Students at the graduate level undergo higher levels of stress compared to their peers, and this stress is known to affect academic performance. Most of the research is focused on the negative aspect of stress. Positive psychology aspects, such as eustress and flow, are related to success in some activities; however, it is unknown whether these correlate with academic performance. Several stress-related theories-Yerkes-Dodson curve, cybernetics, conservation of resources, and choking under pressure-guided this quantitative study of the effects of eustress, flow, and cognitive test anxiety (CTA) on a psychomotor practical examination for physical therapy students. A sample of 192 physical therapy graduate students across 3 campuses and 5 programs participated. Immediately following a standard psychomotor practical examination, and prior to any performance feedback, participants' levels of eustress, flow, and CTA were measured. All 3 variables had statistically significant bivariate correlations with exam score, and in the expected direction. In a standard multiple regression flow was the only statistically significant predictor; exam scores increased as flow increased. A follow-up analysis revealed that flow mediated (a) the positive relationship between eustress and exam score, and (b) the negative relationship between CTA and exam score, mitigating CTA's negative effect. Results suggest positive social change interventions focused on enhancing positive psychological states could improve academic performance and clinical training, leading to better clinical practice performance and outcomes for patients.