Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 10;20(1):296.
doi: 10.1186/s12909-020-02202-5.

Stress, anxiety, self-efficacy, and the meanings that physical therapy students attribute to their experience with an objective structured clinical examination

Érica de Matos Reis Ferreira  1 , Rafael Zambelli Pinto  1 , Paula Maria Machado Arantes  1 , Érica Leandro Marciano Vieira  2 , Antônio Lúcio Teixeira  2 , Fabiane Ribeiro Ferreira  1 , Daniela Virgínia Vaz  3
Affiliations

Stress, anxiety, self-efficacy, and the meanings that physical therapy students attribute to their experience with an objective structured clinical examination

Érica de Matos Reis Ferreira et al. BMC Med Educ. .

Abstract

Background: Excessive stress and anxiety can impair learning. The objective structured clinical examination (OSCE) is a valuable tool to assess and promote the acquisition of clinical skills. However, significant OSCE-related stress and anxiety are frequently reported. The aim of this study was to investigate the relationships between physiological stress, self-reported levels of anxiety due to an OSCE, self-efficacy, and the meanings that physical therapy students attribute to their experience with the exam.

Design: Concurrent mixed methods study.

Methods: A total of 32 students took part in this study. All were enrolled in the third semester of a 10-semester Physical Therapy Bachelor Program. Salivary cortisol levels, self-reported anxiety (State-Trait Anxiety Inventory, STAI) were measured before the OSCE. Exam scores and self-efficacy ratings were also recorded. Correlations between variables were tested with the Pearson correlation, with ɑ at 0.05. Semi-structured interviews were used to explore the personal perspectives of students. Thematic analysis was used to investigate emergent themes.

Results: Trait anxiety scores were significantly higher than normative values (p < 0.001). A high proportion of students showed high (STAI> 49) state anxiety (37.5%) and trait anxiety (65.6%). Salivary cortisol was not associated anxiety (p > 0.05). Neither stress nor anxiety correlated with OSCE scores. A moderate and significant direct correlation was found for self-efficacy scores and OSCE scores (r = 0.475, p = 0.007). Students reported that confidence had a calming effect and led to better self-perceived performance. They also reported that the OSCE can provide meaningful learning experiences despite being stressful.

Conclusions: A high proportion of our students reported a stable/lingering negative affect. However, neither stress nor anxiety related to OSCE scores. Students' confidence in their capabilities was correlated with their performance. Their subjective reports suggest that self-confidence may have protected them from the negative effects of stress and anxiety on academic performance.

Keywords: Anxiety; OSCE; Self-efficacy; Stress.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Dispersion diagrams of correlations between dependent variables
Fig. 2
Fig. 2
Relationship between themes. Plus and minus signs indicate factors that positively or negatively affect anxiety and performance. The dotted line indicates a moderation effect
See this image and copyright information in PMC

References

    1. Regehr C, Glancy D, Pitts A. Interventions to reduce stress in university students: a review and meta-analysis. J Affect Disord. 2013;148(1):1–11. - PubMed
    1. Zeidner M. Test anxiety: the state of the art. Plenum, New York: Moshe Zeidner; 1998.
    1. Harden RM, Stevenson M, Downie WW, Wilson GM. Medical education assessment structured of clinical competence examination using objective. Br Med J. 1975;1(5955):447–451. - PMC - PubMed
    1. Troncon LE d A. Clinical skills assessment: limitations to the introduction of an “OSCE” (objective structured clinical examination) in a traditional Brazilian medical school Avaliação de habilidades clínicas: limitações à introdução de um exame clínico. São Paulo. 2004;122(1):12–17. - PMC - PubMed
    1. Labaf A, Eftekhar H, Majlesi F, Anvari P, Sheybaee-Moghaddam F, Jan D, et al. Students’ concerns about the pre-internship objective structured clinical examination in medical education. Educ Heal Chang Learn Pract. 2014;27(2):188–192. - PubMed

LinkOut - more resources