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Analysis of Psychophysiological Stress Response in Higher Education Students Undergoing Clinical Practice Evaluation

  • Ana Isabel Beltrán-Velasco
  • Pablo Ruisoto-Palomera
  • Alberto Bellido-Esteban
  • Monica García-Mateos
  • Vicente Javier Clemente-SuárezEmail author
Education & Training
  • 14 Downloads
Part of the following topical collections:
  1. Technological Innovations in Biomedical Training and Practice (TEEM 2018)

Abstract

The aim of this study was to analyze the psychophysiological response of Physiotherapy degree students during a complete clinical practice as well as their psychological profile in relation to coping style in stressful situations, and its impact on academic performance. We analysed in 15 students heart rate variability (HRV) to analyse autonomic modulation in three moments during the entire clinical practices of 3 months (4 h per day, 3 days per week), first session, middle session and last session; perceived stress, personality, life engagement, cognitive flexibility before starting the clinical practice the academic performance after the clinical practice. Results based on HRV and related indexes parameters fail to indicate the expected autonomic adaptation during the practice. A complete clinical practice of Physiotherapy degree students did not produce an habituation process since a high sympathetic autonomic nervous system modulation was measured in the beginning, at the middle and at the final of the clinical practice. Below-average scores are presented in a personality factor associated with traditional and non-adaptive coping styles that could explain the non-habituation of the students. Finally, none of the analyzed indexes has been able to relate to academic performance.

Keywords

Autonomic modulation Stress HRV Personality Psychology 

Notes

Funding

The present research was developed with the David Wilson Award for Excellence in Teaching and Learning Research 2017, Project Number XOTRIO1712.

