaxation techniques in times of stress, and the other avoids that they are stressed.
      Some actions I suggest students take to avoid being categorized as a maladaptive perfectionist include researching and looking at the coping mechanisms that have been analyzed through our study such as meditation, relaxation techniques, breathing techniques, and many others finding what works best for them individually.

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  16. Hello! Great job with this research poster! I found it very interesting and easy to follow! As a first year PT student I found this research very relevant to my life currently. While completing this research what were some of the coping mechanisms that were found to be most effective in those dealing with stress/anxiety from their academic program?

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    • Hi Brandon, thanks for your interest in our research. We found that is very relevant and relatable to all PT students going through a high level graduate program. The most effective and utilized coping strategies for those dealing with stress and anxiety were problem focused coping strategies. These strategies are very situational strategies that can be different for everyone but a few examples include completing a homework assignment so you can cross it off the list and not worry about it anymore. It could also include setting boundaries with roommates or lab partners, if they are a stressor to you or invading your personal space/time. A few others including time management or asking for support which are both effective in dealing with increased stress levels.

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  17. Hey guys, great poster! I saw that one limitation you had was that only SPT’s and SPTA’s were surveyed. Do you think this would have been different is you would have included other graduate students? Did you find any research that compared the stress levels of different types of graduate students?

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    • Hi Amanda! I did find in my research that one study mentioned medical students had reported less stress when compared to students of physical therapy. That stood out to me and I thought was interesting. However, there are many factors to include so it may not be generalizable to the entire population of medical students. It would be interesting to me to study more fields such as Occupational Therapy, Physical Therapy, Pharmacy, and Medical Students to compare perfectionist and stress levels. I think we would ultimately find very similar stress levels across the board.

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  18. Great research! I thought it was very easy to follow and presented appropriately! Following your research, did your group find and/or discuss ways that our DPT program could incorporate coping strategies for students to utilize?

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    • Thanks for the kind words Grace. We did find & discuss ways USDPT can incorporate these strategies. Most notably the discussions revolved around making sure all faculty are aware of the hurdles students are facing (think about workload and time management) that isn’t sustainable. The purpose of this research is to establish a normative baseline moving forward with future research to dive deeper in the variables that were of our interest to best guide how any program can implement coping strategies as well as other helpful gestures to ensure all students feel heard and understood. Hope this helps!

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