Why So Stressed? A Descriptive Thematic Analysis of Physical Therapy Students' Descriptions of Causes of Anxiety during Objective Structured Clinical Exams.

Purpose: The purpose of this study was to collect and conduct a descriptive content analysis of the primary triggers of practical exam anxiety in Master of Physical Therapy (MPT) students in a Canadian university programme. Method: First and second-year MPT students were invited to reflect upon their top 5 sources or triggers of OSCE exam anxiety, collected in written format during a low-stress, low-examination period of their programme. All participants had participated in at least 3 OSCEs before providing data. The emergent themes were member-checked with 10 of the original participants to improve trustworthiness of the results.
Results: 56 of a possible 105 students provided 224 triggers of OSCE anxiety. Thematic content analysis revealed 6 emergent meta-themes that adequately captured all triggers. They were: social performance anxiety, fear of lacking competence, overvaluing the outcome, fear of the unknown, impaired personal health/coping resources, and operational/procedural influences. These meta-themes were endorsed by the participant sub-group. Conclusions: OSCEs are common forms of evaluation in MPT training programmes, but are also highly anxiogenic. The first step toward mitigating exam anxiety, thereby ensuring exam performance is less confounded by anxiety, is to identify the common triggers. Confidence in results will be strengthened by replication in other programmes.