Dogs Offering Guidance: Therapeutic Observation for Reducing Examination Anxiety (DOGTOR).

Dogs Offering Guidance: Therapeutic Observation for Reducing Examination Anxiety (DOGTOR). A Pilot Feasibility Study

Physiotherapists work closely with patients to assess, diagnose and treat a variety of conditions. Thus, it is essential that education should assess these key competencies through both written examinations (to measure cognitive understanding) and practical examinations (to measure clinical skills). Practical examinations have been found to require more preparation and have been reported to be more anxiety-inducing than other forms of examination. One possible strategy to assist with reducing examination stress for students is canine interaction. In the inpatient hospital setting, animal-assisted therapy has found to be a safe and useful option for managing stress. Within the university setting, canine interaction has been shown to improve mood, affect, well-being and reduce stress. However, most of the previous work in this area did not investigate canine-intervention during exams. This study will utilise a randomised-controlled trial design to measure the impact of canine interaction immediately prior to practical examinations on perceived and physiological stress and determine if canine interaction impacts examination scores.

Study Overview

• Status: Recruiting
• Conditions: Examination Phobia
• Intervention / Treatment: Behavioral: Canine Group

Detailed Description

Physiotherapy education should prepare graduates to become physiotherapists who work closely with patients to effectively assess, diagnose and treat a variety of conditions. Thus, it is essential that physiotherapy education should also include evaluation that assesses these key skills and competencies. This could be through both written examinations (to measure cognitive skills) and practical exams, such as Objective Structured Clinical Examinations (OSCEs), where students are required to apply their practical knowledge in a standardised, simulated environment. Practical exams usually include a student, a mock patient, a limited time in which a particular skill should be demonstrated and an assessor that provides a score of the student's performance. They are designed to determine whether a student has achieved a threshold of competence that will ideally ensure effective and safe practice in a real-world environment. Most students and assessors endorse practical examinations as a valuable form of feedback.

Despite their potential benefits, like other forms of examination, practical exams are a source of anxiety and stress for many students. Key sources of such exam stress include fear of failing (particularly in front of peers or assessors and "losing face"), not being able to retrieve knowledge under pressure, running out of time and inability to interpret the exam question. Practical exams require more preparation and have been reported to be more anxiety-inducing than other forms of examination, such as written exams. Examination stress is associated low self-esteem, anxiety, depression and poor sleep quality. While some exam-related stress can heighten exam performance, too much or too little stress can impact examination validity by impairing performance of actual ability. Therefore, in the interest of both student and assessor, it is imperative to reduce examination stress where possible so that student performance is better reflection of their actual skills and or competence.

One possible strategy to assist with reducing examination stress for students is canine interaction. In the inpatient hospital setting, animal-assisted therapy has found to be a safe and useful option for managing stress and has demonstrated greater stress reduction than other stress relieving methods such as reading, biofeedback and mindfulness. Within a university setting, canine interaction has been shown to improve mood, affect, well-being, reduce anxiety and stress. However, most of these studies did not investigate canine-intervention during an examination period, and of those which did, canine-intervention was performed some time before (from 60 minutes to two weeks), which allows time for additional stressors to influence findings. To date, there are no randomised studies that have been conducted specifically in physiotherapy students immediately before an OSCE. Therefore, the aims of this study are to (1) measure the impact of canine interaction immediately prior to a practical examination on perceived and physiological stress and (2) to determine if canine interaction impacts examination scores. Understanding the impact of canine interaction in this setting may provide a novel and relatively low-cost strategy to minimise examination stress immediately before an OSCE and boost grades.

