Replacing stressful challenges with positive coping strategies: a resilience program for clinical placement learning

Abstract

Clinical education is foundational to health professional training. However, it is also a time of increased stress for students. A student's perception of stressors and their capacity to effectively manage them is a legitimate concern for educators, because anxiety and decreased coping strategies can interfere with effective learning, clinical performance and capacity to care for patients. Resilience is emerging as a valuable construct to underpin positive coping strategies for learning and professional practice. We report the development and evaluation of a psycho-education resilience program designed to build practical skills-based resilience capacities in health science (physiotherapy) students. Six final year undergraduate physiotherapy students attended four action research sessions led by a clinical health psychologist. Resilience strategies drawn from cognitive behavioural therapy, and positive and performance psychology were introduced. Students identified personal learning stressors and their beliefs and responses. They chose specific resilience-based strategies to address them, and then reported their impact on learning performance and experiences. Thematic analysis of the audio-recorded and transcribed action research sessions, and students' de identified notes was conducted. Students' initial descriptions of stressors as 'problems' outside their control resulting in poor thinking and communication, low confidence and frustration, changed to a focus on how they managed and recognized learning challenges as normal or at least expected elements of the clinical learning environment. The research suggests that replacing stressful challenges with positive coping strategies offers a potentially powerful tool to build self-efficacy and cognitive control as well as greater self-awareness as a learner and future health practitioner.

“I was yelled at, intimidated and treated unfairly”: Nursing students' experiences of being bullied in clinical and academic settings

“…Delany et al. () provide findings to support resilience training in a study with physiotherapy students and claim it “offers a powerful tool to build self‐efficacy and cognitive control.” Several authors have suggested preplacement preparation that includes mindfulness (van der Riet et al., ) and resilience training using simulation (Pines et al., ) that hold promise for enhancing preparation of students. An integrative review also supports interventions to enhance resilience of nursing students (Reyes, Andrusyszyn, Iwasiw, Forchuk, & Babenko‐Mould, ).…”

“…The sense or belief that reporting would not change anything contributes to nonreporting, together with fear of losing one's position or job (Kvas & Seljak, ). In addition to zero tolerance and reporting processes, others have explored the use of resilience training (Delany et al., ; van der Riet, Rossiter, Kirby, Dluzewska, & Harmon, ); education and simulation (Pines et al., ; Ulrich, Gillespie, Boesch, Bateman, & Grubb, ). Yet such programmes appear to remain at pilot level or as isolated initiatives and there is no requirement to embed them in undergraduate education despite the widespread impact of such experiences.…”

Psychosocial student functioning in comprehensive dental clinic education: A qualitative study

“…It is important that dental school faculties recognise the challenge of values education in the dental school environment, as value choices in schooling often remain with dentists their entire careers . Specifically, when dentists recognise the need to value stress management, there are ways to help them learn psychological resilience and positive coping skills . Leaders of dental educational institutions have the responsibility to prioritise improved communication skills and stress management for dental students.…”

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…Moreover, research studies in the United States seem to indicate that females students, as compared to their male counterparts, appear to be more vulnerable to burnouts (Abeysekera and Dawson, ; Luthar, ; Yan et al, ; McLuckie et al, ). This has been proposed to be due to a greater propensity of females to internalize depressive feelings (Delany et al, ; Kenney et al, ) and experience increased generalized anxiety (Kessler, ; Dyrbye et al, ; Liao et al, ; Dyrbye et al, ).…”