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Students coping with change in higher education: An overview
Abstract
Higher education institutions implement purposeful change to improve their performance or impose changes in response to their external environments. To deal with these changes, students are expected to develop their coping capacity – the emotional and cognitive ability to manage the demands of adverse situations. Student coping is composed of four interdependent core elements – self-efficacy, engagement, resilience and anxiety. This article synthesizes the evidence on the effect of higher education changes on student’s ability to cope. Using Polanin et al.’s (2017) overview process, our search generated 551 articles, and after three rounds of screening, the remaining 12 reviews were analyzed using the narrative descriptive synthesis approach. We found that the quality assessment within the included reviews were inconsistent and, sometimes not clearly defined. From the analysis of the reviews, four key themes emerged: (1) change is complex; (2) the nature of change is varied; (3) there is an interdependent relationship between the coping elements; and (4) the measurement of change is not sophisticated. Our findings highlight the need for higher education institutions to adopt a principle-based approach to purposefully develop students’ coping capacity, by improving their self-efficacy, engagement, and resilience, and reducing anxiety. Limitations and future research directions are outlined.
... The case studies serve as a tool to examine the challenges students encounter, aiming to understand the coping mechanisms employed. Research indicates that when confronted with change, students may resort to both positive and maladaptive coping strategies (Co et al. 2023). For instance, stressors perceived as external motivators, such as the pursuit of grants, could potentially lead to increased instances of academic misconduct (Anderman & Midgley 2004). ...
... Higher education has an increased emphasis on improving student engagement (Carini et al. 2006). Studies explore ways to enhance student engagement by fostering their commitment to the academic integrity culture (Co et al. 2023). Graphic novels, with their unique format, may offer this heightened level of engagement; however, further analysis is required to comprehensively assess the effectiveness of this method. ...
Academic integrity is a crucial aspect of the educational process, often receiving insufficient attention until a violation occurs. Researchers emphasize the importance of students comprehending academic integrity to foster ethical professionalism. However, there is a lack of resources available to effectively support these conversations. This study aims to assess academic integrity efficacy and the multi-dimensional ethical scale (MES) through the use of a graphic novel mini-case study. The analysis reveals a significant relationship between academic integrity efficacy, MES dimensions (moral equity, relativism and contractualism), and the case studies among undergraduate participants. The combination of quantitative and qualitative findings provides valuable insights into how graphic novel mini-cases can engage in academic integrity discussions with undergraduate students. The graphic novel mini-cases, along with their limitations and potential for future research, are provided.
... New technologies such as the integration of Information and Communication Technologies (ICTs) [72], augmented and virtual reality (VR) [73], and artificial intelligence (AI) [74] are redefining the way students learn [75]. Higher education institutions are adapting to changes caused by external and internal factors [76]. The external factors include changes in the job market [77,78], the consequences of the COVID-19 pandemic [79], and economic and social development [80,81]. ...
Humans are spending more time indoors than ever due to urbanisation and industrialisation, leading to higher electricity consumption in lighting systems. Recent research has demonstrated the significance of maintaining a balance between daylight and electric light to create an ideal learning environment that can significantly impact students’ academic performance. The objective of this study is to analyse the changes in students’ emotional response depending on the type of lighting in the classroom—whether it is daylight, electric light, or a combination of both. A field study was conducted with 521 university students to assess their affective response to the lighting environment inside their classroom. The results show that students prefer a Clear-efficient lighting environment for writing–reading tasks and a Soft-calm atmosphere for using electronic devices. For the paying attention tasks, a combination of daylighting and electric lighting is determined to be the best solution, while for the tasks of discussing–teamwork, students prefer daylighting. Daylighting is found to be the only lighting option that students like. Despite this, students still consider electric lighting and the combination of daylight and electric light adequate for a classroom. The findings of this study may help educators and designers create learning spaces that promote a positive and stimulating student environment by understanding the relationship between the lighting environment and students’ affective responses.
... In addition to these narrowly focused studies, several review articles have compiled knowledge on how natural disasters affect higher education. Notably, Co et al. [21] performed a comprehensive analysis of 12 studies, looking at how natural disasters affect many facets of higher education, and emphasized the need for adopting a principle-based strategy by higher education institutions to actively enhance students' coping skills by raising their self-efficacy, involvement, and resilience while lowering anxiety. Similarly, Borazon and Chuang [6] analyzed 707 documents to assess the factors of educational resilience and highlighted the role of the environment, individual experiences and background, and educational institution's programs as enablers of resilience-building. ...
This study aims to evaluate how natural disasters affect student enrollment in higher education programs, considering both immediate and long-term consequences. The PRISMA guidelines were adhered to in conducting this review. Multiple databases, such as Web of Science and Scopus, including those with articles from January 2000 to February 2023, were thoroughly searched. Articles focusing on how natural disasters affect students' enrollment in higher education programs met the inclusion requirements. A total of 22 studies were deemed eligible for inclusion and detailed analysis. The findings suggest that natural disasters have a negative influence on higher education enrollment, with the most severe effects being felt by disadvantaged populations. This study reveals that natural disasters impact various aspects of the enrollment process, such as application, acceptance, registration, attendance, retention, and graduation, in higher education due to infrastructural and psychological impacts. Key variables linking natural disasters to enrollment changes include damage to institutional infrastructure, economic and psychological strain, resource limitations, loss of social support networks, and disruptions to academic programs. Enhancing resilience involves adopting online learning, providing financial support, flexible enrollment policies, mental health services, disaster preparedness training, resilient infrastructure development, and collaborative institutional programs. The study highlights the need for comprehensive, context-specific disaster management strategies that address both immediate and long-term educational needs. It identifies potential solutions, including online learning platforms, financial aid, flexible enrollment policies, mental health support, disaster preparedness training, infrastructure resilience, and collaborative programs with other institutions. Context-specific programs are essential to support impacted students by rebuilding educational infrastructure and providing financial and emotional support, thereby ensuring their continued access to higher education. This study offers valuable insights for disaster management, educational policy, and future research on this critical issue.
... Given this rapid transition into a technologically advanced construction sector, curriculum development within HEIs has received increasing scrutiny and attention to ensure modernity and relevance of provisions (cf. Co et al., 2023;Luo and Chan, 2022;Shen et al., 2020;Upsher et al., 2022;Xu et al., 2022). Yet, this scrutiny remains at the institutional level and across the HEI sector a notable lack of connectivity between research conducted also exists (Posillico et al., 2021). ...
Purpose: Higher education curriculum development in the construction industry has historically received scant academic attention and often, courses/programmes are largely developed using the tacit knowledge of individual tutors. This research investigates the core interpersonal and technical skills and competencies required of a contemporary construction management graduate. Specifically, the work culminates in the development of a proof-of-concept model that could be incorporated into higher education curriculum development.
Methodology: A mixed philosophical stance is implemented using both postpositivism and interpretivism together with inductive and abductive reasoning to examine built environment academics’ perceptions of the phenomena under investigation. Descriptive and inferential statistics (i.e., weighted average, relative importance index, one sample t test, Chi-square test and Kruskal-Wallis test) are utilised to formulate a foundational set of core interpersonal skills for construction management curricula. Such knowledge provides a strong foundation for building an optimised course curriculum.
Findings: Research findings demonstrate that, whilst technical skills are relatively important for the construction manager’s role, they significantly pale in comparison to interpersonal skills. Furthermore, an aggregate ranking of skills and competencies suggests that a substantial number of interpersonal skills and competencies out-rank numerous technical skills and competencies. Surprisingly, digital-esque themes rank towards the bottom of the table, with ‘traditional’ skills competencies (i.e., workflow, budgeting and costing) ranking higher.
