Burnout and grit in student physical therapists before and after terminal clinical education experiences: a prospective longitudinal study of a single class-year cohort

Abstract

Rationale: Burnout has been reported by graduate healthcare students during several phases of preprofessional education. The purpose of this study was to explore changes in levels of Doctor of Physical Therapy (DPT) student burnout and grit before and after clinical education. Additional aims included exploring how burnout and grit might differ based on student gender and over time and what relationships might exist between burnout and grit in this population. Methods: All enrolled third year DPT students (n = 50) at a single physical therapist education program participated in this study. Participants were surveyed using the Maslach Burnout Inventory Human Services Survey and the 12-Item Grit Scale at the end of curricular Year 3 and at graduation after terminal clinical education experiences. Descriptive, exploratory, and comparative statistical methods were used. Results: Male participants reported significantly decreased emotional exhaustion (EE) from Year 3 to graduation, p ≤ 0.0001. Overall, the cohort reported significantly decreased EE, F(1,48) = 12.35, p = 0.001, d = 0.44 and increased personal accomplishment, F(1,48) = 13.322, p = 0.001, d = 0.58 after terminal clinical experiences. The main effect of time on grit scores was also significant, p = 0.035. A moderate inverse relationship existed between student grit levels at Year 3 and EE levels at graduation, r = –0.447, p = 0.01. Conclusions: Cohort burnout scores did not meet the Maslach Burnout Inventory criteria definition for burnout; mean EE and personal accomplishment subscale scores significantly changed over time. Male DPT students reported moderate levels of EE at the start of terminal clinical experiences that dropped significantly to low levels compared to female students. Student grit levels in this study were high compared to recent investigations of other DPT cohorts. Grit may have a protective effect against DPT students experiencing burnout. Meshterms: Burnout, Professional; Physical Therapists/education; Achievement.

Factors Contributing to Burnout and Well-Being in Physical Therapist Students

“…Although most of the studies conducted in the United States assessing burnout in physical therapists (PTs) or PT students were published more than 20 years ago, [8][9][10][11][12][13] at least 3 studies have been published within the past 10 years. [14][15][16] Few studies assessing burnout have been published with PT students, although many have been conducted with medical and nursing students. Limited studies exist that describe the process of burnout in PTstudents because no studies were found to follow students through the full course of a PT program.…”

“…ree studies compared levels of PT student burnout at the beginning and end of a semester. 13,15,16 e study by Balogun et al 13 assessed 21 PT students over the course of the 1994 spring semester, using a version of the Maslach Burnout Inventory they had modified for a previous study. e authors found a significant change in emotional exhaustion Allison Smith is a board-certified orthopedic clinical specialist, fellow of the American Academy of Orthopedic Manual Physical erapists, senior physical therapist at Harris Health System in Houston, TX, and adjunct faculty in the Doctor of Physical erapy program at Texas Woman's University, 6700 Fannin St, Houston, TX, 77030 (asmith122@twu.edu).…”

“…The authors found a significant increase in exhaustion and disengagement from the beginning of the semester to the end of the semester in both groups, with second-year students having higher exhaustion and disengagement levels compared with first-year students. Another recent study by Kish et al 16 assessed 50 third-year students from the University of the Incarnate Word DPT program in 2016 using the MBI–Human Services Survey before and after terminal clinical experiences. The authors found a significant decrease in emotional exhaustion scores in male students from moderate to low before and after their terminal clinical experience, whereas female students had low emotional exhaustion scores for both time periods.…”

“…Three studies compared levels of PT student burnout at the beginning and end of a semester. 13,15,16 The study by Balogun et al 13 assessed 21 PT students over the course of the 1994 spring semester, using a version of the Maslach Burnout Inventory they had modified for a previous study. The authors found a significant change in emotional exhaustion from a moderate level at the beginning of the semester to a high level at mid-semester and the end of the semester.…”