Abstract
Perfectionism is a topic relevant to veterinary medicine and has previously been found to be related to higher levels of stress and poorer mental health outcomes. However, many aspects of perfectionism have yet to be researched among veterinary students. This research investigates the relationship between perfectionism and the “Big Five” personality factors. Additionally, the relationship between resilience and neuroticism is addressed. This research includes a sample of 99 veterinary students enrolled at a College of Veterinary Medicine in the southeastern United States. Students completed the Multidimensional Perfectionism Inventory (MPI), the Big Five Inventory (BFI), and the Brief Resilience Scale (BRS). Results show that perfectionism is significantly correlated with personality factors; specifically, self-oriented perfectionism and socially prescribed perfectionism are associated with neuroticism, socially prescribed perfectionism is associated with agreeableness, and self-oriented perfectionism is associated with conscientiousness. Neuroticism was found to have a significant negative correlation with resilience. Findings indicate that veterinary mental health professionals and educators should consider implementing specific strategies to help students develop a healthy balance in their perfectionistic beliefs and have targeted interventions to promote student resilience.
Perfectionism is a multidimensional construct that represents an individual’s tendency to have extremely high expectations for self and often includes holding similar expectations for others and a perception of the existence of socially prescribed standards that measure one’s performance.1–3 Because of the difficulty and intensity of both training and professional practice within the medical professions, perfectionism is a common personality trait found among individuals who enter the health care professions.4,5 Veterinarians and veterinary students are a prime example of this occurrence; perfectionism has been identified as a common trait of individuals within the field of veterinary medicine.4–7 Perfectionism has been acknowledged within the field of human medicine8–10 but has received limited empirical attention within veterinary medicine; research in veterinary medicine has mainly highlighted the link between perfectionism and suicidality.5,6,11,12 Little consideration has been given to perfectionism regarding its possible connection to other personal qualities of veterinarians and veterinary students. More research is needed to explore the link between perfectionism, personality factors, and resilience among veterinary students.4,12
Perfectionism is a common quality of veterinarians and is often viewed as a necessary goal.4,7,11,13 Several authors have discussed the implications that the admissions process and rigorous academic standards may have for perfectionism in veterinary medicine. For example, the process of acceptance into veterinary school is highly competitive and is often tedious. Moffet and Bartram14 found that many veterinary students experienced repeated rejection when applying to graduate school; veterinary programs have a great enough number of applicants that they are afforded the luxury of selecting only the most elite individuals with the highest grades and best relevant work experiences.4 Therefore, an elite selection of highly gifted, determined, and brilliant individuals is chosen for admittance to colleges of veterinary medicine, where each individual joins a group of likeminded peers.13–15 After being accepted, students are then subjected to 4 or more years of highly intense maximized credit loads of academic work and clinical practice amidst their cohort of equally brilliant and elite classmates.13,15,16
Perfectionistic characteristics are typical of the students who earn a spot in veterinary training programs and become more solidified during their time in veterinary school through the perfectionistic standards that are consistently reinforced throughout their training.13,15,17 Not surprisingly, veterinary students have shared that veterinary school is an intensely competitive environment.4,18 According to Larkin,17 many veterinarians make situations much harder on themselves than is necessary because of their drive for perfection, propensity toward competition, and desire to be recognized as exceptional. Veterinary students realize that success after graduation is dependent upon high achievements during the training process and that prestigious post-graduate positions are highly competitive.15 This environment is the perfect storm for setting excessively high standards, fear of not being able to perform adequately, overly critical self-evaluation, heightened efforts to protect against perceived failure, and striving for flawlessness—all characteristics of perfectionism.1,4,7,11,15 Many students believe that perfection is the only option because of high expectations and standards in all areas of training and professional practice within veterinary medicine, which is derived from the high stakes of potentially causing harm to patients with a mistake.7
According to Hewitt and Flett,1–3 perfectionism has three dimensions:
Self-oriented perfectionism is the quality of setting excessively high standards for oneself and being self-critical when these expectations are not met;
Socially prescribed perfectionism is the belief that others have set extraordinary standards that oneself must live up to; and
Others-oriented perfectionism is having unrealistically high expectations and standards for the people around oneself.1–3
Perfectionism can have both positive and negative effects.7,19 The positive side of perfectionism is called “adaptive perfectionism.” Adaptive perfectionism allows individuals to use positive reinforcement to set realistic goals, strive for achievement, and accept minor disappointments in ways that contribute to positive well-being and high self-esteem.7 Within the context of veterinary medicine, adaptive perfectionism contributes positively to quality patient care, excellent clinical practice, and strong professional advocacy.7 Perfectionism can lead to veterinarians being detailed, giving their best effort, double-checking their work, and going above and beyond for their patients.7,11