Originality: This research constitutes the first attempt to: understand the core interpersonal and technical skills and competencies required of a contemporary construction manager; and premised upon this, generate a construction management education curriculum foundation model. Nascent findings pinpoint the core interpersonal skills and competencies that serve as the curriculum’s foundation and expose the inadequacies of digital technical skills in core construction management teaching.
... In fact, change is intrinsic to HE. Thus, proper recognition of the nature of this change is crucial [24]. Nowadays, this transformation is due to external or internal events. ...
The global energy crisis has created an urgent demand to decrease the energy that buildings consume. In universities, the situation is complicated as campuses need to have a high level of comfort and, therefore, consume more energy than other building types. Lighting accounts for a high percentage of this energy expenditure and urgent measures are required to reduce this consumption and, thus, costs. A further complication is that lighting has been shown to have an important influence on cognitive learning processes. One such process is memory, which has a fundamental influence on modern society. In this study, we analyse the psychological responses of 143 students in a memory task in a virtual classroom using three illuminance levels (100 lx, 300 lx and 500 lx) and four colour temperatures (3000 K, 4000 K, 6500 K and 10500 K). The results showed that lighting conditions influence memory. The combination of 100 lx and 6500 K produced the best memory performance. The results showed that varying lighting parameters can significantly reduce the energy expenditure of educational centres and, in turn, provide better cognitive outcomes for students.
A research synthesis was conducted to examine the relationship between a written emotional expression task and subsequent health. This writing task was found to lead to significantly improved health outcomes in healthy participants. Health was enhanced in 4 outcome types—reported physical health, psychological well-being, physiological functioning, and general functioning—but health behaviors were not influenced. Writing also increased immediate (pre- to postwriting) distress, which was unrelated to health outcomes. The relation between written emotional expression and health was moderated by a number of variables, including the use of college students as participants, gender, duration of the manipulation, publication status of the study, and specific writing content instructions.
The coronavirus global pandemic interrupted teaching at Australian universities. Face-to-face teaching was replaced by online delivery. This presented challenges for nursing programmes due to the hands-on teaching requirements and clinical placements. Questions were raised around students' resilience and stress in the face of adversity. This study explored undergraduate nursing students' resilience, challenges experienced, and supports utilized during the pandemic. Convenience sampling recruited students from one nursing programme (n = 340). Quantitative and qualitative data were collected. The Connor-Davidson Resilience Scale (CD-RISC-25) examined resilience scores through non-parametric analysis. Narrative responses were analysed using inductive thematic analysis. 121 surveys (40.3%) were completed. Most participants were from second year (n = 77, 63.6%). The difference in median resilience scores among employed participants was statistically significant (P = 0.029) and higher than the unemployed. The median scores of students working in nursing-related roles were higher than others. Median resilience score across all year levels was 70 (IQR = 62-80), in the lowest score range. Major themes identified were fear of the virus, isolation, and mental health problems. The coping strategies identified were developing daily routines, staying connected, and establishing self-help techniques. This research has implications to optimize students' learning experience, enhance resilience, and promote mental health and well-being.
Against the scourge of the COVID-19 pandemic, college students’ learning engagement has become a key issue in universities and society. Guided by the theories of existential positive psychology and social perception, we explored the positive effect of a growth mindset on learning engagement during the COVID-19 pandemic. A total of 1,040 college students from universities in Henan Province of China effectively completed online questionnaires. The results showed that growth mindset was positively related to learning engagement and negatively associated with perceived COVID-19 event strength and perceived stress; perceived COVID-19 event strength was positively related to perceived stress, while perceived COVID-19 event strength and perceived stress were negatively associated with learning engagement. Growth mindset affected learning engagement through three indirect paths: the mediating role of perceived COVID-19 event strength, the mediating role of perceived stress, and the serial mediating role of both perceived COVID-19 event strength and perceived stress. The results indicated that the growth mindset could contribute to college students’ learning engagement through the roles of perceived COVID-19 event strength and perceived stress during the COVID-19 pandemic. This study advances the understanding of the mechanism underlying the relationship between growth mindset and college students’ learning engagement during the COVID-19 pandemic. Furthermore, the findings of the study have important implications for promoting college students’ learning engagement during the pandemic.
Due to the COVID-19 pandemic and during the middle of the spring 2020 semester, many universities were forced to move from face-to-face (FTF) in-classroom to remote instruction. Many institutions used Zoom as their delivery platform. The purpose of this study was to investigate students’ attitudes towards the use of Zoom in remote learning, and their perceptions of its effects on their learning and engagement in comparison to FTF learning. Thirty-one university students participated in this study. Data were collected using a 5-point Likert-type survey. The results indicated that students had a negative attitude toward the use of Zoom and perceived it as having a negative effect on their learning experience and their motivation to learn. Students listed flexibility as a main advantage to using Zoom for learning.
Background:
The COVID-19 pandemic outbreak might induce acute stress disorder (ASD) to people living in the epidemic regions. The current study aims to investigate the association of COVID-19-related stressful experiences with ASD and possible psychological mechanisms of the association among college students.
Methods:
Data were collected from 7,800 college students via an online survey during the initial stage of the COVID-19 outbreak in China (from 31 January to 11 February 2020). Existing scales were adapted to measure stressful experiences, resilience, coping, social support, and ASD symptoms. Path analysis was employed to examine the research hypotheses.
Results:
Among the 7,800 college students, 61.53% were women and their mean age was 20.54 years. Both direct and indirect effects from COVID-19-related stressful experiences to ASD symptoms were significant. The relationship between COVID-19-related stressful experiences and ASD could be mediated by resilience (β = 0.01, p < .001), adaptive coping strategies (β = 0.02, p < .001), and social support (β = 0.01, p < .001); while not being significantly mediated by maladaptive coping strategies.
Conclusion:
The findings presented the ASD symptoms related to the COVID-19 outbreak and the mediating role of interpersonal and intrapersonal factors in the association. Identifying the risk and protective factors is important to reduce acute psychological responses.
In daily academic life, students are exposed to a wide range of potentially stressful situations which could negatively affect their academic achievement and their health. Among the factors that could be weakened by academic stress, attention has been paid to expectations of self-efficacy, which are considered one of the most important determinants for student engagement, persistence, and academic success. From a proactive perspective, research on academic stress has emphasized the importance of coping strategies in preventing harmful consequences. In recent years, there has been a growing interest in discovering the extent to which individuals are able to combine different coping strategies and the adaptive consequences this flexibility entails. However, studies using this person-centered approach are still scarce in the academic context. On that basis, this current study had two objectives: (a) to examine the existence of different profiles of university students based on how they combined different approach coping strategies (positive reappraisal, support seeking, and planning) and (b) to determine the existence of differences in general expectations of self-efficacy between those coping profiles. A total of 1,072 university students participated in the study. The coping profiles were determined by latent profile analysis (LPA). The differences in the self-efficacy variable were determined using ANCOVA, with gender, university year, and degree type as covariates. Four approach coping profiles were identified: (a) low generalized use of approach coping strategies; (b) predominance of social approach coping approaches; (c) predominance of cognitive approach coping approaches; and (d) high generalized use of approach coping strategies. The profile showed that a greater combination of the three strategies was related to higher general self-efficacy expectations and vice versa. These results suggest that encouraging flexibility in coping strategies would help to improve university students’ self-efficacy.
Resilience is a term commonly used to describe the ability to turn adversity into opportunities and learn from demanding situations. There seems to be a need to identify support strategies for developing resilience among nursing students in order to strengthen their professional practice. The aim of this review was to synthesize qualitative research exploring how resilience can be developed in nursing students. The review question was: How can nurse educators support students’ development of resilience? Relevant publications were identified by systematic data searches in May 2017 in the following electronic databases: MEDLINE, CINAHL, Scopus, Embase, PubMed, PsycInfo, Webb of Science, ProQuest, Academic and Eric. Eight qualitative research studies in English that explored resilience in the context of nursing education were included. Five descriptive themes emerged: Demonstrating caring relationships, Recognizing resources and power, Acknowledging uncertainty, Reframing burdensome experiences and Adjusting frames for learning. In addition, two overarching analytic themes emerged: An educational culture of trustworthiness and Readiness to care.
