First-Year Doctor of Physical Therapy Students Demonstrate Change in Coping With Stress
Authors: Van Veld Renée , Slaven Emily J. , Reynolds Ben , Shupe Paul , Woolery Creola 
Published: April 2018

Background and Purpose.
Admission to a Doctor of Physical Therapy (DPT) program has traditionally required a determined cognitive level with less emphasis being placed on noncognitive attributes. It is now appreciated that many noncognitive factors such as coping self-efficacy, resilience, and emotional intelligence can factor into students' ability to successfully complete a graduate program that presents with increased workload and other demands that can invoke stress. To maximize success, students must be able to effectively cope with these stresses. The first purpose of this study was to determine if a cohort of students enter a DPT program with similar perceptions of their abilities to cope with stress. The second purpose was to determine if perceived coping abilities and specific coping strategies of this cohort changed over the first year of the program.

Subjects.
Physical therapy students enrolled in the first year of a 3-year DPT program at a Midwestern university were invited to participate. Of this cohort, 29 (60%) responded to the first survey, 23 (79%) of the initial participants completed the second survey, and 19 (65%) completed the third survey.

Methods.
An electronic survey was sent to these students at the beginning of their first, second, and third semesters. Students completed the survey anonymously. The Coping Self-Efficacy Scale (CSE) was used along with open-ended prompts about students' coping strategies and sources of stress. Repeated-measures analysis of variance (ANOVA) and post hoc paired t tests with Bonferroni correction were used to compare mean CSE scores between each semester. Qualitative content analysis of the responses from the open-ended questions was completed.

Results.
The mean CSE score from the initial survey was 6.35 (SD ± 0.32). Of the 26 questions in the CSE survey, 19 questions had a variance in score of eight points or more on a 10-point scale. There was a statistically significant difference between CSE scores over the three testing periods as determined by a repeated-measures ANOVA, F(2,50) = 79.19, P < .001). A Bonferroni post hoc test revealed that the differences between CSE scores occurred between all levels of testing (P < .001). Five themes describing active coping strategies and one theme of avoidance strategy emerged in the first round of data collection. In the second and third rounds of data collection, the avoidance strategy theme disappeared and only active strategies were mentioned.

Discussion.
The ability to cope with stress is an important factor affecting a student's success in an academic program. In this study, there was wide variability in students' perceived ability to cope with stress as determined from the CSE score when entering a DPT program. Statistically significant increases in CSE scores over each subsequent semester indicated improved confidence in coping ability after succeeding despite stressful situations typical of the first year of a DPT program. Qualitative themes from open-ended prompts about coping strategies also supported this conclusion. Findings suggest that planned intervention on the part of academic faculty to further facilitate this growth in coping ability should be considered to increase student success.