EDUCATION & TRAINING Analysis of Psychophysiological Stress Response in Higher Education Students Undergoing Clinical Practice Evaluation Ana Isabel Beltrán-Velasco 1 & Pablo Ruisoto-Palomera 1,2 & Alberto Bellido-Esteban 3 & Monica García-Mateos 4 & Vicente Javier Clemente-Suárez 1,4,5 Received: 28 November 2018 /Accepted: 30 January 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract The aim of this study was to analyze the psychophysiological response of Physiotherapy degree students during a complete clinical practice as well as their psychological profile in relation to coping style in stressful situations, and its impact on academic performance. We analysed in 15 students heart rate variability (HRV) to analyse autonomic modulation in three moments during the entire clinical practices of 3 months (4 h per day, 3 days per week), first session, middle session and last session; perceived stress, personality, life engagement, cognitive flexibility before starting the clinical practice the academic performance after the clinical practice. Results based on HRV and related indexes parameters fail to indicate the expected autonomic adaptation during the practice. A complete clinical practice of Physiotherapy degree students did not produce an habituation process since a high sympathetic autonomic nervous system modulation was measured in the beginning, at the middle and at the final of the clinical practice. Below-average scores are presented in a personality factor associated with traditional and non-adaptive coping styles that could explain the non-habituation of the students. Finally, none of the analyzed indexes has been able to relate to academic performance. Keywords Autonomic modulation . Stress . HRV . Personality . Psychology Introduction The application of simulation scenarios in the learning process in health science degrees is extended, especially in Physiotherapy studies, since students must face the profes- sional clinical environment and for this they need to have assimilated valuable theoretical and practical knowledge [1–3]. This academic experience allows students to acquire therapeutic and professional skills that will be essential in their professional future due to the repeated exposure that facilitates the acquisition of the habituation process [4, 5]. This experi- ence tried to offer a real but controllable environment where the students could face a clinical situation as in real future situations with the advantage of not putting a person at risk. This event is stressful, and students must value the demands of the environment and its tools to cope with them, which causes a stress response due to the student’ s perception of the uncon- trollability of the environment. The impact produced by this acute stress response has been studied in other areas such as sport or the military context, showing how the stress response negatively affects the correct neuronal functioning in prefron- tal regions, thereby affecting complex processes such as mem- ory, decision-making and the learning process itself [6]. This stress response led to an increase in sympathetic autonomic modulation [7–9], a fact previously associated with the alter- ation of hippocampal areas related to superior cortical func- tions [10–13]. It was also found that acute stress produces a reduction in blood flow in the prefrontal cortex, decreasing the This article is part of the Topical Collection on Education & Training * Vicente Javier Clemente-Suárez vicentejavier.clemente@universidadeuropea.es 1 Applied Psychophysiological Research Group, European University of Madrid, Madrid, Spain 2 Department of Basic Psychology, Psychobiology and Methodology of Behavioural Sciences, University of Salamanca, Salamanca, Spain 3 Department of Psychology, European University of Madrid, Madrid, Spain 4 Faculty of Sport Science, Universidad Europea de Madrid, Madrid, Spain 5 Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla, Colombia Journal of Medical Systems (2019) 43:68 https://doi.org/10.1007/s10916-019-1187-7