The Student Who Needs to Be Perfect: How Perfectionism Holds Back Clinical Learners

By Britney Pos, Clinical Instructor, R.D.H., R.D.A

Perfectionism has long been embedded in healthcare training. From mastering clinical skills to ensuring patient safety, students in medicine, nursing, and dentistry are expected to perform at exceptionally high levels. While striving for excellence is important as a clinical learner, growing research shows that unchecked perfectionism can significantly harm student well-being, learning, and long-term professional performance.

As clinical instructors, how do we mitigate this? How do we teach students to be the best they can be while simultaneously teaching them that perfectionism is not the ultimate goal?

Getting 100% on the exam is not as important as understanding and applying the information to patient care.

The Hidden Cost of Perfectionism in Clinical Education

Recent research demonstrates that perfectionism is common in healthcare students and often shown to be maladaptive and harmful to the clinical learner.

For example, a 2023 perspective piece published in the Journal of Graduate Medical Education observed that perfectionism is strongly associated with anxiety, depression, and burnout, especially when it becomes “excessive” rather than performance-enhancing (Johnson et al., 2023). Similarly, research on medical students shows that socially prescribed perfectionism, the pressure to be perfect imposed by others, is associated with academic burnout and reduced self-efficacy (Yu et al., 2016).

Dental education reflects the same trend. A large UK study found that 35% of dental students were maladaptive perfectionists, and these students experienced significantly higher levels of stress, burnout, and psychological distress (Collin et al., 2020).

Across professions, the message is clear: perfectionism is not just a personality trait. It is a risk factor for mental health decline in clinical learners.

Why Clinical Environments Intensify Perfectionism

1. High-Stakes Learning

Healthcare students are trained in environments where mistakes can impact patient safety. This creates a culture where errors can feel unacceptable, reinforcing perfectionistic thinking. Dental and medical students report that clinical responsibilities, workload, and fear of failure are major stressors, especially as they transition into patient care roles (Alamoush et al., 2024; Lugassy et al., 2025).

2. External Expectations and Evaluation

Students are constantly evaluated by instructors, peers, and institutions. Studies show that this external pressure fuels socially prescribed perfectionism, which is the type most strongly linked to burnout (Yu et al., 2016).

3. Competitive Culture

Healthcare programs attract high-achieving individuals and reinforce competition. These environments often reward flawless performance and discourage vulnerability. Unfortunately this can encourage students to hide mistakes instead of learning from them.

Consequences for Students and Patient Care

Mental Health Risks

Students that feel the need to be perfect throughout their educational journey have increased anxiety and depression, higher levels of burnout, and reduced self-esteem and well-being (Collin et al., 2020; Gao et al., 2023).

Learning and Performance Issues

Perfectionism can undermine learning in three ways. The first being that a fear of failure can reduce a student’s willingness to try skills in a new way. With students that are driven by a desire to be perfect, they might choose to not attempt a new strategy or approach to a given situation because they already “know” how to complete the task perfectly. As we know, healthcare is constantly growing and changing and it is imperative to teach our students that there can, and will be, multiple ways to approach a situation.

The second way perfectionism undermines learning is that a student’s tendency to overthink a particular situation can lead to procrastination and indecision. If a student is overwhelmed by not knowing EVERYTHING about an assignment and potentially not receiving full credit, they may choose to postpone until they have more information. This leads to added stress. Ultimately, done is better than perfect.

The last hindrance to learning in perfectionists is that many of these students will avoid getting feedback to protect the “perfect” image. The need to be perceived as confident and self-assured can get in the way of instructors being able to answer the unasked questions they are holding back.

Long-Term Professional Impact

Perfectionism does not stop once the desired degree has been achieved. Oftentimes perfectionism continues into a clinician’s career and can lead to chronic burnout across all areas of their life, reduced resilience to schedule and staffing changes, and difficulty coping with inevitable errors.