• Study Type: Interventional
• Enrollment (Estimated): 22
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mary Duffy, MA; Phone Number: 6103094791204; Email: mary.duffy@latrobe.edu.au
• Study Contact Backup: Name: Leanne Clinch; Phone Number: 61 3 9479 1443; Email: leanne.clinch@latrobe.edu.au

Study Locations

• Australia
  • Victoria
    • Bundoora, Victoria, Australia, 3086
      • Recruiting
      • La Trobe University
      • Contact: Mary Duffy, MA; Phone Number: 61 3 94791204; Email: mary.duffy@latrobe.edu.au
      • Sub-Investigator: Arushka D'Souza, PhD
      • Sub-Investigator: Matthew King, PhD
      • Sub-Investigator: Andrew Hahne, PhD
      • Sub-Investigator: Marlena Calo, B Physio
      • Sub-Investigator: Andrea Bruder, PhD
      • Sub-Investigator: Madeline Hannington, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Students enrolled in subject PTY5015 (Preparation for Clinical Practice) in the La Trobe University Physiotherapy Graduate Entry Masters program only.

Exclusion Criteria:

• Anyone not enrolled in PTY5015

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Canine Group; examination. During this time, they will be in a quiet room with the dog and a dog-handler. Participants will be instructed that they can freely interact with the dog (for example, observe, pat, hold, talk with the dog, play with the dog toys) within the room. The dog handler will observe and only interact if required to assist with participant or dog safety. The dog is a former Seeing Eye Dog in training who has been introduced to the students and will be re-familiarised with them prior to the trial by attending classes during this term.	Behavioral: Canine Group; In a quiet room with a dog and dog handler, students will be able to freely interact with the dog prior to commencing their examinations. Both groups, intervention or control, participants will have their blood pressure (BP) and heart rate (HR) measured by a member of the research team and complete a short questionnaire (details below). The intervention/control will occur 10 minutes prior to the participant's allocated examination slot. Following their examination, participants will have their BP and HR measured by a member of the research team and be asked to rate their stress on a visual analogue scale again. Participants who received the intervention will be asked to report their interaction types with the dog and invited to participate in a focus group to discuss their experience in the trial.
No Intervention: Control group; Students placed in the control group will have a quiet room to sit in for 10 minutes immediately prior to their examination.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood Pressure measurement	All participants will enter a holding room prior to their examination. Within 30 minutes of the intervention or control, participants will have their blood pressure (BP) measured by a member of the research team . The intervention/control will occur 10 minutes prior to the participant's allocated examination slot. Following the intervention/control, the participant will have their BP measured by a member of the research team and be asked to rate their stress on a visual analogue scale. They will then complete their examination which will last 30 minutes. Following their examination, participants will have their BP measure again by a member of the research team.	30 minutes prior to practical exam, immediately prior to the practical examination and five minutes after the examination
Completion of Stress Visual Analog Scale (SVAS)	Immediate perceived stress will be measured using the SVAS at Timepoints 1, 2 and 3. This scale ranges from 0 to 9, where 0 is "no stress" and 9 is "most severe imaginable". Visual Analog scales are widely used self-reported measures with acceptable validity and reliability in health outcomes such as pain, anxiety, feelings and mood. This scale has widely been used to measure the effect of canine-intervention in other studies. It will be self-administered via a RED Cap survey	30 minutes prior to the practical examination; immediately prior to commencing the examination, 5 minutes after the examination
Perceived Stress Scale (PSS-10)	The PSS-10 is a 10-item scale where participants self-appraise their life stress over the past one month, with options ranging from "never" (zero) to "very often" (four). It has been found to be valid and reliable in students and will be collected prior to the examination. It will be self-administered via a REDCap survey.	Immediately prior to the examination
Heart Rate	All participants will enter a holding room prior to their examination. Within 30 minutes of the intervention or control, participants will have their heart rate (HR) measured by a member of the research team . The intervention/control will occur 10 minutes prior to the participant's allocated examination slot. Following the intervention/control, the participant will have their HR measured by a member of the research team and be asked to rate their stress on a visual analogue scale. They will then complete their examination which will last 30 minutes. Following their examination, participants will have their HR measured by a member of the research team.	Time Frame: 30 minutes prior to practical exam, immediately prior to the practical examination and five minutes after the examination