In conclusion, a learning culture characterized by trustworthiness appears to be a catalyst for developing resilience in nursing students. A variety of support strategies in nursing education contribute to resilience in nursing students, thus influencing their readiness to care.
Background:
College students are increasingly reporting common mental health problems, such as depression and anxiety, and they frequently encounter barriers to seeking traditional mental health treatments. Digital mental health interventions, such as those delivered via the Web and apps, offer the potential to improve access to mental health treatment.
Objective:
This study aimed to review the literature on digital mental health interventions focused on depression, anxiety, and enhancement of psychological well-being among samples of college students to identify the effectiveness, usability, acceptability, uptake, and adoption of such programs.
Methods:
We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration number CRD42018092800), and the search strategy was conducted by a medical research librarian in the following databases: MEDLINE (Ovid), EMBASE (Elsevier), PsycINFO (EbscoHost), the Cochrane Library (Wiley), and Web of Science (Thomson Reuters) from the date of inception to April 2019. Data were synthesized using a systematic narrative synthesis framework, and formal quality assessments were conducted to address the risk of bias.
Results:
A total of 89 studies met the inclusion criteria. The majority of interventions (71/89, 80%) were delivered via a website, and the most common intervention was internet-based cognitive behavioral therapy (28, 31%). Many programs (33, 37%) featured human support in the form of coaching. The majority of programs were either effective (42, 47%) or partially effective (30, 34%) in producing beneficial changes in the main psychological outcome variables. Approximately half of the studies (45, 51%) did not present any usability or acceptability outcomes, and few studies (4, 4%) examined a broad implementation of digital mental health interventions on college campuses. Quality assessments revealed a moderate-to-severe risk of bias in many of the studies.
Conclusions:
Results suggest that digital mental health interventions can be effective for improving depression, anxiety, and psychological well-being among college students, but more rigorous studies are needed to ascertain the effective elements of these interventions. Continued research on improving the user experience of, and thus user engagement with, these programs appears vital for the sustainable implementation of digital mental health interventions on college campuses.
In our research, we examined the efficacy of an Internet-based stress management program. Our interest in evaluating this type of intervention is based on the increasing accessibility of the Internet today, the growth of Internet-based interventions for various psychopathological problems, and the observation that despite the prevalence of stress among university students, only a fraction of students ever seek professional help. Methodology: "I'm managing my stress" ("Je gère mon stresse"), an Internet-based self-help program composed of four sessions, was examined in this study. The aforementioned program is based on cognitive-behavioral therapy and was inspired by the "Funambule" program in Quebec. Four questionnaires (Perceived Stress Scale, Rosenberg Self-Esteem Scale, Scale of Satisfaction in Studies, and General Health Questionnaire) uploaded online were answered thrice: during "preintervention", "postintervention", and "follow-up" stages, the latter of which occurred three months after the intervention. The sample comprised 128 university students, with the majority being women (81.25%). The subjects were divided randomly into two groups (an experimental group and a control group that did not follow the program). Results: The self-esteem scores of the control group were significantly higher than those of the experimental group at the preintervention stage, but this difference disappeared at the postintervention and follow-up stages. There were also significantly lower scores on the General Health Questionnaire subfactors of somatic symptoms and anxiety/insomnia in the experimental group than in the control group during the postintervention stage, though no differences were observed before the intervention. These differences no longer remained after three months. ANOVA revealed significant effects of the intervention over time in the experimental group. Effects were observed at both the postintervention and follow-up stages for self-esteem, perceived stress, satisfaction in studies, and in the somatic symptoms, anxiety and insomnia and severe depression aspects of the General Health Questionnaire (Cohen's d = 0.38 to 4.58). In contrast, no effects were observed in the control group. Conclusion: This type of Internet-based program has the ability to reach a large number of students due to its rather short format and accessibility. It has already shown improvements in terms of the levels of perceived stress, psychological distress and satisfaction with studies. The option of online interventions could appeal specifically to students who do not seek professional help. However, even though these results are promising at the postintervention stage, they are limited, as indicated by the lack of significant differences between the two groups after the initial three months of follow-up. We still, specifically, need to improve this intervention program and, generally, need more research to address the methodological problems raised by this type of intervention. Trial registration: ISRCTN registry, ISRCTN13709272.
Background: The effect of natural disasters internationally is linked to intensity and duration and the impact of these events for tertiary level professional students is not clearly understood. Following a 7.1 magnitude earthquake in New Zealand in 2010 (with aftershocks lasting 27 months) a number of tertiary nursing students experienced significant disruption to their studies.
Aim: To compare the psychological health, resilience and the impact on learning for three cohorts of students engaged in tertiary nursing education during this time.
Method: A cross-sectional survey design and convenience sampling was used for three cohorts of learners. An online survey was completed (n = 290) and included: Depression Anxiety and Stress Scale; PTSD Checklist; Work and Social Adjustment Scale; Connor-Davidson Resilience Scale.
Results: Statistically significant differences were found across the psychometric scales with regard to relationship status. Whilst an increase in self-reported physical and mental health issues prior to and following the earthquakes were noted, mitigating factors were also identified.
Conclusions: In order to support psychological health amongst nursing students, tertiary education systems need to plan for sustainable learning. The importance of facilitating future orientation within organisations is necessary to develop resilience amongst staff and students, which, in turn, will enable on-going education during significant disaster events.
Context
The effectiveness of cultural competency education in improving health practitioner proficiency and addressing health inequities for minoritised patient groups is uncertain. Identification of institutional factors that shape or constrain development of indigenous health curricula may provide insights into the impact of these factors on the broader cultural competency curricula.
Methods
We undertook a systematic review using actor–network theory to inform our interpretive synthesis of studies that reported indigenous health curricula evaluated within medical, nursing and allied health education. We searched the MEDLINE, OVID Nursing, Educational Resources Information Center (ERIC), PsycINFO, EMBASE, Web of Science and PubMed databases to December 2017 using exploded MeSH terms ‘indigenous’ and ‘medical education’ and ‘educational professional’ and ‘health professional education’. We included studies involving undergraduate or postgraduate medical, nursing or allied health students or practitioners. Studies were eligible if they documented indigenous health learning outcomes, pedagogical practices and student evaluations.
Results
Twenty‐three studies were eligible for the review. In an interpretive synthesis informed by actor–network theory, three themes emerged from the data: indigenous health as an emerging curriculum (drivers of institutional change, increasing indigenous capacity and leadership, and addressing deficit discourse); institutional resource allocation to indigenous health curricula (placement within the core curriculum, time allocation, and resources constraining pedagogy), and impact of the curriculum on learners (acceptability of the curriculum, learner knowledge, and learner behaviour).
Conclusions
Systemic barriers acting on and within educational networks have limited the developmental capacity of indigenous health curricula, supported and sustained hidden curricula, and led to insufficient institutional investment to support a comprehensive curriculum. Future research in health professional education should explore these political and network intermediaries acting on cultural competence curricula and how they can be overcome to achieve cultural competency learning outcomes.
Background: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment.
Objective: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students.
Methods: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 ≥8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies’ Depression Scale >17).
Results: A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression.
Conclusions: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help.