Why Clinical Instructors Play a Critical Role

No one is perfect and it is imperative that we accept this of ourselves and share with our students. As clinical instructors, we have the ability to help shape how students interpret expectations and mistakes. We can guide clinical learners through their first challenges and teach them that these potential “mistakes” are a growing opportunity rather than a negative event. Early recognition of maladaptive perfectionism can help prevent burnout and improve well-being (Johnson et al., 2023).

Strategies to Mitigate Perfectionism

1. Normalize Mistakes

Frame errors as learning opportunities. Share your own instructor experiences with students. When students see that their instructors have made mistakes and grown from them, it creates space for them to do the same.

2. Emphasize Competence Over Perfection

Focus on safe, effective care rather than flawless execution. Reinforce progress and improvement rather than only measuring against an ideal standard.

3. Provide Balanced Feedback

Include strengths, not only deficits. Avoid overly critical language that reinforces the belief that anything less than perfect is failure.

4. Promote Psychological Safety

Encourage open discussion in the clinical setting. Support vulnerability and create an environment where asking questions is valued, not judged.

5. Teach Coping and Self-Compassion

Encourage reflection and support resilience development. Help students build the skills to recover from setbacks rather than avoid them entirely.

Moving Forward

“Don’t let being perfect get in the way of being good.”

The above is a modern take on a translated quote from French philosopher Voltaire: “Le mieux est l’ennemi du bien,” or “The best is the enemy of the good.”

Perfectionism contributes to burnout, stress, and poor mental health, and it begins during clinical training. Clinical instructors can help students shift from:

“I must be perfect” → “I am learning to be competent and continually improving.”

Bottom Line

Mitigating perfectionism is not lowering standards. It is protecting students, improving learning, and ensuring better patient care. It is imperative that we recognize maladaptive perfectionism in our students and approach the behavior directly to prevent long-term clinician burnout and mental health decline.

Need Some More Ideas? Looking for Educator Support?

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These two goals are not separate. The institutional relationships we build through consulting create the foundation for community outreach. As we help programs become stronger, we also help connect them to students in communities that have historically lacked access to health professions exposure.

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References

Alamoush, R. A., Al-Sawaeir, S., Abu Baker, D., Aljamani, S., & Alomoush, S. (2024). Stress experienced by dental students performing clinical training: A cross-sectional study. Journal of Occupational Health, 66(1), uiae006. https://doi.org/10.1093/joccuh/uiae006

Collin, V., O’Selmo, E., & Whitehead, P. (2020). Stress, psychological distress, burnout and perfectionism in UK dental students. British Dental Journal, 229(9), 605-614. https://doi.org/10.1038/s41415-020-2281-4

Gao, X., Zhong, J., Li, H., Pei, Y., Li, X., Zhang, S., Yue, Y., & Xiong, X. (2023). The relationship between perfectionism, self-perception of orofacial appearance, and mental health in college students. Frontiers in Public Health, 11, Article 1154413. https://doi.org/10.3389/fpubh.2023.1154413

Johnson, K. M., Slavin, S. J., & Takahashi, T. A. (2023). Excellent vs excessive: Helping trainees balance performance and perfectionism. Journal of Graduate Medical Education, 15(4), 424-427. https://doi.org/10.4300/JGME-D-23-00003.1

Lugassy, D., Ben-Izhack, G., Zissu, S., Shitrit Lahav, R., Rosner, O., Elzami, R., Shely, A., & Naishlos, S. (2025). Anxiety, stress, and depression levels among dental students: Gender, age, and stage of dental education related. Psychology, Health & Medicine, 30(7), 1394-1408. https://doi.org/10.1080/13548506.2025.2476085

Yu, J. H., Chae, S. J., & Chang, K. H. (2016). The relationship among self-efficacy, perfectionism and academic burnout in medical school students. Korean Journal of Medical Education, 28(1), 49-55. https://doi.org/10.3946/kjme.2016.9