However, the negative side of perfectionism, or “maladaptive perfectionism,” has often been identified in veterinarians.12 Maladaptive perfectionism contributes to paralyzing fear of failure, punitive self-criticism, self-doubt, anxiety, stress, and low self-esteem.7,11 This type of perfectionism has been found to be associated with many forms of distress for veterinarians, including poorer mental health, negative arousal emotions in the workplace, higher levels of distress in morally significant workplace challenges, relationship concerns, burnout, and risk of suicide.6,11–13,20,21 Although perfectionism has been identified as a common quality of veterinarians and veterinary students, more research is needed to understand its prevalence and also how perfectionism might be related to the personality factors of students who are selected for entry into veterinary schools.4,12
Personality factors and psychological characteristics of students and professionals is an under-researched area of the veterinary medical literature; although similar personality patterns have been assumed, little empirical information is known about the personality traits that are common to individuals who pursue this profession.5,12 A wealth of literature has discussed the negative dispositions and qualities that may contribute to poor mental health outcomes for veterinary students; however, much less information is available to provide a descriptive understanding of factors that might contribute to the psychological well-being and growth of veterinary students.21,22 Weston et al.21 found that personality traits and temperament contribute more significantly to psychological well-being among veterinary students than their circumstances, though specific personality traits were not addressed in their research. Johnson et al.23 reported that in the past, veterinary students have generally been considered to have the Myers–Briggs Type Indicator24 personality profile of ESTJ or ISTJ. ISTJ personality types are rational, efficient, practical, and decisive. They are task-oriented, conscientious, and reliable, and stay focused on whatever goal or task they are working toward. ESTJ personality types are problem solvers, decision makers, planners, rule followers, direct communicators, and skeptical thinkers. Although these two personality types resonate with many previous cohorts of veterinary students, Johnson et al.23 found that current cohorts represent greater diversity in personality. More research is needed to investigate this growing divergence in personality types among students.23
The “Big Five” personality factors—openness, conscientiousness, extraversion, agreeableness, and neuroticism25,26—have been used in several studies of veterinarians. The personality factors of conscientiousness, extroversion, and openness were found to be related to prosocial, relational, and mentorship roles.27 Dawson and Thompson28 found that personality was a greater predictor of occupational stress for veterinarians than their working environment. Specifically, the personality factor of neuroticism was a significant predictor of occupational stress. More research is needed to better understand the personality factors of both veterinarians and veterinary students.
Resilience is a relatively new and popular topic emerging within veterinary medical literature.14 Resilience represents a person’s ability to recover or rebound from different stressors and to positively adapt to fluctuating circumstances22 and adverse conditions.29 According to Moffett and Bartram,14 veterinary students have reported that resilience is a necessary quality to have in order to successfully navigate the many different kinds of challenges that arise in veterinary medicine, starting with the process of being admitted to a veterinary program and continuing throughout training. Students reported concerns related to the long-term pressures of their graduate studies, heightened anxiety over performance and grades, time management, high expectations, and feelings of inadequacy to succeed in veterinary medical studies. Factors that influenced veterinary students’ ability to demonstrate resilience through all of these concerns included their past experiences of success or failure, their support network, the expectations of people around them, their personal attributes, and their personality.14
Resilience is important not only in veterinary training but also in the professional practice of veterinary medicine.14,30,31 Although there are many rewards that come from working as a veterinarian, resilience is an important quality to mitigate the stressors and help to balance the professional and personal challenges that can compound throughout one’s career.29 Resilient veterinarians are more likely to understand their personal needs and to engage in self-care activities including exercise, adequate sleep, spiritual practices, and a healthy diet. Veterinarians who are resilient are also more likely to set realistic and helpful goals, both personal and professional, and to make efficient plans to meet these goals.29 It is important to educate veterinary students about emotional resiliency and how it is important to their career success.29,32 Additional research could help to demonstrate the relationship between resilience and other personal qualities, such as personality factors, to provide further insight into how to best promote resilience among students.
This study is designed to answer three research questions pertaining to perfectionism, personality factors, and resilience among veterinary students. First, are the levels of perfectionism of veterinary students significantly related to their personality factors? Second, do levels of perfectionism differ between men and women veterinary students? Third, are levels of resilience of veterinary students significantly correlated with their levels of neuroticism? To answer these questions, the author used a descriptive research design using an online survey methodology.
Participants in this study were students enrolled in the Doctor of Veterinary Medicine program at an institution in the Southern region of the United States accredited by the Association of American Veterinary Medical Colleges (AAVMC). Approximately 330 students were enrolled at this college at the time of the study, and 99 students participated, giving a 30% response rate. Consistent with national enrollment demographics of veterinary students,33 the majority of participants were female (82.7%). Most participants were between the ages of 23 and 25 years old (55.6%) and in their first year of training (43.4%; see Table 1 for more demographic information). Descriptive statistics for each variable included in the analysis are included in Table 2.