Background:
Treatment rates for social anxiety, a prevalent and potentially debilitating condition, remain among the lowest of all major mental disorders today. Although computer-delivered interventions are well poised to surmount key barriers to the treatment of social anxiety, most are only marginally effective when delivered as stand-alone treatments. A new, Web-based cognitive behavioral therapy (CBT) intervention called Overcome Social Anxiety was recently created to address the limitations of prior computer-delivered interventions. Users of Overcome Social Anxiety are self-directed through various CBT modules incorporating cognitive restructuring and behavioral experiments. The intervention is personalized to each user's symptoms, and automatic email reminders and time limits are used to encourage adherence.
Objective:
The purpose of this study was to conduct a randomized controlled trial to investigate the effectiveness of Overcome Social Anxiety in reducing social anxiety symptoms in a nonclinical sample of university students. As a secondary aim, we also investigated whether Overcome Social Anxiety would increase life satisfaction in this sample.
Methods:
Following eligibility screening, participants were randomly assigned to a treatment condition or a wait-list control condition. Only those assigned to the treatment condition were given access to Overcome Social Anxiety; they were asked to complete the program within 4 months. The social interaction anxiety scale (SIAS), the fear of negative evaluation scale (FNE), and the quality of life enjoyment and satisfaction questionnaire-short form (Q-LES-Q-SF) were administered to participants from both conditions during baseline and 4-month follow-up lab visits.
Results:
Over the course of the study, participants assigned to the treatment condition experienced a significant reduction in social anxiety (SIAS: P<.001, Cohen d=0.72; FNE: P<.001, Cohen d=0.82), whereas those assigned to the control condition did not (SIAS: P=.13, Cohen d=0.26; FNE: P=.40, Cohen d=0.14). Additionally, a direct comparison of the average change in social anxiety in the 2 conditions over the course of the study showed that those assigned to the treatment condition experienced significantly more improvement than those assigned to the control condition (SIAS: P=.03, Cohen d=0.56; FNE: P=.001, Cohen d=0.97). Although participants assigned to the treatment condition experienced a slight increase in life satisfaction, as measured by Q-LES-Q-SF scores, and those assigned to the control condition experienced a slight decrease, these changes were not statistically significant (treatment: P=.35, Cohen d=-0.18; control: P=.30, Cohen d=0.18).
Conclusions:
Our findings indicate that Overcome Social Anxiety is an effective intervention for treating symptoms of social anxiety and that it may have further utility in serving as a model for the development of new interventions. Additionally, our findings provide evidence that contemporary Web-based interventions can be sophisticated enough to benefit users even when delivered as stand-alone treatments, suggesting that further opportunities likely exist for the development of other Web-based mental health interventions.
Trial registration:
ClinicalTrials.gov NCT02792127; https://clinicaltrials.gov/ct2/show/record/NCT02792127 (Archived by WebCite at http://www.webcitation.org/6xGSRh7MG).
Background:
One in five Canadians experience mental health issues with those in the age range of 15 to 24 years being most at risk of a mood disorder. University students have shown significantly higher rates of mental health problems than the general public. Current university support services are limited by factors such as available staff and finances, and social stigma has frequently been identified as an additional barrier that prevents students from accessing these resources. Mobile health (mHealth) apps are one form of alternative health support that is discrete and accessible to students, and although they are recognized as a promising alternative, there is limited research demonstrating their efficacy.
Objective:
The aim of this study was to evaluate a mindfulness-based app's ("DeStressify") efficacy on stress, anxiety, depressive symptomology, sleep behavior, work or class absenteeism, work or school productivity, and quality of life (QoL) among university students.
Methods:
Full-time undergraduate students at a Canadian university with smartphones and Internet access were recruited through in-class announcements and on-campus posters. Participants randomized into an experimental condition were given and instructed to use the DeStressify app 5 days a week for 4 weeks. Control condition participants were wait-listed. All participants completed pre- and postintervention Web-based surveys to self-assess stress, anxiety, depressive symptomatology, sleep quality, and health-related QoL.
Results:
A total of 206 responses were collected at baseline, with 163 participants completing the study (86 control, 77 experimental). Using DeStressify was shown to reduce trait anxiety (P=.01) and improve general health (P=.001), energy (P=.01), and emotional well-being (P=.01) in university students, and more participants in the experimental condition believed their productivity improved between baseline and postintervention measurements than the number of participants expected to believe so randomly by chance (P=.01). The app did not significantly improve stress, state anxiety, physical and social functioning, and role limitations because of physical or emotional health problems or pain (P>.05).
Conclusions:
Mindfulness-based apps may provide an effective alternative support for university students' mental health. Universities and other institutions may benefit from promoting the use of DeStressify or other mindfulness-based mHealth apps among students who are interested in methods of anxiety management or mindfulness-based self-driven health support. Future steps include examining DeStressify and similar mHealth apps over a longer period and in university staff and faculty.
This study evaluated the efficacy of Internet-based stress management programs for college students. This approach is particularly fitting for students owing to a lack of mental health resources on campus and to high levels of Internet use among students. Because a history of interpersonal trauma (IPT) is associated with more distress and poorer academic performance, IPT history was assessed as a moderator of intervention efficacy. Students (N = 365) were randomly assigned to a mindfulness plus present control intervention, a mindfulness only intervention, or a stress management information condition that served as an active comparison. Prior research has supported the efficacy of the mindfulness plus present control intervention (Nguyen-Feng et al., 2015). Outcome measures were self-report measures of stress, anxiety, depression, and perceived stress completed online at preintervention, postintervention, and 2 follow-ups (2–3 weeks and 4–5 weeks postintervention). Linear mixed modeling was used to assess change over time. Participants in all 3 groups reported significant decreases on all primary outcomes. All time-by-intervention group interaction effects were nonsignificant, suggesting that the 3 conditions were equally effective. When examining IPT history as a moderator, the mindfulness plus present control and stress management conditions were both more effective for IPT survivors than the mindfulness only intervention. Results suggested that Internet-based interventions are effective for lowering distress among college students and that specific approaches may be differentially effective for certain subgroups of students. They also suggested that providing students with stress management information without providing training in 1 specific skill may also be helpful.
Background:
College students and working adults are particularly vulnerable to stress and other mental health problems, and mental health promotion and prevention are needed to promote their mental health. In recent decades, mindfulness-based training has demonstrated to be efficacious in treating physical and psychological conditions.
Objective:
The aim of our study was to examine the efficacy of an Internet-based mindfulness training program (iMIND) in comparison with the well-established Internet-based cognitive-behavioral training program (iCBT) in promoting mental health among college students and young working adults.
Methods:
This study was a 2-arm, unblinded, randomized controlled trial comparing iMIND with iCBT. Participants were recruited online and offline via mass emails, advertisements in newspapers and magazines, announcement and leaflets in primary care clinics, and social networking sites. Eligible participants were randomized into either the iMIND (n=604) or the iCBT (n=651) condition. Participants received 8 Web-based sessions with information and exercises related to mindfulness or cognitive-behavioral principles. Telephone or email support was provided by trained first tier supporters who were supervised by the study's research team. Primary outcomes included mental and physical health-related measures, which were self-assessed online at preprogram, postprogram, and 3-month follow-up.
Results:
Among the 1255 study participants, 213 and 127 completed the post- and 3-month follow-up assessment, respectively. Missing data were treated using restricted maximum likelihood estimation. Both iMIND (n=604) and iCBT (n=651) were efficacious in improving mental health, psychological distress, life satisfaction, sleep disturbance, and energy level.
Conclusions:
Both Internet-based mental health programs showed potential in improving the mental health from pre- to postassessment, and such improvement was sustained at the 3-month follow-up. The high attrition rate in this study suggests the need for refinement in future technology-based psychological programs. Mental health professionals need to team up with experts in information technology to increase personalization of Web-based interventions to enhance adherence.
Trial registration:
Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-12002623; https://www2.ccrb.cuhk.edu.hk/ registry/public/191 (Archived by WebCite at http://www.webcitation.org/6kxt8DjM4).
