Variable levels of perceived stress and anxiety reported by physiotherapy students during clinical placements – quantitative data

Kathy Stiller1, Deborah Gallasch2, Amy Conlon-Leard3, Michelle Hardy4, Anna Phillips5, Gisela Van Kessel5

1Central Adelaide Local Health Network, Adelaide, Australia, 2Royal Adelaide Hospital, Adelaide, Australia, 3The Queen Elizabeth Hospital, Adelaide, Australia, 4Hampstead Rehabilitation Centre, Adelaide, Australia, 5University of South Australia, Adelaide, Australia

Background: Clinical placements are often the first time physiotherapy students are exposed to ‘real’ patients and, as a result, stress and anxiety levels are heightened. While some stress is necessary for effective learning, excessive stress can interfere with learning and negatively affect academic performance and well-being. We have observed an apparent increase in students’ levels of stress and anxiety and the number struggling to cope with clinical placements. This study measured levels of stress and anxiety of physiotherapy students during clinical placements and examined factors influencing these. Relationships between stress and anxiety levels, the students’ baseline individual personal trait anxiety and academic performance were also examined.

Methods: Data were collected from March – December 2018. Physiotherapy students from the University of South Australia undertaking clinical placements (i.e. acute care, rehabilitation or primary/ambulatory care) at any Central Adelaide Local Health Network site in 2018 were eligible for participation. Outcome measures included the Trait portion of the State-Trait Anxiety Inventory (which measures general level of stress/anxiety and characteristics of an individual’s personality [STAI]) and perceived stress and anxiety (visual analogue scales [VAS]).

Results: Data were obtained from 159 of 175 (91%) clinical placements (85 [54%] females; mean [SD] age 24 [5] years; 137 [86%] undergraduates). Mean (SD) baseline STAI was 42 (9), reflecting slightly higher stress/anxiety than that seen in US college students. Perceived stress and anxiety levels (VAS) were highly variable between students over the clinical placements, with means (SD; ranges) of 53 (22; 5-100) and 51 (24; 0-100) respectively. Baseline STAI was significantly correlated with mean VAS stress and anxiety. Baseline and mean VAS stress and anxiety were significantly correlated with academic outcomes.

Discussion: Some, but not all, students demonstrated excessive levels of stress and anxiety during clinical placements. Interventions to better identify and assist these students are required.


Kathy Stiller has a background in physiotherapy, having worked in ICU for over 20 years. More recently she has worked part time as the research coordinator for physiotherapy and then allied health.

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