|
| Characteristic | n | % of sample |
| Sex | ||
| Female | 81 | 82.7 |
| Male | 17 | 17.3 |
| Age (years) | ||
| 18–22 | 26 | 26.3 |
| 23–25 | 55 | 55.6 |
| 26–28 | 11 | 11.1 |
| 29–31 | 3 | 3.0 |
| 32–34 | 2 | 2.0 |
| 35–39 | 2 | 2.0 |
| Classification | ||
| First-year DVM student | 43 | 43.4 |
| Second-year DVM student | 21 | 21.2 |
| Third-year DVM student | 15 | 15.2 |
| Fourth-year DVM student | 17 | 17.2 |
| DVM PhD student | 3 | 3.0 |
Note: One participant did not report sex
N = 99
|
| Variable | M | SD |
| Self-oriented perfectionism | 56.70 | 9.81 |
| Others-oriented perfectionism | 46.37 | 9.22 |
| Socially prescribed perfectionism | 44.09 | 10.00 |
| Openness | 36.36 | 5.43 |
| Conscientiousness | 36.15 | 5.11 |
| Conscientiousness (transformed) | 3.02 | 0.85 |
| Extraversion | 25.08 | 7.19 |
| Agreeableness | 36.34 | 4.87 |
| Neuroticism | 25.80 | 4.47 |
| Resilience | 21.56 | 4.47 |
Note: Scores on Self-oriented, Others-oriented, and Socially prescribed perfectionism each range from 15 to 75; scores on Extraversion and Neuroticism range from 8 to 40; scores on Agreeableness and Conscientiousness range from 9 to 45; and scores on Openness range from 10 to 50
N = 99
Permission was obtained from the Institutional Review Board and from the Dean of the College of Veterinary Medicine at the university where the study was conducted. A list of student emails was obtained from the Dean’s Office, and an email was sent from the first author to all students inviting them to participate in an anonymous online survey. The email contained a web link that could be clicked to access a survey created through SurveyMonkey.a Participants were taken to an informed consent page and could indicate their consent to continue and complete the online questionnaire in 10–15 minutes. A reminder email with a final invitation to participate was sent approximately 10 days after the initial invitation.
Several non-identifying demographic questions were answered by participants, including their year of study and their sex. Participants also completed the Multidimensional Perfectionism Scale (MPS),1 Big Five Inventory (BFI),25 and the Brief Resilience Scale (BRS).34
The MPS is a 45-item scale with three subscales: Self-Oriented Perfectionism, Others-Oriented Perfectionism, and Socially Prescribed Perfectionism. Participants respond to statements (e.g., “I strive to be as perfect as I can be”) on a 7-point Likert-type scale (ranging from 1 = strongly disagree to 7 = strongly agree). However, for this research study, a 5-point Likert-type scale (ranging from 1 = strongly disagree to 5 = strongly agree) was used instead of a 7-point scale to provide consistency across all instruments. With this adjustment, scores on each of the three subscales ranged from 15 to 75, with higher scores indicating a higher level of perfectionism endorsed.1,2 Reliability coefficient alphas for this study were found to be .85 for Self-Oriented Perfectionism, .83 for Others-Oriented Perfectionism, and .81 for Socially Prescribed Perfectionism.
The BFI is a 44-item scale with five subscales indicating the participant’s levels of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. Participants endorse statements (e.g., “I am someone who is talkative”) on a 5-point Likert-type scale (ranging from 1 = disagree strongly to 5 = agree strongly). Scores on the Extraversion and Neuroticism subscales can range from 8 to 40, scores on the Agreeableness and Conscientiousness subscales can range from 9 to 45, and scores on the Openness subscale can range from 10 to 50.25,26 Reliability coefficient alphas for this study were found to be .90 for Extraversion, .77 for Agreeableness, .76 for Conscientiousness, .74 for Neuroticism, and .75 for Openness.
The BRS is a 6-item instrument on a 5-point Likert-type scale (ranging from 1 = strongly disagree to 5 = strongly agree). Participants are asked to choose the extent to which they agree with statements such as, “I tend to bounce back quickly after hard times.” Scores range from 6 to 30, with higher scores indicating greater resilience.34 The reliability coefficient alpha for this study was found to be .85.
A canonical correlation was used to determine the relationship between the three variables in the Perfectionism set (Self-Oriented, Others-Oriented, and Socially Prescribed) and five variables in the Personality set (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism). A one-way multiple analysis of variance (MANOVA) was used to determine the difference in levels of perfectionism (three dependent variables) between genders (two independent variables). A Pearson correlation was used to determine how strongly the level of resilience and the level of neuroticism are correlated. An alpha level of .05 was used to identify statistical significance for all three analyses.
Are the levels of perfectionism of veterinary students significantly related to their personality factors? Assumptions were checked for the canonical correlation analysis. Cook’s test revealed that no individual cases were determined to be highly influential in the data set; therefore, all 99 participants were included in the canonical correlation analysis. Multivariate normality was checked for both variable sets using Mardia’s test. For the Perfection set, Mardia’s test showed skewness of p = .005 and kurtosis of p = .070, violating the assumption of multivariate normality. For the Personality set, Mardia’s test showed skewness of p = .013 and kurtosis of p = .650, meeting the assumption of multivariate normality. Univariate normality was checked for each of the variables using graphic methods and the Shapiro–Wilk test; all variables except Others-Oriented Perfectionism (p = .020) and Conscientiousness (p = .015) met the assumption of normality. Conscientiousness was corrected using a reflect and square root transformation (p = .144); however, Others-Oriented Perfectionism could not be corrected, and normality cannot be assumed for this variable. Assumptions of linearity, homoscedasticity, and multicollinearity were satisfied for all variables.
