Burnout and grit in student physical therapists before and after terminal clinical education experiences: a prospective longitudinal study of a single class-year cohort
Main Article Content
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.
- West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences, and solutions. J Intern Med 2018; 283: 516–29. doi: 10.1111/joim.12752
- Dewa CS, Loong D, Bonato S, Trojanowski L. The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review. BMJ Open 2017; 7: e015141. doi: 10.1136/bmjopen-2016-015141
- Williams ES, Manwell LB, Konrad TR, Linzer M. The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev 2007; 32: 203–12. doi: 10.1097/01.HMR.0000281626.28363.59
- Bullock G, Kraft L, Amsden K, et al. The prevalence and effect of burnout on graduate healthcare students. Can Med Educ J 2017; 8: e90–108. https://doi.org/10.36834/cmej.36890
- Williams PS, Mueller MK, Carroll HC, Cornwall MW, Denney LM, Kroneberger LM. Patterns of academic burnout, emotional distress, and coping in physical therapy students. Int J Health, Wellness Soc. 2018; 8: 31–46. doi: 10.18848/2156-8960/CGP/v08i03/31-46
- Macauley K, Plummer L. Prevalence and predictors of anxiety in doctor of physical therapy students. J Allied Health 2017; 46: e39–41.
- Maslach C, Jackson SE, Leiter MP. Using the MBI-Human Services Survey. In: Maslach C, Jackson SE, eds. Maslach Burnout Inventory Manual. Menlo Park, CA: Mind Garden, Inc; 1996, pp. 4–17.
- Halbesleben JRB, Demerouti E. The construct validity of an alternative measure of burnout: investigating the English translation of the Oldenburg Burnout Inventory. Work & Stress 2005; 19: 208–20. doi: 10.1080/02678370500340728
- Struessel T, Forster JE, Van Zytveld C. Doctor of physical therapy student experiences during clinical education: patient safety, error, and the system. J Phys Ther Educ 2019; 33: 3–15. doi: 10.1097/JTE.0000000000000072
- Berry JW. A regional survey and analysis of burnout among physical therapists in frontier counties. Phys Ther J Policy Admin Leadership 2015; 15: J3–J11.
- Balogun JA, Titoloye V, Balogun A, Oyeyemi A, Katz J. Prevalence and determinants of burnout among physical and occupational therapists. J Allied Health 2002; 31: 131–139.
- Robertson HD, Elliott AM, Burton C, et al. Resilience of primary healthcare professionals: a systematic review. Br J Gen Pract 2016; 66: e423–33. doi: 10.3399/bjgp16X685261
- Mueller K, Prins R, de Heer HD. An online intervention increases empathy, resilience, and work engagement among physical therapy students. J Allied Health 2018; 47: 196–203.
- Halbur B, Kopp A. Grit of first and second-year physical therapy students: a pilot study. Phys Ther Schol Project 2019; 664. Available from: https://commons.und.edu/pt-grad/664/ [cited 30 August 2019].
- Roll M, Canham L, Salamh P, Covington K, Simon C, Cook C. A novel tool for evaluating non-cognitive traits of doctor of physical therapy learners in the United States. J Educ Eval Health Prof 2018; 15: 1–8. doi: 10.3352/jeehp.2018.15.19
- Bliss R, Jacobson E. Doctor of physical therapy student grit as a predictor of academic success: A pilot study. Health Prof Educ 2020; 6: 1–7. doi: 10.1016/j.hpe.2020.06.006
- Duckworth AL, Peterson C, Matthews MD, Kelly DR. Grit: Perseverance and passion for long-term goals. J Pers Soc Psychol 2007; 92: 1087–101. doi: 10.1037/0022-35184.108.40.2067
- Richardson S, Scotto M, Belcina M, Patel R, Wiener K. Grit, and academic performance in doctor of physical therapy students. Internet J Allied Health Sci Pract 2020; 18: 1–4.
- Huhn K, Brittney Rusinski DPT, Amanda Saucier DPT, et al. Exploration of grit and emotional intelligence and success in a doctor of physical therapy program. Internet J Allied Health Sci Pract 2021; 19: 1–7.
- Carp S, Fry K, Gumerman B, Pressley K, Whitman A. Relationship between grit scale score and academic performance in a doctor of physical therapy program: a case study. J Allied Health 2020; 49: 29–35.
- Jumat MR, Chow PK-H, Allen JC Jr, et al. Grit protects medical students from burnout: a longitudinal study. BMC Med Educ 2020; 20: 1–9. doi: 10.1186/s12909-020-02187-1
- Cortez AR, Winer LK, Kassam A-F, et al. Exploring the relationship between burnout and grit during general surgery residency: a longitudinal, single-institution analysis. Am J Surg 2020; 219: 322–7. doi: 10.1016/j.amjsurg.2019.09.041
- Van Veld R, Slaven EJ, Reynolds B, Shupe P, Woolery C. First-year doctor of physical therapy students demonstrate change in coping with stress. J Phys Ther Educ 2018; 32: 138–44. doi: 10.1097/JTE.0000000000000037
- Niessen ASM, Meijer RR, Tendeiro JN. Measuring non-cognitive predictors in high-stakes contexts: the effect of self-presentation on self-report instruments used in admission to higher education. Pers Individ Dif 2017; 106: 183–9. doi: 10.1016/j.paid.2016.11.014
- Duckworth AL, Yeager DS. Measurement matters: assessing personal qualities other than cognitive ability for educational purposes. Educ Res 2015; 44: 237–51. doi: 10.3102/0013189X15584327
- The Commission on Accreditation in Physical Therapy Education. Aggregate program data 2019–2020: Physical therapist education programs fact sheet. Published March 2020. Available from: http://www.capteonline.org/uploadedFiles/CAPTEorg/About_CAPTE/Resources/Aggregate_Program_Data/AggregateProgramData_PTPrograms.pdf [cited 01 February 2021].
- Spataro BM, Tilstra SA, Rubio DM, McNeil MA. The toxicity of self-blame: sex differences in burnout and coping in internal medicine trainees. J Women’s Health 2016; 25: 1147–52. doi: 10.1089/jwh.2015.5604
- López-López IM, Gómez-Urquiza JL, Cañadas GR, et al. Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis. Int J Ment Health Nurs 2019; 28: 1032–41. doi: 10.1111/inm.12606
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.