Interpersonal violence (IPV) is common among college students and is associated with greater distress and school dropout. A web-based intervention designed to increase perceived present control has been shown to be effective in decreasing distress in this at-risk population (Nguyen-Feng et al., 2015). The present study evaluated the efficacy of 2 new versions of this intervention relative to the original intervention. Psychology students (N = 314) from a large Midwestern university, most of whom identified as White (72%) and female (63%), were randomly assigned to 1 of 3 conditions: the original present control intervention, an enhanced present control intervention, or a present control plus mindfulness intervention. Self-report measures of distress (depression, anxiety, stress symptoms), perceived stress, and worry were completed pre- and postintervention. IPV history was reported by 35% of the sample. Analyses of covariance assessed whether there were differences in efficacy across the 3 conditions or interactions between intervention condition and IPV status; significant interactions would indicate that students with and without a history of IPV responded differently to the 3 interventions. There were significant Condition × IPV interactions for distress symptoms and worry. Paired t tests suggested that the 2 new versions of the intervention decreased symptoms more than the original intervention, and that the enhanced present control intervention decreased symptoms the most among students with an IPV history (mean within-group d = −.48). This brief web-based intervention may be an effective way of targeting skills and decreasing general distress among students with (and without) an IPV history.
Background
Interventions based on meditation and mindfulness techniques have been shown to reduce stress and increase psychological well-being in a wide variety of populations. Self-administrated Internet-based mindfulness training programs have the potential to be a convenient, cost-effective, easily disseminated, and accessible alternative to group-based programs.
Objective
This randomized controlled pilot trial with 90 university students in Stockholm, Sweden, explored the feasibility, usability, acceptability, and outcomes of an 8-week Internet-based mindfulness training program.
Methods
Participants were randomly assigned to either an intervention (n=46) or an active control condition (n=44). Intervention participants were invited to an Internet-based 8-week mindfulness program, and control participants were invited to an Internet-based 4-week expressive writing program. The programs were automated apart from weekly reminders via email. Main outcomes in pre- and postassessments were psychological well-being and depression symptoms. To assess the participant’s experiences, those completing the full programs were asked to fill out an assessment questionnaire and 8 of the participants were interviewed using a semistructured interview guide. Descriptive and inferential statistics, as well as content analysis, were performed.
Results
In the mindfulness program, 28 out of 46 students (60%) completed the first week and 18 out of 46 (39%) completed the full program. In the expressive writing program, 35 out of 44 students (80%) completed the first week and 31 out of 44 (70%) completed the full program. There was no statistically significantly stronger intervention effect for the mindfulness intervention compared to the active control intervention. Those completing the mindfulness group reported high satisfaction with the program. Most of those interviewed were satisfied with the layout and technique and with the support provided by the study coordinators. More frequent contact with study coordinators was suggested as a way to improve program adherence and completion. Most participants considered the program to be meaningful and helpful but also challenging. The flexibility in performing the exercises at a suitable time and place was appreciated. A major difficulty was, however, finding enough time to practice.
Conclusions
The program was usable, acceptable, and showed potential for increasing psychological well-being for those completing it. However, additional modification of the program might be needed to increase retention and compliance.
ClinicalTrial
ClinicalTrials.gov NCT02062762; https://clinicaltrials.gov/ct2/show/NCT0206276 (Archived by WebCite at http://www.webcitation.org/6j9I5SGJ4)
Objectives: The Aboriginal Cultural Safety Initiative (ACSI) created at Anishnawbe Health Toronto offers an innovative curriculum to address gaps in postsecondary health sciences curricula in this area for future healthcare providers. Participants: Evaluations were collected from 1,275 students in health sciences programs in colleges and universities in Ontario. Setting: Trained volunteer Aboriginal instructors were invited as guest speakers to college and university classes in various health science disciplines. Intervention: Our instructors offered a 2- to 3-hour teaching session to health sciences students that included 3 modules on the health of Aboriginal peoples: (a) The impact of colonial and postcolonial policies on social determinants of health, (b) Contemporary health determinants and health outcomes, and (c) Aboriginal concepts of health and healing practices. Outcomes: The ACSI was able to impart the intended learning objectives to a wide array of students across health sciences disciplines, as demonstrated in the student evaluations. A significant number of students reported that their knowledge of, and interest in, Aboriginal health increased substantially when compared to their prior knowledge and interest. Conclusion: The success of this program suggests that, in the absence of Aboriginal faculty members in postsecondary health sciences departments, a committed cadre of volunteer Aboriginal instructors can improve student knowledge around issues related to Aboriginal health and can influence student attitudes through the inclusion of personal experiences in the teaching session. A lack of availability in curriculum time continues to be the largest obstacle to including content on Aboriginal cultural safety in health sciences programs.
Objective:
This study sought to test the feasibility of a web-based Acceptance and Commitment Training (ACT) prototype prevention program called ACT on College Life (ACT-CL).
Method:
A sample of 234 university students was randomized to either the ACT-CL website or a mental health education (MHE) website.
Results:
Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website. There were no significant differences between conditions on outcome measures at post or follow-up. However, statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline. There were no differences between conditions on ACT process of change measures. Changes in psychological flexibility were predictive of changes in mental health across conditions, but relations dissipated over time. Furthermore, greater engagement in some components of ACT-CL predicted improvements in psychological flexibility, though not on mental health outcomes.
Conclusions:
The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website, although there was a lower level of program engagement with ACT-CL. Findings are discussed in the context of feasibility issues and lessons learned for program revisions.
Extending the argument made in Bushe and Marshak (2009) of the emergence of a new species of Organization Development (OD) that we label Dialogic, to differentiate it from the foundational Diagnostic form, we argue that how any OD method is used in practice will be depend on the mindset of the practitioner. Six variants of Dialogic OD practice are reviewed and compared to aid in identification of a Weberian ideal-type Dialogic Mindset, consisting of eight premises that distinguish it from the foundational Diagnostic Mindset. Three core change processes that underlie all successful Dialogic OD processes are proposed, and suggestions for future research offered.
Background: Guided Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment of social anxiety disorder (SAD). However, the treatment is not effective for all. The amount and type of therapist contact have been highlighted as a possible moderator of treatment outcome.
Objective: The aim of this study was to examine whether treatment effects of ICBT are enhanced with an initial 90 min face-to-face psychoeducation (PE) session for university students with SAD.
Method: University students with SAD (N = 37) were randomized into one out of two conditions: 1) an initial therapist-led face-to-face PE session followed by guided ICBT, 2) guided ICBT without an initial PE session. Data was analysed with an intent-to-treat approach.
Results: Eight participants (21.6%) dropped out of treatment. A statistically significant reduction in symptoms was found for all outcome measures for both groups. There were no significant additional effects of adding the initial face-to-face PE. Moderate to large within-group effect sizes on self-rated social anxiety symptoms were found at post-treatment (d = 0.70–0.95) and at a six month follow-up (d = 0.70–1.00). Nearly half of the participants were classified as recovered.
Conclusions: Notwithstanding limitations due to the small sample size, the findings indicate that guided ICBT is an effective treatment for students with SAD. Adding an initial face-to-face PE session to the guided ICBT did not lead to enhanced outcomes in the present study.
Objective: Many college students have a history of interpersonal violence (IPV) and are thus at risk of greater mental health problems. This study evaluated the efficacy of a web-based stress management program targeting the established protective factor of present control in promoting well-being among students with and without a history of IPV. Method: Students from an introductory psychology course were randomly assigned in a 2:1 ratio to the web-based stress management intervention (n = 329) or the waitlist comparison group (n = 171). Self-report measures of 4 outcomes (perceived stress, symptoms of depression, anxiety, and stress) and 2 mediators of intervention efficacy (present control, rumination) were completed online pre-and postintervention. IPV history was assessed preintervention. Results: Thirty-nine percent reported an IPV history. The intervention group reported less distress than the comparison group at posttest but effects were larger in the IPV group (mean d =.44) than in the no IPV group (mean d =.10). Increases in present control mediated intervention effects in both groups; decreases in rumination mediated intervention effects in the IPV group only. Conclusions: Web-based universal prevention stress management programs may be a cost-effective way to teach protective skills to students with an IPV history.