The canonical correlation for this data set yielded three functions. Function 1 was found to be statistically significant [R c = .530; Wilks’ λ = .564, F (15, 251.61) = 3.87, p < .001]. In Function 1, the three variables composing the Perfectionism set share an average of 41.6% of their variance with the linear composite of scores from their own set (see Table 3) and an average of 11.7% of their variance with the linear composite of the Personality set (see Table 4). The five variables in the Personality set share an average of 18% of their variance with the linear composite of scores from their own set (see Table 3) and an average of 5.1% of their variance with the linear composite of the Perfectionism set (see Table 4). Function 1 explains 22% of the variance in the data set.
|
| F1 | Stzd | Unstzd | F2 | Stzd | Unstzd | F3 | Stzd. | Unstzd | |
| Perfectionism set | |||||||||
| Self | .887 | .975 | .099 | −.101 | −.915 | −.093 | .451 | .097 | .010 |
| Others | .062 | −.473 | −.051 | .170 | .296 | .032 | .984 | .995 | .108 |
| Social | 675 | .244 | .024 | .730 | 1.174 | .117 | .103 | −.218 | .022 |
| Adequacy | .416 | .191 | .394 | ||||||
| Personality set | |||||||||
| Open. | .099 | .080 | .015 | .093 | .288 | .053 | −.319 | −.343 | −.063 |
| Consc. | −.251 | −.366 | −.429 | .676 | .480 | .563 | −.516 | −.711 | −.834 |
| Extra. | .143 | .148 | .021 | .250 | .279 | .039 | .558 | .559 | .078 |
| Agree. | .032 | .073 | .015 | −.810 | −.688 | −.141 | −.295 | −.537 | −.110 |
| Neur. | .899 | .975 | .218 | .269 | .082 | .018 | −.230 | −.230 | −.051 |
| Adequacy | .180 | .251 | .164 |
F1 = Function 1 canonical loadings; Stzd = standardized coefficients; Unstzd = unstandardized coefficients; F2 = Function 2 canonical loadings; F3 = Function 3 canonical loadings; Self = self-oriented perfectionism; Others = others-oriented perfectionism; Social = socially prescribed perfectionism; Open. = openness; Consc. = conscientiousness; Extra. = extraversion; Agree. = agreeableness; Neur. = neuroticism
N = 99
|
| Function 1 | Function 2 | Function 3 | |
| Perfectionism set | |||
| Self | .470 | −.035 | .146 |
| Others | .033 | .060 | .318 |
| Social | .358 | .257 | .033 |
| Redundancy | .117 | .034 | .041 |
| Personality set | |||
| Open. | .053 | .033 | −.103 |
| Consc. | −.133 | .238 | −.167 |
| Extra. | .076 | .088 | .180 |
| Agree. | .017 | −.285 | −.095 |
| Neur. | .477 | .095 | −.074 |
| Redundancy | .051 | .031 | .017 |
Self = self-oriented perfectionism; Others = others-oriented perfectionism; Social = socially prescribed perfectionism; Open. = openness; Consc. = conscientiousness; Extra. = extraversion; Agree. = agreeableness; Neur. = neuroticism
N = 99
Function 2 was found to be statistically significant [Rc = .352; Wilks’ λ = .784, F(8, 184) = 2.97, p = .004]. In Function 2, the three variables comprising the Perfectionism set share an average of 19.1% of their variance with the linear composite of scores from their own set and an average of 3.4% of their variance with the linear composite of the Personality set. The five variables in the Personality set share an average of 25.1% of their variance with the linear composite of scores from their own set and an average of 3.1% of their variance with the linear composite of the Perfectionism set. Function 2 explains 11.6% of the variance in the data set.
Function 3 was found to be statistically significant [Rc = .323 Wilks’ λ = .896, F(3, 93) = 3.61, p = .016]. In Function 3, the three variables comprising the Perfectionism set share an average of 39.4% of their variance with the linear composite of scores from their own set and an average of 4.1% of their variance with the linear composite of the Personality set. The five variables in the Personality set share an average of 16.4% of their variance with the linear composite of scores from their own set and an average of 1.7% of their variance with the linear composite of the Perfectionism set. Function 3 explains approximately 10.4% of the variance in the data set. Together, Functions 1, 2, and 3 explain 43.6% of the variance in the data set.
As shown in Table 5, several variables show statistically significant correlational relationships. First, Pearson’s correlation for Self-Oriented Perfectionism and Neuroticism (r = .380) is significant (p < .001) and represents a large effect size.35 The coefficient of determination (r2 = .144) shows that Self-Oriented Perfectionism and Neuroticism share approximately 14.4% of their variance with one another. As shown in Table 3 by the standardized coefficients, this pair is given the most emphasis within the canonical root of the first canonical function.
|
| Self | Others | Social | Open. | Consc. | Extra. | Agree. | Neur. | |
| Self | 1 | .217* | ||||||
| Others | .481† | 1 | −.132 | |||||
| Social | .572† | .267† | 1 | .067 | ||||
| Open. | −.003 | −.093 | .049 | 1 | −.159 | |||
| Consc. | −.214* | .142 | −.076 | .142 | 1 | −.003 | −.334† | .157 |
| Extra. | .140 | .197 | .134 | −.028 | .005 | 1 | ||
| Agree. | .001 | −.141 | −.207* | .156 | .342† | .027 | 1 | |
| Neur. | .380† | −.028 | .384† | −.047 | −.184 | −.006 | −.184 | 1 |
Note: Correlations above the diagonal represent transformed values; correlations below the diagonal represent non-transformed values.
