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

Adv Health Sci Educ Theory Pract. 2015 Dec;20(5):1303-24. doi: 10.1007/s10459-015-9603-3. Epub 2015 Apr 3.


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.

Keywords: Clinical education; Learning stressors; Psychology and learning; Resilience training; Self-efficacy; Undergraduate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Awareness
  • Clinical Clerkship*
  • Communication
  • Humans
  • Mindfulness
  • Patient Education as Topic / methods*
  • Perception
  • Physical Therapy Specialty / education*
  • Resilience, Psychological
  • Self Efficacy
  • Stress, Psychological / prevention & control*
  • Stress, Psychological / therapy*
  • Students / psychology*