While natural disasters have been reported internationally in relation to the injury burden, role of rescuers and responders, there is little known about the impact on education in adult professional populations. A 7.1 magnitude earthquake affected the Canterbury region of New Zealand on 4 September 2010 followed by more than 13,000 aftershocks in the three years to September 2013. As part of a larger study, a mixed method survey was used to explore factors impacting nurses engaged in education through polytechnic and university courses. This paper presents factors that were self-identified by students as supporting their ability to continue with education. Participants were recruited from three nursing settings: undergraduate nursing students, Registered Nurses (RNs) engaged in post-registration education and RNs engaged in postgraduate courses. A total of 290 participants took part in the study. A number of factors identified by participants could be addressed in pre-disaster course planning and curriculum design; through education and support of both students and staff; and the active promotion of personal, professional and institutional resilience.
Organizations are increasingly seeking candidates possessing high levels of teamwork knowledge, skills, and abilities (KSAs; Stevens & Campion, 1994). Yet, despite a greater emphasis in higher education settings on developing a ready workforce (e. g., O'Neil, Allerd, & Baker, 1997), not enough is done to explicitly develop teamwork KSAs in university curricula. We describe a university course intended to develop students' teamwork KSAs. Results from a quasi-experimental evaluation study demonstrate that the course significantly increased the levels of students' teamwork knowledge and skills. However, the course did not significantly improve teamwork-related attitudes and self-efficacy. We discuss implications for school-to-work policies and the development of teamwork KSAs in higher education settings, as well as directions for future research.
BACKGROUND: Self-efficacy is crucial for student success. Studies have demonstrated a positive relationship between flipped learning approach and self-efficacy. Anxiety, however, can reduce self-efficacy.
OBJECTIVE: Testing the relationship between the flipped approach and self-efficacy by flipping a nursing module within an externally-imposed and once-off anxiety-inducing context.
METHOD: Students completed a self-efficacy survey before (n = 71) and after (n = 91) a compressed semester, which provided the anxiety-inducing context.
RESULTS: Pre-semester self-efficacy was 2.93/4, and post-semester was 2.98/4. The results demonstrated no significant change in students' self-efficacy.
CONCLUSION: We argue the flipped approach counters anxiety-inducing effects to maintain self-efficacy. In less anxiety-inducing contexts, we argue the flipped approach would develop students' confidence, capability, persistence and strength beliefs, collectively enhancing self-efficacy perceptions.
A COVID-19 epidemic has been spreading in China and other parts of the world since December 2019. The epidemic has brought not only the risk of death from infection but also unbearable psychological pressure. We sampled college students from Changzhi medical college by using cluster sampling. They responded to a questionnaire packet that included the 7-item Generalized Anxiety Disorder Scale (GAD-7) and those inquiring the participants’ basic information. We received 7,143 responses. Results indicated that 0.9% of the respondents were experiencing severe anxiety, 2.7% moderate anxiety, and 21.3% mild anxiety. Moreover, living in urban areas (OR = .810, 95% CI = .709 - .925), family income stability (OR = .726, 95% CI = .645 - .817) and living with parents (OR = .752, 95% CI = .596 - .950) were protective factors against anxiety. Moreover, having relatives or acquaintances infected with COVID-19 was a risk factor for increasing the anxiety of college students (OR = 3.007, 95% CI = 2.377 - 3.804). Results of correlation analysis indicated that economic effects, and effects on daily life, as well as delays in academic activities, were positively associated with anxiety symptoms (P < .001). However, social support was negatively correlated with the level of anxiety (P < .001). It is suggested that the mental health of college students should be monitored during epidemics.
Motivated by a dearth of research on student’s stress, particularly in the context of Indonesia, the author attempts to analyze the relationship among stress, Type A personality, and academic performance in an Indonesian business school. Hierarchical regression is applied to examine this relationship. In addition, questionnaires were distributed to 628 students in various departments and semesters. As expected, this research reveals that students’ stress negatively affects academic performance. Type A personality has proven to have a positive effect on academic performance. Ultimately, university should create a positive competitive atmosphere, build competency to map students’ personality that specifically is causing stress, and present the stress management practice to lead students in coping with stress.
To examine co-operative learning between pairs of college students in the field of education, the reciprocal peer tutoring (RPT) procedure was used in two experiments with 97 graduates (Experiment 1) and 100 undergraduates (Experiment 2). Contrary to initial studies using a different population of college students, results in both experiments indicated that RPT failed to improve students' understandings of course material compared to an individualised study task. In addition, RPT neither increased students' feelings of self-efficacy nor did it decrease students' levels of test anxiety relative to the control condition. However, participants overwhelmingly reported RPT to be helpful for studying the course content. Results suggest careful consideration of ecological validity in research and expected gains in practice.
Mental disorders and sleep dysfunction are common among Chinese university students. This study aimed to evaluate a low cost scalable mindfulness intervention program to improve psychological health and sleep quality among Chinese university students. A randomized controlled trial with 101 university students (mean age 22.30±2.63, 69.31% female) was conducted. Participants were randomized into 4 groups: Group 1: control group (n=25), Group 2: mindfulness only group (n=27), Group 3: mindfulness + plain-text reminder group (n=24), and Group 4: mindfulness + enhanced text reminder with animal meme group (n=25).The mindfulness intervention consisted of two in-person guided sessions along with weekly self-guided practice for 7 weeks. The Depression, Anxiety and Stress Scale (DASS-21) and The Pittsburgh Sleep Quality Index (PSQI) were used to measure depression, anxiety, stress, and sleep dysfunction. After the intervention at week 4, compared to controls, completers in group 2, 3 and 4 (n=42) showed significantly reduced depression (Cohen's d=0.83), anxiety (Cohen's d=0.84), and stress (Cohen's d=0.75), and improved subjective sleep quality (Cohen's d=2.00), sleep latency (Cohen's d=0.55), and habitual sleep efficiency (Cohen's d=0.86). The effect was maintained at week 7. Low-intensity mindfulness interventions might be a useful intervention program in university settings.
Purpose: Educational organizations have to continuously adapt their structures, processes and practices to meet the evolving institutional and social challenges raised by the external environment. From this point of view, organizational change is a fundamental ingredient of the recipe for success in educational management. This paper tries to contextualize organizational change to educational institutions, pointing out its determinants, barriers and consequences.
Design/methodology/approach: A systematic literature review was performed, involving 330 scientific contributions. Manuscripts were searched in two large citation databases. Tailored selection and inclusion criteria were designed in order to exclusively focus on papers investigating organizational change dynamics in the educational environment. On the whole, 41 contributions were included in this literature review.
Findings: Organizational change in the educational context paves the way for relevant managerial challenges. Firstly, the internal and external triggers of change should be concomitantly handled, in order to curb isomorphic pressures and steer organizational evolution. Secondly, specific strategies should be implemented to overcome the barriers to organizational change, including ambiguity and uncertainty. Lastly, yet importantly, the side-effects of organizational change should be recognized, in an attempt to attenuate their drawbacks on employees’ working conditions.