Self = self-oriented perfectionism; Others = others-oriented perfectionism; Social = socially prescribed perfectionism; Open. = openness; Consc. = conscientiousness; Extra. = extraversion; Agree. = agreeableness; Neur. = neuroticism
* Correlation is significant at the .05 level (2-tailed)
† Correlation is significant at the .01 level (2-tailed)
N = 279
Second, Pearson’s correlation for Socially Prescribed Perfectionism and Agreeableness (r = −.207) is significant (p < .040) and represents a medium effect size.35 The coefficient of determination (r 2 = .043) shows that Socially Prescribed Perfectionism and Agreeableness share approximately 4.3% of their variance with one another. As shown in Table 3 by the standardized coefficients, this pair is given the most emphasis within the canonical root of the second canonical function.
Third, Pearson’s correlation for Socially Prescribed Perfectionism and Neuroticism (r = .384) is significant (p < .001) and represents a large effect size.35 The coefficient of determination (r 2 = .147) shows that Self-Oriented Perfectionism and Neuroticism share approximately 14.4% of their variance with one another. Finally, Pearson’s correlation for Self-Oriented Perfectionism and Conscientiousness (r = .214) is significant (p < .034) and represents a medium effect size (34). The coefficient of determination (r 2 = .046) shows that Self-Oriented Perfectionism and Conscientiousness share approximately 4.6% of their variance with one another.
Do levels of perfectionism differ between men and women veterinary students? Cook’s test revealed that no individual cases were determined to be highly influential in the data set; therefore, all 99 participants were included in the one-way MANOVA. Multivariate normality was checked for the data set. Mardia’s test showed that the assumption of multivariate normality was met for the male group (skewness: p = .397, kurtosis: p = .758) but not for the female group (skewness: p = .004; kurtosis: p = .161). The Shapiro–Wilk test revealed that Self–Perfectionism for men (p = .657) and women (p = .073), Others–Perfectionism for men (p = .179), and Socially Prescribed Perfectionism for women (p = .277) met the assumption of univariate normality. Others–Perfectionism for women (p = .023) and Socially Prescribed Perfectionism for men (p = .022) were found to violate this assumption. No transformations corrected this violation. Despite achieving a satisfactory fit to normal distributions for the individual variables, multivariate normality was not achieved. Box’s M test showed that the assumption of the equality of covariance was satisfied for the data set (p = .786). Results from the MANOVA indicate that no statistically significant differences among men and women were found; Wilks’ λ was reported at .954, F (3, 94) = 1.50, p = .219, η2 = .046.
Are levels of resilience of veterinary students significantly correlated with their levels of neuroticism? Visual inspection of a scatterplot revealed that the data set did not show any outliers and satisfied the assumption of linearity. Visual inspection of normal Q–Q plots showed that the assumption of normality was satisfied. Pearson’s correlation for Resilience and Neuroticism (r = −.421) is significant (p < .001) and represents a large effect size.35 The coefficient of determination (r 2 = .177) shows that Neuroticism and Resilience share approximately 17.7% of their variance with one another.
This study investigated the association between perfectionism and personality factors, the differences in perfectionism among men and women, and the correlation between resilience and neuroticism among veterinary students. All students enrolled at a southeastern college accredited by AAVMC were invited to participate in this online research study. Ninety-nine veterinary students chose to participate in the study. Participants completed the MPS, the BFI, and the BRS.
A canonical correlation was used to investigate the relationship between the Perfectionism set (Self-Oriented, Others-Oriented, and Socially Prescribed) and the Personality set (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) among veterinary students. The results of this study found that the levels of perfectionism of veterinary students are statistically significantly related to their personality factors. The three functions yielded in the analysis were found to be statistically significant, and together these functions explained approximately 44% of the variance in the data set. The practical significance of this shared variance is explained through the correlational relationships among the variables in each set.
Self-Oriented Perfectionism was found to be statistically significantly related to Neuroticism. These two variables were the most influential pair in the first canonical function. The results of this study indicate a positive correlation between these variables and a large effect size for this relationship.35 Neuroticism is characterized by moodiness, sadness, anxiety, irritability, and a tendency to be stressed.25,26 Although this relationship has not been directly stated in the veterinary literature, intuitively this finding makes sense for veterinary students. It is not surprising that individuals who hold themselves to higher standards of perfection also experience greater levels of moodiness, anxiety, irritability, and tension.25,26
Previous literature identified that perfectionism is related to an increased likelihood of veterinarians experiencing negative emotions and distress, as well as greater levels of vulnerability to work-related moral stress.13 Neuroticism has also been linked to occupational stress,28 and individuals who hold themselves to very high or unrealistic standards are likely to experience higher levels of stress in the workplace. It is likely that veterinarians who demonstrate high levels of perfectionism—and in turn, high levels of neuroticism—experience a higher level of difficulty demonstrating a non-anxious presence,36 communicating effectively,37 and remaining calm and flexible in tense workplace experiences. It may be helpful for veterinary mental health professionals and educators to help students understand this correlation between perfectionism and neuroticism and the potentially negative effects that can result from having unrealistic expectations for self. Efforts directed at helping students balance their high expectations with appropriate self-love and self-care could directly influence the emotional health and well-being of veterinary students.