Compliance with Ethical Standards

Conflict of Interest

None.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Munroe, B., Buckley, T., Curtis, K., and Morris, R., Designing and implementing full immersion simulation as a research tool. Australasian Emergency Nursing Journal., 2016.  https://doi.org/10.1016/j.aenj.2016.01.001.
  2. 2.
    Borggreve, A., Meijer, J., Schreuder, H., and Ten Cate, O., Simulation-based trauma education for medical students: A review of literature. Medical Teacher 39(6):631–638, 2017.  https://doi.org/10.1080/0142159X.2017.1303135.CrossRefPubMedGoogle Scholar
  3. 3.
    Sobh, A., Izham, M., Diab, M. et al., Qualitative evaluation of a cumulative exit-from degree objetive structured clinical examination in a gulf context. Pharmacy Education 17(1):73–80, 2017.Google Scholar
  4. 4.
    Beltrán-Velasco, A., Bellido-Esteban, A., Ruisoto-Palomera, P., and Clemente-Suárez, V., Use of portable digital devices to analyze autonomic stress response in psychology objective structured clinical examination. Journal of Medical Systems 42(2):35, 2018.  https://doi.org/10.1007/s10916-018-0893-x.CrossRefPubMedGoogle Scholar
  5. 5.
    Clemente-Suárez, V., Beltrán-Velasco, A. I., Bellido-Esteban, A., and Ruisoto, P., Autonomic adaptation to clinical simulation in psychology students: teaching applications. Applied Psychophysiology and Biofeedback., 2018a.  https://doi.org/10.1007/s10484-018-9404-6.
  6. 6.
    Delgado-Moreno, R., Robles-Pérez, J., and Clemente-Suárez, V., Combat stress decreases memory of warfighters in action. Journal of Medical Systems 41(8):124, 2017.  https://doi.org/10.1007/s10916-017-0772-x.CrossRefPubMedGoogle Scholar
  7. 7.
    Belinchon-deMiguel, P., and Clemente-Suárez, V., Psychophysiological, body composition, biomechanical and autonomic modulation analysis procedures in an ultraendurance mountain race. Journal of Medical Systems 42(2):32, 2018.  https://doi.org/10.1007/s10916-017-0889-y.CrossRefPubMedGoogle Scholar
  8. 8.
    Mielgo-Ayuso, J., Zourdos, M., Clemente-Suárez, V., Calleja-González, J., and Shipherd, A., Can psychological well-being scales and hormone levels be used to predict acute performance of anaerobic training tasks in elite female volleyball players? Physiology and Behavior 180:31–38, 2017.  https://doi.org/10.1016/j.physbeh.2017.08.008.CrossRefPubMedGoogle Scholar
  9. 9.
    Clemente-Suarez, V., and Robles-Perez, J., Psycho-physiological response of soldiers in urban combat. Anales de Psicología 29(2):598–603, 2013.  https://doi.org/10.6018/analesps.29.2.150691.CrossRefGoogle Scholar
  10. 10.
    Clemente-Suárez, V., de la Vega, R., Robles-Pérez, J., Lautenschlaeger, M., and Fernández-Lucas, J., Experience modulates the psychophysiological response of airborne warfighters during a tactical combat parachute jump. International Journal of Psychophysiology 110:212–216, 2016.  https://doi.org/10.1016/j.ijpsycho.2016.07.502.CrossRefPubMedGoogle Scholar
  11. 11.
    Mccabe, D., Roediger, H., Mcdaniel, M., Balota, D., and Hambrick, D., The relationship between working memory capacity and executive functioning: Evidence for a common executive attention construct. Neuropsychology 24(2):222–243, 2010.  https://doi.org/10.1037/a0017619.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Kane, M., and Engle, R., The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective. Psychonomic Bulletin and Review 9(4):637–671, 2002.  https://doi.org/10.3758/BF03196323.CrossRefPubMedGoogle Scholar
  13. 13.
    Shields, G., Bonner, J., and Moons, W., Does cortisol influence core executive functions? A meta-analysis of acute cortisol administration effects on working memory, inhibition, and set-shifting. Psychoneuroendocrinology., 2015.  https://doi.org/10.1016/j.psyneuen.2015.04.017.
  14. 14.
    Wolf, O., The impact of stress on executive functions in human. Psychoneuroendocrinology 71:13, 2016.  https://doi.org/10.1016/j.psyneuen.2016.07.044.CrossRefGoogle Scholar
  15. 15.
    Starcke, K., Wiesen, C., Trotzke, P., and Brand, M., Effects of acute laboratory stress on executive functions. Frontiers in Psychology 7:461, 2016.  https://doi.org/10.3389/fpsyg.2016.00461.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pabst, S., Schoofs, D., Pawlikowski, M., Brand, M., and Wolf, O., Paradoxical effects of stress and an executive task on decisions under risk. Behavioral Neuroscience 127(3):369–379, 2013.  https://doi.org/10.1037/a0032334.CrossRefPubMedGoogle Scholar