Practical implications: Organizational change should be understood as an iterative process, rather than as a circumscribed event. Educational managers should design specific approaches and deploy ad hoc tools to effectively implement organizational change
The present research examined the effectiveness of an 8-week online strengths-based intervention in promoting subjective and psychological well-being of first year university students. The intervention was composed of five modules pertaining to (a) finding and cultivating on character strengths, (b) regulation of emotions and increasing positive emotions, (c) constructive communication, establishing social connectedness and positive relationships (d) effective decision-making and problem solving and (e) achieving flow and practicing gratitude. A total 92 students volunteered to participate in the study. They were randomly assigned to either the intervention or a control group. Students’ quality of life (psychological health and social relations domains), life satisfaction, subjective happiness and ontological well-being were measured before and after the intervention. Significant improvements in well-being of intervention group participants were observed over an 8-week period whereas control group participants did not show a significant increase in any of these well-being variables.
Promoting mental health, preventing the development of depression, and providing treatment to first-year college students are crucial areas in need of attention and resources. Online programs may be a cost-effective and efficient way to reach a large numbers of students who may not otherwise seek out mental health services. We tested the feasibility and efficacy of an online version of a previously studied acceptance-based behavioral (ABBT) program, the Mindful Way through the Semester (MWTS), for decreasing levels of depression and enhancing acceptance in first year college students. The current study also sought to examine the impact of engagement in mindfulness and values practice on depression, as well as to replicate the finding that change in acceptance is associated with change in depression. This study also examined whether students' participation in the workshop was associated with improvements in depression in comparison to the control condition. One hundred three students were randomly assigned to either the online MWTS workshop condition or the waitlist control condition (in which the students were not contacted until follow-up). Results revealed that the workshop did not significantly affect depression or acceptance. However, changes in acceptance were negatively associated with changes in depression (i.e., larger increases in acceptance were associated with larger decreases in depression) across conditions. Lastly, level of engagement in mindfulness and values practice was significantly associated with decreases in depression in the workshop condition. Implications of these findings for future interventions are discussed.
Background
Substantial numbers of Enrolled Nurses (ENs) enrol in higher education programs to undergo the transition to Registered Nurse (RN) with the experience described as containing numerous challenges.
Objectives
This paper reports on a synthesis of the literature that explores the experiences of ENs undertaking a program of study to convert to RN. Consequently, a model is developed to identify educational interventions and resources to enable a successful transition for these students.
Design
A narrative review was completed with thematic synthesis of the literature guided by Schlossberg's Transition Theory, and Thomas and Harden's framework for systematic analysis of qualitative studies.
Data sources
CINAHL, Scopus, ProQuest Central and Health Collection were searched.
Review methods
The databases were searched for English language journal articles, theses and grey literature published from 1987 to 2016 from Australia, New Zealand, the United Kingdom, Canada and the USA. The key search words included truncations of: “enrolled nurse”, ‘licensed practical nurse’, “transition”, “conversion” and “experience”. This resulted in the identification of 33 related articles for review.
Results
Themes and sub-themes developed from the literature synthesis were integrated into an ‘EN to RN Transition model.’ The four stages of the model reflect the experiences of the ENs as they overcame the various challenges they encountered during their transition to RN. The model was used to develop recommendations that may improve their transition experience and decrease attrition.
Conclusion
This paper reports on a synthesis of the literature, and presents a four stage model, that reflects the experiences of ENs in their transition to RN. Recognising the elements within each stage can assist educators develop strategies and provide educational resources to enhance the EN journey.
Training physicians to be effective practitioners throughout their careers begins in undergraduate medical education with particular focus on self-directed inquiry, professional and interprofessional development, and competency-based assessment. A select number of medical schools are restructuring their curricula by placing the student at the center of content delivery to enhance the learning experience. While this restructuring may benefit the adult learner, administrators often make assumptions about how students will perceive and respond to such innovative and unfamiliar educational concepts. This can create a disconnect between students and their curriculum. Administrative mindfulness of student experiences is needed to ensure successful implementation of curricular change, facilitate the transition from old to new modalities, and train competent physician graduates.
Vanderbilt University School of Medicine (VUSM) recently completed a curriculum update, and student representatives have been essential participants in the transition, from the earliest stages in preplanning to rapid-cycle feedback as the curriculum runs. Two of the authors are members of VUSM’s Student Curriculum Committee, which facilitates gathering and relaying student feedback to the administration. Drawing from their experiences, five specific considerations to address and manage when implementing student-centered curricular change are presented: (1) Communicate the rationale, (2) acknowledge anxiety, (3) adjust extracurricular leadership roles, (4) manage “The Bulge” of learners in the clinical environment, and (5) foster ongoing collaboration of students and administrators. For each consideration, examples and proposed solutions are provided.
Undergraduate nursing students experience significant stress and anxiety, inhibiting learning and increasing attrition. Twenty-six intervention studies were identified and evaluated, updating a previous systematic review which categorized interventions targeting: (1) stressors, (2) coping, or (3) appraisal. The majority of interventions in this review aimed to reduce numbers or intensity of stressors through curriculum development (12) or to improve students' coping skills (8). Two studies reported interventions using only cognitive reappraisal while three interventions combined reappraisal with other approaches. Strength of evidence was limited by choice of study design, sample size, and lack of methodological rigor. Some statistically significant support was found for interventions focused on reducing stressors through curriculum development or improving students' coping skills. No statistically significant studies using reappraisal, either alone or in combination with other approaches, were identified, although qualitative findings suggested the potential benefits of this approach do merit further study. Progress was noted since 2008 in the increased number of studies and greater use of validated outcome measures but the review concluded further methodologically sound, adequately powered studies, especially randomized controlled trials, are needed to determine which interventions are effective to address the issue of excessive stress and anxiety among undergraduate nursing students.
Overviews, or syntheses of research syntheses, have become a popular approach to synthesizing the rapidly expanding body of research and systematic reviews. Despite their popularity, few guidelines exist and the state of the field in education is unclear. The purpose of this study is to describe the prevalence and current state of overviews of education research and to provide further guidance for conducting overviews and advance the evolution of overview methods. A comprehensive search across multiple online databases and grey literature repositories yielded 25 total education-related overviews. Our analysis revealed that many commonly reported aspects of systematic reviews, such as the search, screen, and coding procedures, were regularly unreported. Only a handful of overview authors discussed the synthesis technique and few authors acknowledged the overlap of included systematic reviews. Suggestions and preliminary guidelines for improving the rigor and utility of overviews are provided.
Background:
Nurses returning to school while working, raising families, and maintaining other roles, can experience stress, mood changes and cognition disturbance that negatively impact their academic success.
Objectives:
To explore the effect of an online mindfulness meditation intervention with distance nursing students on stress, mood and cognition.
Design:
A 24 week descriptive study.
Settings:
An 8 week online intervention was offered to all undergraduate and graduate nursing students, of three nursing programs of a middle-sized university in mid-Atlantic US.
Participants:
A total of 26 nursing students completed the study.
Methods:
An 8 week online, asynchronous mindfulness intervention was provided through the learning management system with a 16 week follow-up.
Outcomes measures:
Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HADS), and Attention Network Test (ANT).
Results:
Stress was significantly reduced (F(2,24)=4.163, p=.019). A decreasing trend for anxiety was noted with significant difference between time points (F(1,23)=6.889, p=.015) when practice frequency was weekly to daily. Cognition: ability to shift attention, attention selection, concentration, and accuracy improved.
Conclusion:
Findings from this study may illuminate the usefulness of a mindfulness based stress reduction program offered to distance nursing students. Further studies are needed to better demonstrate the effectiveness of the intervention.
Introduction: The current Australian health professionals workforce is unevenly distributed between metropolilan. regional, rural, remote and the very remote areas. Many health professionals preler maior cities or towns. This placement was created in the tirat semester of the course. atlowing the students to see rural and remote settings, to lacilitate understanding ol aspects taught later during the course and to set the scene br further placements. It also aligns with the school locus of health probessionals' ability to practice in challenging environments.