Socially Prescribed Perfectionism was found to be statistically significantly related to Agreeableness. Results from this study indicate a positive correlation between these two variables and a medium effect size for this relationship.35 Agreeableness is characterized by caring for and wanting to please others and wanting to contribute to the well-being and happiness of others,25,26 and socially prescribed perfectionism is working to meet the perceived high expectations of those around oneself.1,2 Although agreeableness can be a very positive personality factor, it is important to note that it may contribute to veterinary students feeling intense pressure to please and impress their peers, professors, and clients, which ultimately perpetuates the intense stress level and competitiveness of veterinary training.4,17,18
In veterinary medicine, excessively high standards may actually be just as great as students perceive them to be, which creates a difficult reality for students. On the one hand, it may be helpful for them to learn to rethink their socially prescribed perfectionism and relax the pressure they feel because of it; but on the other hand, they may very well lose merit and opportunities in their field if they do not strive to live up to the high expectations surrounding them.4,15,17,18 Therefore, it may be helpful for veterinary educators to help their students make the distinction between adaptive perfection and maladaptive perfection4 so that individuals who are higher in socially prescribed perfectionism can find a healthy balance of adaptively striving for excellence without experiencing the heightened stress and other negative symptoms that can coincide with trying to meet others’ standards of excellence.
Socially Prescribed Perfectionism was found to be statistically significantly related to Neuroticism. Results from this study indicate a positive correlation between these two variables and a large effect size for this relationship.35 Again, the idea of helping students to find ways to be adaptive perfectionists instead of maladaptive perfectionists is vital for student well-being. Individuals who are more heavily burdened by striving to meet the high standards of others are likely to experience the range of negative emotions characterized by neuroticism. It is important that veterinary students learn how to cope with less-than-perfect actions and outcomes appropriately. Although perfection may be a helpful and necessary goal in some high stakes situations in veterinary medicine, excellence rather than perfection may be a more appropriate goal in the day to day practice of veterinary medicine to promote wellness and to avoid compassion fatigue and burnout.35 Finding healthy ways to set and accomplish goals without doubt, self-criticism, and anxiety getting in the way is critical for veterinary students.
Self-Oriented Perfectionism was found to be statistically significantly related to Conscientiousness. Results from this study indicate a positive correlation between these two variables and a medium effect size for this relationship.35 Conscientiousness is characterized by being structured, detailed, organized, prepared, committed to completing projects, and aware of how one’s own actions influence others.25,26 This corresponds well with the self-oriented perfectionist’s need to be excellent in all things, hold self to high standards, not make mistakes, and be self-critical.1–3 In human medicine, conscientiousness has been identified as a risk factor for stress, depression, suicidal ideation, and other mental health concerns among medical students and young doctors,38 and it is likely to be the same among veterinary students. Although this pair of characteristics has the potential to help veterinary students succeed brilliantly in their academic and professional pursuits, it could also contribute to a low quality of life if not managed productively.
A MANOVA was used to investigate the differences in levels of perfectionism among men and women veterinary students. The results of this study show that no statistically significant differences between men and women were found. Additional research is needed to provide further confirmation of similarities in levels of perfection between the sexes. Although this study did not reveal differences between the sexes, it is very possible that men and women do experience the pressures of excellent performance and perfectionism differently even though their scores on the Multidimensional Perfectionism Inventory were not significantly different. Further research should strive to quantify this potential difference so that veterinary mental health professionals can know how to best promote the well-being and mental health of both sexes.
Pearson’s correlation was used to demonstrate the strength of the association between levels of Resilience and the personality factor Neuroticism among the sample. Resilience and Neuroticism were found to be statistically significantly correlated with one another. The results of this study show a negative correlation between these two variables and indicate a large effect size for this relationship.35 In human medicine, neuroticism has been found to be related to higher levels of emotional exhaustion and a risk factor for stress, suicidal ideation, and depression for medical students and doctors.38,39 Resilience, on the other hand, is correlated with better mental health and well-being,14 interpretation of stressful environments as non-threatening, self-care,29 reduced vulnerability, and increased coping skills32 in human medicine and veterinary medicine. Therefore, it makes sense that as resilience increases, neuroticism would be expected to decrease, and vice versa. It is valuable to know that efforts that veterinary training programs put into increasing their students’ resilience also have the potential to help decrease neuroticism and perhaps, in turn, indirectly help students to manage their perfectionistic standards in more balanced ways.
Several limitations of this study should be considered. Perfectionism is not easy to objectively measure or test, which makes self-report a common method of investigation. However, research based on self-report of participants does present limitations. The typical risks of response bias must be acknowledged. However, an additional level of social desirability may be present because of the nature of both what is being investigated and the population being studied. Highly perfectionistic individuals may, by nature, have more difficulty admitting what might be perceived as imperfections or negative qualities. Researchers interested in further exploring this topic could employ a qualitative or experimental design to provide a more in-depth study of student perfectionism and perhaps diminish some of this self-report bias.
Additionally, this research is limited by its inclusion of only one college of veterinary medicine. Results may or may not be representative of schools in neighboring states or other regions of the country. Further research could include multiple colleges across the United States to gain a more generalizable understanding of perfectionism among veterinary students. Researchers could also consider an investigation of personality profiles specific to the various specializations within veterinary medicine, as well as longitudinal designs. The small sample of men veterinary students in this study suggests that a lack of differences in levels of perfectionism among men and women should be interpreted cautiously. Finally, although the online design of this research provides convenience for student participation, it also includes the limitation of being easily ignored or forgotten by a busy veterinary student population.
