Stress and Burnout in Postgraduate Physiotherapy Students: A Mixed Methods Observational Cohort Study

Background and Purpose:
The impact of stress and burnout in students is an emerging topic. When students perceive that they are unable to cope with stressors, there is increased potential for burnout. To maximise students’ higher educational institution (HEI) outcomes, students must be able to effectively cope with stressful demands. Research suggests physiotherapy students, in particular, suffer from a high risk of stress and burnout, however limited research exists on postgraduate, pre-registration, physiotherapy students. The purpose of this study was to determine perceived stress, burnout and associated coping strategies across three time points in the first year of a post-graduate, pre-registration physiotherapy program.

Subjects: All first year Doctor of Physiotherapy (DPHTY) students at Bond University 2019 were invited to participate.

Methods: A mixed methods observational cohort design was implemented in one Australian HEI to determine stress, burnout and coping strategies across 3 time points. The 51-item self-administered questionnaire consisted of demographics, the Coping Self Efficacy (CSE) Scale and Maslach Burnout Inventory – General Survey for Students (MBI-GS (S)), and open-ended questions.

Results: A response rate of 62% (n=38) was achieved. There were no differences in stress and burnout scores between sexes, nor differences in stress and burnout over time. Highest median CSE scores were seen at T1, with highest median MBI-GS (S) cynicism (CYN) scores at T2, exhaustion (EX) at T1 and T2, and professional efficacy (PE) at T1 and T2. The greatest mean CSE changes were seen from T1-T2 and T1-T3, and PE greatest changes from T2-T3 and T1-T3. No strong correlation was found between stress and burnout. Curriculum coursework was a frequently reported stressor, along with clinical placement and transition periods. Coping strategies utilized by students were both positive and maladaptive. Positive strategies included sporting activities, baking, listening to music, and social connections, whereas maladaptive strategies included alcohol consumption, excessive eating and gaming.

Conclusion: Student consistently identified periods of stress and burnout, with curriculum coursework in particular being a trigger. Findings acknowledge the need for further investigation on sources of perceived stress, burnout and coping mechanisms to optimise student welfare and enhance HEI outcomes.