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Health professional students experience high levels of psychological stress. Individuals with higher levels of resilience are better equipped to handle stress. The purpose of this study is to evaluate the effects of an 8-hour resilience curriculum on stress levels, resilience, coping, protective factors, and symptomatology on students enrolled in a doctor of physical therapy (DPT) program.
Hypothesis: The curriculum will decrease stress levels, increase resilience, coping flexibility, protective factors (optimism, positive affect, and social support), and reduce symptomatology (negative affect, illness). Research on stress and its consequences experienced by physical therapy students in particular is limited. If the results of this study support this hypothesis, it may establish the benefit of adding a resilience component to the curriculum for students of physical therapy.
The study involves curriculum development and evaluation by randomized controlled trial. Participants will be randomized to the intervention group to receive a Resilience Curriculum or to a wait-list control group to receive a condensed version of the curriculum following the post-intervention assessments.
Pre- and post-intervention assessments will be administered to both groups, with baseline assessments administered in the first two weeks of the semester. The assessments will include measures of stress levels, levels of resilience, coping flexibility, optimism, positive and negative emotions, social support, and symptoms of illness. The intervention, the presentation of a resilience curriculum, will be delivered to the intervention group during the week following the baseline assessments and it will last for four weeks.
The resilience curriculum will provide education for participants about methods to increase protective factors against stress, the use of effective coping strategies, and the importance of accessing social support, with the goal of better managing stress and enhancing resilience. The intervention will include a didactic component, skills-building training, and homework exercises to encourage the application of the skills. The curriculum will be delivered in four 2-hour modules, with one module delivered each week. The follow-up assessments will occur after midterm examinations are concluded. An abbreviated curriculum which will last approximately two hours will be delivered to the wait-list control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Resilience Curriculum | Experimental | The intervention is exposure to an 8-hour Resilience Curriculum. It will provide education for participants about methods to increase protective factors against stress, the use of effective coping strategies, and the importance of accessing social support, with the goal of better managing stress and enhancing resilience. The curriculum will include a didactic component, skills-building training, and homework exercises to encourage the application of the skills. |
|
| No Resilience Curriculum | No Intervention | The Waitlist Control group will receive no exposure to the Resilience Curriculum. After the final data is collected, this group will be offered the opportunity to attend a condensed 2-hour version of the curriculum. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Resilience Curriculum | Other | The Resilience Curriculum consists of 4 modules, with one 2-hour module presented each week. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in psychological resilience at 8 weeks | The 25-item Connor-Davidson Resilience Scale measures a variety of constructs of resilience including hardiness, personal competence, social bonds, patience, and spiritual influences. | Baseline and 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in perceived psychological stress at 8 weeks | The 10-item Perceived Stress Scale was created to assess the perception of stress in the previous month, | Baseline and 8 weeks |
| Change from baseline in coping flexibility at 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in symptoms of Illness at 8 weeks | The Symptoms of Illness Checklist is a 33-item tool designed to measure the number, frequency, and severity of physical symptoms experienced in the previous two-week period. | Baseline and 8 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anne M Mejia-Downs, PT, MPH | University of Indianapolis | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Indiana University Purdue University Indianapolis | Indianapolis | Indiana | 46202 | United States | ||
| University of Indianapolis |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9373376 | Background | O'Leary VE, Ickovics JR. Resilience and thriving in response to challenge: an opportunity for a paradigm shift in women's health. Womens Health. 1995 Summer;1(2):121-42. | |
| 20674652 | Background | Walsh JM, Feeney C, Hussey J, Donnellan C. Sources of stress and psychological morbidity among undergraduate physiotherapy students. Physiotherapy. 2010 Sep;96(3):206-12. doi: 10.1016/j.physio.2010.01.005. Epub 2010 Apr 8. |
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Individual data will not be shared.
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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The Coping Flexibility Scale is a 10-item tool to measure the ability of an individual to effectively modify coping behavior.
| Baseline and 8 weeks |
| Change from baseline in optimism at 8 weeks | The Revised Life Orientation Test is a 10-item scale designed to measure optimism in an individual. | Baseline and 8 weeks |
| Change from baseline in positive and negative emotions at 8 weeks | The 20-item Modified Differential Emotion Scale, an adaptation of the original Differential Emotion Scale, measures positive and negative emotions that an individual has experienced in the previous 2 weeks. | Baseline and 8 weeks |
| Change from baseline in social support at 8 weeks | The Social Provisions Scale is a 24-item assessment of six areas of social relationships (guidance, reliable alliance, attachment, social integration, reassurance of worth, and opportunity for nurturance) used to measure perceived social support. | Baseline and 8 weeks |
| Indianapolis |
| Indiana |
| 46227 |
| United States |
| 23094641 | Background | Jacob T, Itzchak EB, Raz O. Stress among healthcare students--a cross disciplinary perspective. Physiother Theory Pract. 2013 Jul;29(5):401-12. doi: 10.3109/09593985.2012.734011. Epub 2012 Oct 24. |
| 2926629 | Background | Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989 Feb;56(2):267-83. doi: 10.1037//0022-3514.56.2.267. |
| 14769087 | Background | Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol. 2004 Feb;86(2):320-33. doi: 10.1037/0022-3514.86.2.320. |
| 18316290 | Background | Steinhardt M, Dolbier C. Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. J Am Coll Health. 2008 Jan-Feb;56(4):445-53. doi: 10.3200/JACH.56.44.445-454. |
| 19056153 | Background | McAllister M, McKinnon J. The importance of teaching and learning resilience in the health disciplines: a critical review of the literature. Nurse Educ Today. 2009 May;29(4):371-9. doi: 10.1016/j.nedt.2008.10.011. Epub 2008 Dec 3. |
| 12964174 | Background | Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: 10.1002/da.10113. |