Perfectionism is a common characteristic of veterinary students and may even be necessary for success in the rigorous, competitive environments of veterinary training programs. However, it is important for veterinary educators and mental health professionals to understand both the positive and negative impact that perfection can have on student well-being, as well as the ways that perfection is related to personality factors. Veterinary training programs that are willing to teach strategies to manage perfectionism, promote resilience, and help students develop healthy ways to set and pursue goals in a high-pressure environment will be able to positively impact their students’ well-being, and thus positively impact the future of veterinary medicine.
a SurveyMonkey, SurveyMonkey LLC, Palo Alto, CA, USA, http://www.surveymonkey.com
| 1. | Hewitt PL, Flett GL. Perfectionism and depression: a multidimensional analysis. J Soc Behav Pers. 1990;5(5):423–38. https://psycnet.apa.org/record/1991-04621-001. Google Scholar |
| 2. | Hewitt PL, Flett GL. Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. J Pers Soc Psychol. 1991;60(3):456–70. https://doi.org/10.1037/0022-3514.60.3.456. Medline: 2027080 Medline, Google Scholar |
| 3. | Hewitt PL, Flett GL, Turnbull-Donovan W, Mikail SF. The multidimensional perfectionism scale: reliability, validity, and psychometric properties in psychiatric samples. Psychol Assess. 1991;3(3):464–8. https://doi.org/10.1037//1040-3590.3.3.464. Google Scholar |
| 4. | Allister R. Veterinary perfectionism: why good enough should be good enough [Internet]. Pract Life. 2014 Sep/Oct [cited 2019 Jul 11]:24–26. Available from: https://veterinarywellbeing.files.wordpress.com/2014/ 10/scan-f001-1.pdf. Google Scholar |
| 5. | Fink-Miller EL, Nestler LM. Suicide in physicians and veterinarians: risk factors and theories. Curr Opin Psychol. 2018;22:23–6. https://doi.org/10.1016/ j.copsyc.2017.07.019. Medline: 30122273 Medline, Google Scholar |
| 6. | Bartram DJ, Baldwin DS. Veterinary surgeons and suicide: a structured review of possible influences on increased risk. Vet Rec. 2010;166(13):388–97. https://doi.org/10.1136/vr.b4794. Medline: 20348468 Medline, Google Scholar |
| 7. | Oxtoby C. Managing perfectionism. Vet Rec. 2018;183(3):106. https://doi.org/10.1136/vr.k3182. Medline: 30026364 Medline, Google Scholar |
| 8. | Henning K, Ey S, Shaw D. Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Med Educ. 1998;32(5):456–64. https://doi.org/10.1046/j.1365-2923.1998.00234.x. Medline: 10211285 Medline, Google Scholar |
| 9. | Peters M, King J. Perfectionism in doctors: can lead to unhealthy behaviours in stressful work situations. BMJ. 2012;344(7858):10. https://doi.org/10.1136/bmj.e1674. Google Scholar |
| 10. | Smith SI, Dandignac M. Perfectionism: addressing lofty expectations in medical school. In: Smith CR, editor. Exploring the pressures of medical education from a mental health and wellness perspective. Hershey, PA: IGI Global; 2018. p. 68–91. Google Scholar |
| 11. | Haas KB. The perils of perfectionism. J Am Vet Med Assoc. 1994;205(8):1118. Medline, Google Scholar |
| 12. | Platt B, Hawton K, Simkin S, Mellanby RJ. Suicidal behaviour and psychosocial problems in veterinary surgeons: a systematic review. Soc Psychiatry Psychiatr Epidemiol. 2012;47(2):223–40. https://doi.org/10.1007/s00127-010-0328-6. Medline: 21181111 Medline, Google Scholar |
| 13. | Crane MF, Phillips JK, Karin E. Trait perfectionism strengthens the negative effects of moral stressors occurring in veterinary practice. Aust Vet J. 2015;93(10):354–60. https://doi.org/10.1111/avj.12366. Medline: 26412116 Medline, Google Scholar |
| 14. | Moffett JE, Bartram DJ. Veterinary students’ perspectives on resilience and resilience-building strategies. J Vet Med Educ. 2017;44(1):116–24. https://doi.org/10.3138/jvme.0216-046R1. Medline: 28206832 Link, Google Scholar |
| 15. | Zenner D, Burns GA, Ruby KL, DeBowes RM, Stoll SK. Veterinary students as elite performers: preliminary insights. J Vet Med Educ. 2005;32(2):242–8. https://doi.org/10.3138/jvme.32.2.242. Medline: 16078178 Link, Google Scholar |
| 16. | Viner B. Success in veterinary practice: maximising clinical outcomes and personal well-being. Hoboken, NJ: John Wiley & Sons; 2010. Google Scholar |
| 17. | Larkin M. Finding calm amid the chaos [Internet]. Schaumburg, IL: American Veterinary Medical Association; 2013 Nov 15 [cited 2017 Sep 16]. Available from: https://www.avma.org/News/JAVMANews/Pages/131115a.aspx. Google Scholar |
| 18. | Stamp SS, Thoren J. Turning negativity to positivity: it helps to S.M.I.L.E. [Internet]. Tulsa, OK: Clinician’s Brief; 2015 Jan/Feb [cited 2019 Jul 11]. Available from: https://www.cliniciansbrief.com/article/turning-negativity-positivity-it-helps-smile. Google Scholar |
