Date of Award

Spring 5-2023

Document Type


Degree Name

PHD - Doctor of Philosophy



First Advisor

Marion Nesbit, Ph.D.

Second Advisor

Edward Feller, M.D.

Third Advisor

Kelvin Ramirez, Ph.D.


Physician Assistant (PA) students, similar to other students enrolled in medical education, experience a variety of stressors throughout their education and training that can inhibit their academic and clinical success and affect patient care outcomes. The purpose of this mixed-methods research study was to explore PA students' and alumni's perceived stressors, their experiences of the stressors, and the help-seeking behaviors they employ and perceive as useful to address them. Following an explanatory sequential design, all PA students and alumni (n = 288) from one program in the northeast were invited to complete an anonymous online survey assessing their perceptions and experiences with PA program-related stress (n =150 completed the survey). The qualitative phase then utilized two focus group interviews (n = 21) to help clarify and add insights to the results. Faculty from the same institution were also surveyed to explore their perceptions of students' stress to gain a third, triangulated perspective for this study. ANOVA and Tukey statistical analyses revealed that stress levels attributed to academic workload, academic performance concerns, clinical site experiences, transportation issues, and employment were statistically significant (p < 0.01). Findings also revealed that even when acknowledging experiences of stress and its associated adverse effects, respondents were unlikely to seek help when needed, citing barriers such as lack of time, accessibility to resources viewed as appropriate and safe, and a perception of pervasive mental health stigma within the PA profession. Findings from the faculty survey showed similar perceptions of student stress and help seeking tendencies. This research study accentuated the lack of diversity in the PA field and the insufficient existing resources to address students' needs. Findings indicate a need for additional research to explore larger samples across multiple institutions in the field to consider stressors and identify ways to reduce them at both individual and institutional levels. Moreover, a better understanding of the stigma(s) related to mental health and seeking help could inform the design of a comprehensive prevention strategy within the PA field and medical education at large.

Embargo Period





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