Collaborators and Investigators

• Sponsor: La Trobe University
• Investigators: Principal Investigator: Emily C Bell, PhD, Discipline of Physiotherapy, School of Allied Health, Human Services & Sport, La Trobe University

Publications and helpful links

General Publications

• Zunhammer M, Eichhammer P, Busch V. Sleep quality during exam stress: the role of alcohol, caffeine and nicotine. PLoS One. 2014 Oct 3;9(10):e109490. doi: 10.1371/journal.pone.0109490. eCollection 2014.
• Zhang N, Walton DM. Why So Stressed? A Descriptive Thematic Analysis of Physical Therapy Students' Descriptions of Causes of Anxiety during Objective Structured Clinical Exams. Physiother Can. 2018 Fall;70(4):356-362. doi: 10.3138/ptc.2016-102.e.
• Zhang N, Henderson CN. Test anxiety and academic performance in chiropractic students. J Chiropr Educ. 2014 Spring;28(1):2-8. doi: 10.7899/JCE-13-20. Epub 2013 Dec 18.
• Ward-Griffin E, Klaiber P, Collins HK, Owens RL, Coren S, Chen FS. Petting away pre-exam stress: The effect of therapy dog sessions on student well-being. Stress Health. 2018 Aug;34(3):468-473. doi: 10.1002/smi.2804. Epub 2018 Mar 12.
• Walker C. The Impact of Therapy Dogs on Prelicensure Baccalaureate Nursing Student Test Anxiety. Nurs Educ Perspect. 2023 Mar-Apr 01;44(2):98-104. doi: 10.1097/01.NEP.0000000000001042. Epub 2022 Aug 31.
• Peel N, Nguyen K, Tannous C. The Impact of Campus-Based Therapy Dogs on the Mood and Affect of University Students. Int J Environ Res Public Health. 2023 Mar 8;20(6):4759. doi: 10.3390/ijerph20064759.
• Thelwell ELR. Paws for Thought: A Controlled Study Investigating the Benefits of Interacting with a House-Trained Dog on University Students Mood and Anxiety. Animals (Basel). 2019 Oct 21;9(10):846. doi: 10.3390/ani9100846.
• Machova K, Prochazkova R, Vadronova M, Souckova M, Prouzova E. Effect of Dog Presence on Stress Levels in Students under Psychological Strain: A Pilot Study. Int J Environ Res Public Health. 2020 Mar 28;17(7):2286. doi: 10.3390/ijerph17072286.
• Haleem DJ, Inam QU, Haider S, Perveen T, Haleem MA. Serum leptin and cortisol, related to acutely perceived academic examination stress and performance in female university students. Appl Psychophysiol Biofeedback. 2015 Dec;40(4):305-12. doi: 10.1007/s10484-015-9301-1.
• Grajfoner D, Harte E, Potter LM, McGuigan N. The Effect of Dog-Assisted Intervention on Student Well-Being, Mood, and Anxiety. Int J Environ Res Public Health. 2017 May 5;14(5):483. doi: 10.3390/ijerph14050483.
• Brand HS, Schoonheim-Klein M. Is the OSCE more stressful? Examination anxiety and its consequences in different assessment methods in dental education. Eur J Dent Educ. 2009 Aug;13(3):147-53. doi: 10.1111/j.1600-0579.2008.00554.x.
• Anderson D, Brown S. The effect of animal-assisted therapy on nursing student anxiety: A randomized control study. Nurse Educ Pract. 2021 Mar;52:103042. doi: 10.1016/j.nepr.2021.103042. Epub 2021 Mar 27.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2025
• Primary Completion (Estimated): November 1, 2027
• Study Completion (Estimated): November 1, 2027

Study Registration Dates

• First Submitted: May 11, 2026
• First Submitted That Met QC Criteria: September 10, 2026
• First Posted (Actual): September 14, 2026

Study Record Updates

• Last Update Posted (Actual): September 14, 2026
• Last Update Submitted That Met QC Criteria: September 10, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: HEC25361

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No