Physiotherapy students’ pre-clinical stress prior to an outpatient placement – triggers and remedies

Ms Rebecca Lee1, Ms Dragana Ceprnja1, Dr Mahbub  Sarkar2

1Physiotherapy Department , Westmead Hospital, Sydney, Australia, 2Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing & Health Sciences, Monash University , Melbourne, Australia

Background: Physiotherapy students frequently report stress prior to an outpatient clinical placement. As stress can have a negative impact on student’s ability to learn and maximise the value of their clinical experience, exploring the factors related to their pre-clinical stress in the outpatient setting would seems important.

Aim: This paper explored physiotherapy students’ perceptions of the factors related to pre-clinical stress prior to a musculoskeletal outpatient placement, and the possible mitigation strategies that could be applied.

Methods: Focus groups with 3rd and final year physiotherapy students undertaking musculoskeletal outpatient clinical placement were used to collect qualitative data.   A visual analogue scale (VAS) was used to measure students’ perceived stress prior to the outpatient placement.

Results: There was generally an increase in perceived pre-clinical stress among students. Students viewed outpatients as a complex area that challenges their preparedness for practice as a physiotherapist. Negotiating a new workplace and aligned environmental stresses were also viewed as contributing factors to induce uncertainty and further pre-clinical stress. Adequate information about, and preparation for, the outpatient settings seem valuable to mitigate the pre-clinical stress.

Discussion: Pre-clinical stress related to a musculoskeletal outpatient placement for physiotherapy students appears to be multi-faceted in its origin.

Conclusions: Whilst much of the pre-clinical stress felt by students prior to an outpatient clinical placement relates to the need to assume a more responsible and independent role as a clinician, other precipitating factors would be worthwhile addressing for optimal outcomes for students.


Rebecca Lee is an experienced physiotherapist and educator. Her work has centered around the education of physiotherapy students in both the academic and clinical settings. A strong interest in improving the clinical education experience of both students and educators has seen her recently complete a Master of Health Professional Education through Monash University.

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