5 Ways to Manage Anxiety during Practical Exams
The idea of a practical exam used to freak. me. out. I didn’t have an exercise physiology, nor an athletic training, background - I studied psychology and religious studies in undergrad, and I was pretty sure knowing the 5 pillars of Islam wouldn’t help me to diagnose an ACL tear.
I knew I had to overcome my severe anxiety around practical exams, however, and I had to do it quick. We had practical exams in all our major PT school classes - MSK, neuro, cardiopulm - and not only was I able to tolerate these exams, but I almost came to look forward to them thanks to the positive impact they’ve had on my confidence and my patient care.
Here’s how I did it:
Looked for “fun” facts
I don’t like anxiety, I’m not exactly practical exams’ #1 fan, but I do LOVE to learn. The more ‘fun facts’ I can find out and learn about whatever I’m preparing for - MSK or neuro exam, acute care practical, transfers, etc. - the more interested and invested I become in the material. This makes me more likely to want to keep studying rather than feeling resentful of the preparation process.
Need examples? Here are some interesting facts I learned in PT school and residency that boosted my motivation to study for the exam, and just made me feel more knowledgeable and competent overall:
Walking subjects your knees to about 30% of your body weight, jogging 3-4x your body weight. Standing up from sitting in a chair, however?
6.7x YOUR BODY WEIGHT. Does this make me afraid to ever stand up from a chair again? A little. Does this help me to realize just how cool and resilient our bodies are, and how I can use this information to help patients who have fear avoidant behaviors in the future? Heck yeah!
Aquatic PT is HARD. We had an aquatics lab in school and got to try out various exercises and stretches in the pool, and that water resistance was no joke.
Potential for recovery after a spinal cord injury is different for every person, but it seems as though most of the recovery a person will make post-SCI will be in the first year after injury.
Most of your grip strength comes from the ulnar (inside) half of your hand and can be a common source of pain for regular weightlifters. Also, your grip is strongest with your wrist in a neutral position (as opposed to being in flexion or extension).
Thought about my future patients
In PT school, I put a sticky note above my desk that read, “Your patients need you.” This was a reminder for myself every time I felt close to burn out or just simply did not feel like preparing for a test. It was a call back to why I had begun this journey in the first place, and it never failed to be a kick in the butt to go back to working, or to take time to take care of myself to be able to provide better for others.
practiced - alone and with others
I have friends that are violently against practicing with other people, and I do get it. Some people get stressed out by other people who make them feel behind. Others don’t want to look stupid because they haven’t practiced on their own enough.
I’ve been there, too. I will typically practice on my own for a bit - be it miming a physical skill in the air or talking a case out loud - but then will always ask someone to challenge me in a real-life type scenario and work cases with me. Bouncing ideas off another person is the best way I learn, and this method really worked to decrease the newness of a practical exam situation.
Scheduled something to look forward to after
Our musculoskeletal (MSK) practical exams were consistent for every exam, which meant that I was always testing at the same time as the same other people in my group for that testing time. One of my closest friends in the class tested at the same time as I did. This meant that we also finished at the same time.
After every MSK practical, he and I would walk a few laps around the parking lot and discuss the cases we’d been given, how we thought it went, the silly mistakes we made, and how the proctor reacted. If we had time, we’d make a quick run to Bruegger’s Bagels and grab breakfast after the oral part of our exam and prior to the physical examination portion.
pretended it was real, and ungraded
Your patients wont be grading you, they just want to feel better and be heard. And that’s exactly what these practical exams are meant to prepare you for - not to get better at performing for a proctor, but to treat your patients to the highest level of your license. So, I played pretend; I pretended I was speaking to a real patient. I asked my fake patient about their fake families, their fake hobbies, and showed real interest in their fake interests as I went through my clinical exam.
This always led to positive feedback on my ability to build therapeutic alliance with the patient, but it also helped me to stall. While the fake patient answered my questions about their life, I planned my next move in the exam.
Even when there was no patient available and it was just me and the proctor (in an oral exam, for example), I pretended I was discussing the case with a colleague that I was co-treating with, rather than talking with an authority figure. This helped me to relax, focus, and not take feedback as a personal attack, but rather guidance to strengthen the patient’s chances for recovery.