| 19. | Enns MW, Cox BJ, Clara I. Adaptive and maladaptive perfectionism: developmental origins and association with depression proneness. Pers Individ Dif. 2002;33(6):921–35. https://doi.org/10.1016/S0191-8869(01)00202-1. Google Scholar |
| 20. | O’Connor RC. The relations between perfectionism and suicidality: a systematic review. Suicide Life Threat Behav. 2007;37(6):698–714. https://doi.org/10.1521/suli.2007.37.6.698. Medline: 18275376 Medline, Google Scholar |
| 21. | Weston JF, Gardner D, Yeung P. Stressors and protective factors among veterinary students in New Zealand. J Vet Med Educ. 2017;44(1):22–8. https://doi.org/10.3138/jvme.0116-014R1. Medline: 28206841 Link, Google Scholar |
| 22. | Cake MA, Bell MA, Bickley N, Bartram DJ. The life of meaning: a model of the positive contributions to well-being from veterinary work. J Vet Med Educ. 2015;42(3):184–93. https://doi.org/10.3138/jvme.1014-097R1. Medline: 26075621 Link, Google Scholar |
| 23. | Johnson SW, Gill MS, Grenier C, Taboada J. A descriptive analysis of personality and gender at the Louisiana State University School of Veterinary Medicine. J Vet Med Educ. 2009;36(3):284–90. https://doi.org/10.3138/jvme.36.3.284. Medline: 19861716 Link, Google Scholar |
| 24. | Myers IB. The Myers–Briggs Type Indicator. Palo Alto, CA: Consulting Psychologists Press; 1983. Google Scholar |
| 25. | John OP, Donahue EM, Kentle RL. The Big Five Inventory--versions 4a and 54. Berkeley, CA: Institute of Personality and Social Research; 1991. Google Scholar |
| 26. | John OP, Naumann LP, Soto CJ. Paradigm shift to the integrative Big Five trait taxonomy: history, measurement, and conceptual issues. In: John OP, Robins RW, Pervin LA, editors. Handbook of personality: theory and research, 2nd ed. New York, NY: Guilford Press; 2008. p. 114–58. Google Scholar |
| 27. | Niehoff BP. Personality predictors of participation as a mentor. Career Dev Int. 2006;11(4):321–33. https://doi.org/10.1108/13620430610672531. Google Scholar |
| 28. | Dawson BF, Thompson NJ. The effect of personality on occupational stress in veterinary surgeons. J Vet Med Educ. 2017;44(1):72–83. https://doi.org/10.3138/jvme.0116-020R. Medline: 28206844 Link, Google Scholar |
| 29. | Moffett J, Matthew S, Fawcett A. Building career resilience. In Pract. 2015;37(1):38–41. https://doi.org/10.1136/inp.g3958. Google Scholar |
| 30. | Boulton C, McIntyre J. Aiding the transition from vet school to practice. Vet Rec. 2012;171(18):441–2. https://doi.org/10.1136/vr.e7114. Medline: 23125263 Medline, Google Scholar |
| 31. | Mastenbroek NJ. The art of staying engaged: the role of personal resources in the mental well-being of young veterinary professionals. J Vet Med Educ. 2017;44(1): 84–94. https://doi.org/10.3138/jvme.0216-041R1. Medline: 28206838 Link, Google Scholar |
| 32. | Jackson D, Firtko A, Edenborough M. Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. J Adv Nurs. 2007;60(1):1–9. https://doi.org/10.1111/j.1365-2648. 2007.04412.x. Medline: 17824934 Medline, Google Scholar |
| 33. | University of Florida College of Veterinary Medicine. Dissecting demographics: an overview of diversity in medical, dental, and veterinary schools. In: Insight into diversity. St. Louis, MO: Potomac Publishing; 2017 May. p. 45. Google Scholar |
| 34. | Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. https://doi.org/10.1080/10705500802222972. Medline: 18696313 Medline, Google Scholar |
| 35. | Cohen J. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. Google Scholar |
| 36. | Strand EB. Enhanced communication by developing a non-anxious presence: a key attribute for the successful veterinarian. J Vet Med Educ. 2006;33(1):65–70. https://doi.org/10.3138/jvme.33.1.65. Medline: 16767640 Link, Google Scholar |
| 37. | Hess-Holden CL, Jackson DL, Morse DT, Monaghan CL. Understanding non-technical competencies: compassion and communication among fourth-year veterinarians-in-training. J Vet Med Educ. 2019 Feb 26;1–12. Epub 2019 Feb 26. https://doi.org/10.3138/jvme.0917-131r1. Medline: 30806557 Google Scholar |
| 38. | Tyssen R, Dolatowski FC, Røvik JO, et al. Personality traits and types predict medical school stress: a six-year longitudinal and nationwide study. Med Educ. 2007;41(8):781–7,. https://doi.org/10.1111/j.1365-2923. 2007.02802.x. Medline: 17661886 Medline, Google Scholar |
| 39. | McManus IC, Keeling A, Paice E. Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates. BMC Med. 2004;2(1):29. https://doi.org/10.1186/1741-7015-2-29. Medline: 15317650 Medline, Google Scholar |