  17. 17.
    Dickerson, S. S., and Kemeny, M. E., Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin 130(3):355–391, 2004.  https://doi.org/10.1037/0033-2909.130.3.355.CrossRefPubMedGoogle Scholar
  18. 18.
    Scult, M., Knodt, A., Radtke, S. et al., Prefrontal executive control rescues risk for anxiety associated with high treat and low reward brain function. Cerebral Cortex, 2017.  https://doi.org/10.1093/cercor/bhx304.
  19. 19.
    Bellido, A., Ruisoto, P., Beltran-Velasco, A., and Clemente-Suárez, V., State of the art on the use of portable digital devices to assess stress in humans. Journal of Medical Systems., 2018.  https://doi.org/10.1007/s10916-018-0955-0.
  20. 20.
    Nasir, A., Yusuf, A., Abdur-Rahman, L., Babalola, O., Adeyeye, A., Popoola, A., and Adeniran, J., Medical students’ perception of objective structured clinical examination: A feedback for process improvement. Journal of Surgical Education 71(5):701–706, 2014.  https://doi.org/10.1016/j.jsurg.2014.02.010.CrossRefPubMedGoogle Scholar
  21. 21.
    Cheng, C., Lau, H., and Chan, M., Coping flexibility and psychological adjustment to stressful life changes: A meta-analytic review. Psychological Bulletin 140(6):1582–1607, 2014.  https://doi.org/10.1037/a0037913.CrossRefPubMedGoogle Scholar
  22. 22.
    Clemente-Suárez, V., Fernandes, R., Arroyo-Toledo, J., Figueiredo, P., González-Ravé, J., and Vilas-Boas, J., Autonomic adaptation after traditional and reverse swimming training periodizations. Acta Physiologica Hungarica 102(1):105–113, 2015.  https://doi.org/10.1556/APhysiol.102.2015.1.11.CrossRefPubMedGoogle Scholar
  23. 23.
    Malik, M., Bigger, J., Camm, A., and Kleiger, R., Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. European Heart Journal 17:354–381, 1996.CrossRefGoogle Scholar
  24. 24.
    Moya Albiol, L., and Salvador, A., Respuesta cardíaca y electrodérmica ante estresores de laboratorio. Revista Española de Motivación y Emoción 4:5–6, 1997.Google Scholar
  25. 25.
    Tapia, D., Cruz, C., Gallardo, I., and Dasso, M., Adaptación de la Escala de Percepción global de Estrés- (EPGE) en estudiantes adultos de escasos recursos en Santiago. Chile: Revista de Administracion Sanitaria, 2007.Google Scholar
  26. 26.
    Scheier, M., Wrosch, C., Baum, A., Cohen, S., Martire, L., Matthews, K., and Zdaniuk, B., The life engagement test: Assessing purpose in life. Journal of Behavioral Medicine 29(3):291–298, 2006.  https://doi.org/10.1007/s10865-005-9044-1.CrossRefPubMedGoogle Scholar
  27. 27.
    Sinclair, V., and Wallston, K., The development and psychometric evaluation of the brief resilient coping scale. Assessment 11(1):94–101, 2004.  https://doi.org/10.1177/1073191103258144.CrossRefPubMedGoogle Scholar
  28. 28.
    Cohen, S., Kamarck, T., and Mermelstein, R., A global measure of perceived stress. Journal of Health and Social Behavior 24(4):385, 1983.  https://doi.org/10.2307/2136404.CrossRefPubMedGoogle Scholar
  29. 29.
    Houston, B., Smith, T., and Zurawski, R., Principal dimensions of the Framingham type a scale: Differential relationships to cardiovascular reactivity and anxiety. Journal of Human Stress 12(3):105–112, 1986.  https://doi.org/10.1080/0097840X.1986.9936774.CrossRefPubMedGoogle Scholar
  30. 30.
    Costa, P., and McCrae, R., Professional manual: Revised NEO personality inventory (NEO-PI-R) and NEO five-factor inventory (NEO-FFI). Odessa FL Psychological Assessment Resources 3:101, 1992.  https://doi.org/10.1037/1040-3590.4.1.5.CrossRefGoogle Scholar
  31. 31.
    Edwards, J., Walsh, N., Diment, P., and Roberts, R., Anxiety and perceived psychological stress play an important role in the immune response after exercise. Exercise Immunology Review. 24:26–34, 2018.PubMedGoogle Scholar
  32. 32.
    Sagone, E., and De Caroli, M., A correlational study on dispositional resilience, psychological well-being, and coping strategies in university students. Americal Journal of Educational Research. 2(7):463–471, 2014.  https://doi.org/10.12691/education-2-7-5.CrossRefGoogle Scholar
  33. 33.
    Clemente-Suárez, V., Palomera, P., and Robles-Pérez, J., Psychophysiological response to acute-high-stress combat situations in professional soldiers. Stress and Health 2:247–252, 2018b.CrossRefGoogle Scholar
  34. 34.
    Chan, C., So, W., and Fong, D., Hong Kong baccalaureate nursing students’ stress and their coping strategies in clinical practice. Journal of Professional Nursing., 2009.  https://doi.org/10.1016/j.profnurs.2009.01.018.
  35. 35.
    Unsworth, N., Fukuda, K., Awh, E., and Vogel, E. K., Working memory and fluid intelligence: Capacity, attention control, and secondary memory retrieval. Cognitive Psychology., 2014.  https://doi.org/10.1016/j.cogpsych.2014.01.003.
  36. 36.
    Erazo, M., Moncada, L., Llanos, G. et al., Psychological profile of 1st year nursing students. Preliminary study. Ciencia y Enfermería 15(1):99–108, 2009.Google Scholar
  37. 37.
    Mills, B., Carter, O., Rudd, C., Claxton, L., and O’Brien, R., An experimental investigation into the extent social evaluation anxiety impairs performance in simulation-based learning environments amongst final-year undergraduate nursing students. Nurse Education Today., 2016.  https://doi.org/10.1016/j.nedt.2016.06.006.
  38. 38.
    May, R., Seibert, G., Sanchez-Gonzalez, M., and Fincham, F., Physiology of school burnout in medical students: Hemodynamic and autonomic functioning. Burnout Research., 2016.  https://doi.org/10.1016/j.burn.2016.05.001.
  39. 39.
    Clemente-Suárez, V., Robles-Pérez, J., and Fernández-Lucas, J., Psycho-physiological response in an automatic parachute jump. Journal of Sports Sciences 35(19):1872–1878, 2017.  https://doi.org/10.1080/02640414.2016.1240878.CrossRefPubMedGoogle Scholar
  40. 40.
    Szabo, A., Ward, C., and Jose, P., Uprooting stress, coping, and anxiety: A longitudinal study of international students. International Journal of Stress Management., 2016.  https://doi.org/10.1037/a0039771.
  41. 41.
    Martin, Y., Estres academico y frontamiento en estudiantes de Medicina. Revista Humaninades Medicas., 2010.  https://doi.org/10.1989/ejep.v3i1.47.
  42. 42.
    Mushtaq, I., and Khan, S., Factors affecting students’ academic performance. Global Journal of Management and Business Research., 2012.  https://doi.org/10.1002/tea.3660200906.
  43. 43.
    Myers, S., Sweeney, A., Popick, V., Wesley, K., Bordfeld, A., and Fingerhut, R., Self-care practices and perceived stress levels among psychology graduate students. Training and Education in Professional Psychology., 2012.  https://doi.org/10.1037/a0026534.
  44. 44.
    Wolf, L., Stidham, A., and Ross, R., Predictors of stress and coping strategies of US accelerated vs. generic baccalaureate nursing students: An embedded mixed methods study. Nurse Education Today, 2015.  https://doi.org/10.1016/j.nedt.2014.07.005.
  45. 45.
    Naqvi, S., Factors affecting Student’s Perfomance. Bangladesh e-Journal of Sociology 3(1):10, 2006.Google Scholar
  46. 46.
    Blomberg, K., Bisholt, B., Kullén Engström, A., Ohlsson, U., Sundler Johansso, A., and Gustafsson, M., Swedish nursing students’ experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education. Journal of Clinical Nursing., 2014.  https://doi.org/10.1111/jocn.12506.
  47. 47.
    Thomson, D., Boyle, D., Legg, C., Owen, M., Newman, M., and Cole, M., Clinical placements: The perspectives of UK physiotherapy students on how prepared they were by their university for their first clinical placements: An example of one HEI. International Journal of Practice-Based Learning in Health and Social Care., 2014.  https://doi.org/10.11120/pblh.2014.00031.
  48. 48.
    Thomson, D., Patterson, D., Chapman, H., and Toner, M., Exploring the experiences and implementing strategies for physiotherapy students who perceive they have been bullied or harassed on clinical placements: Participatory action research. Physiotherapy 103(1):73–80, 2015.  https://doi.org/10.1016/j.physio.2015.12.003.CrossRefPubMedGoogle Scholar
  49. 49.
    Soliman, M., Perception of stress and coping strategies by medical students at King Saud University, Riyadh, Saudi Arabia. Journal of Taibah University Medical Sciences., 2014.  https://doi.org/10.1016/j.jtumed.2013.09.006.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Applied Psychophysiological Research GroupEuropean University of MadridMadridSpain
  2. 2.Department of Basic Psychology, Psychobiology and Methodology of Behavioural SciencesUniversity of SalamancaSalamancaSpain
  3. 3.Department of PsychologyEuropean University of MadridMadridSpain
  4. 4.Faculty of Sport ScienceUniversidad Europea de MadridMadridSpain
  5. 5.Grupo de Investigación en Cultura, Educación y SociedadUniversidad de la CostaBarranquillaColombia

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