This study examined the effectiveness of a journal club for teaching critical appraisal skills to residents in psychiatry and their transfer of those skills to clinical scenarios. Twelve residents participated in a 12- week journal club, and 12 residents were matched control subjects. Following the journal club, there remained no difference in performance between the two groups, although two-thirds of the journal club residents did show an improvement or no change, compared with one-third of the control residents. Furthermore, there was a trend for the journal club residents to require less time to review an article. This format of a journal club may not be an effective method for teaching critical appraisal skills to residents in psychiatry.
Objective: The primary purpose of this paper was to narratively review the research testing the effects of mindfulness meditation on stress and anxiety in the college students; reviewing the inclusion of mindfulness was a secondary purpose. Methods: A literature search resulted in 57 studies on the effectiveness of mindfulness meditation in reducing stress and anxiety in college students. Conclusions: Researchers examined anxiety in 40 studies, self-reported stress in 34, physiological stress in 11, and mindfulness in 24. Thirty-three of 40 and 25 of 34 studies showed significant decreases in anxiety and stress respectively; 22 of 24 showed an increase in mindfulness. Physiological stress had inconsistent results indicating a need for further research. Overall, mindfulness meditation shows promise in reducing stress and anxiety in college students. Additionally, there are a number of differences in mindfulness interventions including frequency, duration, instructional method, and inclusion of yoga, that need quantitative examination (meta-analysis) to determine which is most effective.
This integrated literature review examined factors associated with the ability of students to persist in an online course. Lack of persistence in online education and its' consequence of attrition, is an identified problem within the United States and internationally. Terminology has wavered between persistence and success, where each has been interchangeably used to characterize a student that completes a course and continues to program completion. Separate searchers were conducted in Academic Search Premier, CINAHL Plus, the Directory of Open Access Journals (DOAJ) Education Full Text, Ovid, and the Journal of Online Learning and Teaching (JOLT). Search terms included persistence, distance education, and online learning. Inclusion criteria included published after 1999, article from a peer-reviewed journal, and article addresses student factors leading to persistence. Exclusion criteria included article not related to factors of persistence, no original data, and article not written in English or not related to online courses. Factors associated with student persistence in an online program include satisfaction with online learning, a sense of belonging to the learning community, motivation, peer, and family support, time management skills, and increased communication with the instructor. Persistence carries the nuance of complexity beyond mere success. Factors unrelated to knowledge have the ability to provide support, thus allowing the student to overcome hardships in completing a course. If persistence factors are not present in sufficient quantity, the student may be at risk of withdrawing from an online course.
Importance:
In the United States, approximately 1 physician dies by suicide every day. Training physicians are at particularly high risk, with suicidal ideation increasing more than 4-fold during the first 3 months of internship year. Despite this increase, to our knowledge, very few efforts have been made to prevent the escalation of suicidal thoughts among training physicians.
Objective:
To assess the effectiveness of a web-based cognitive behavioral therapy (wCBT) program delivered prior to the start of internship year in the prevention of suicidal ideation in medical interns.
Design, setting, and participants:
A randomized clinical trial conducted at 2 university hospitals with 199 interns from multiple specialties during academic years 2009-2010 or 2011-2012. The current study was conducted from May 2009 to June 2010 and May 2011 to June 2012, and data were analyzed using intent-to-treat principles, including last observation carried forward.
Interventions:
Interns were randomly assigned to 2 study groups (wCBT and attention-control group [ACG]), and completed study activities lasting 30 minutes each week for 4 weeks prior to starting internship year. Participants assigned to wCBT completed online CBT modules and those assigned to ACG received emails with general information about depression, suicidal thinking, and local mental health professionals.
Main outcomes and measures:
The Patient Health Questionnaire-9 was used to assess suicidal ideation (ie, "thoughts that you would be better off dead or hurting yourself in some way") prior to the start of intern year and at 3-month intervals throughout the year.
Results:
A total of 62.2% of interns (199 of 320) agreed to take part in the study; 100 were assigned to the wCBT group and 99 to the ACG. During at least 1 point over the course of internship year, 12% of interns (12 of 100) assigned to wCBT endorsed suicidal ideation compared with 21.2% of interns (21 of 99) assigned to ACG. After adjusting for covariates identified a priori that have previously shown to increase the risk for suicidal ideation, interns assigned to wCBT were less likely to endorse suicidal ideation during internship year (relative risk, 0.40; 95% CI, 0.17- 0.91; P = .03) compared with those assigned to ACG.
Conclusions and relevance:
This study demonstrates that a free, easily accessible, brief wCBT program is associated with reduced likelihood of suicidal ideation among medical interns. Prevention programs with these characteristics could be easily disseminated to medical training programs across the country.
Trial registration:
anzctr.org.au Identifier: ACTRN12610000628044.
Background:
Aboriginal and Torres Strait Islander peoples, particularly those in remote communities, have lower access to health services when compared with the rest of the Australian population. This research examined the expectations and outcomes of medical students who went on a 2-day trip to a remote Aboriginal community.
Methods:
Activities were organised by community members, ground staff and fly-in fly-out health professionals. Students wrote about their expectations and post-trip reflections on personal, medical and cultural themes.
Results:
Twenty-three students participated in this study. Themes included complex, different and increased illnesses; how culture affects day-to-day life and health; personal growth; administrative, health delivery and advocacy skills; learning cultural awareness firsthand; and future career options.
Discussion:
The 2-day trip gave students a profound learning experience. To build a culturally appropriate and dedicated workforce for Abo-riginal and Torres Strait Islander peoples, medical schools should consider incorporating short trips to remote Aboriginal and Torres Strait Islander communities into their curriculum.
ProblemDespite the increasing prevalence of mental health disorders in university students, few receive needed evidence-based treatment.Objective
The purpose of this study was to assess the feasibility and preliminary effects of a seven-session online cognitive-behavioral skill-building intervention (i.e., COPE, Creating Opportunities for Personal Empowerment) versus a comparison group on their anxiety, depressive symptoms, and grade performance.MethodsA randomized controlled pilot study was conducted from September 2012 to May 2013 with 121 college freshmen enrolled in a required one credit survey course.FindingsAlthough there were no significant differences in anxiety and depressive symptoms between the groups, only COPE students with an elevated level of anxiety at baseline had a significant decline in symptoms. Grade point average was higher in COPE versus comparison students. Evaluations indicated that COPE was a positive experience for students.ConclusionsCOPE is a promising brief intervention that can be integrated effectively into a required freshman course.
The systematic review of evidence is the research method which underpins the traditional approach to evidence-based healthcare. There is currently no uniform methodology for conducting a systematic review of association (etiology). This study outlines and describes the Joanna Briggs Institute's approach and guidance for synthesizing evidence related to association with a predominant focus on etiology and contributes to the emerging field of systematic review methodologies. It should be noted that questions of association typically address etiological or prognostic issues.The systematic review of studies to answer questions of etiology follows the same basic principles of systematic review of other types of data. An a priori protocol must inform the conduct of the systematic review, comprehensive searching must be performed and critical appraisal of retrieved studies must be carried out.The overarching objective of systematic reviews of etiology is to identify and synthesize the best available evidence on the factors of interest that are associated with a particular disease or outcome. The traditional PICO (population, interventions, comparators and outcomes) format for systematic reviews of effects does not align with questions relating to etiology. A systematic review of etiology should include the following aspects: population, exposure of interest (independent variable) and outcome (dependent variable).Studies of etiology are predominantly explanatory or predictive. The objective of reviews of explanatory or predictive studies is to contribute to, and improve our understanding of, the relationship of health-related events or outcomes by examining the association between variables. When interpreting possible associations between variables based on observational study data, caution must be exercised due to the likely presence of confounding variables or moderators that may impact on the results.As with all systematic reviews, there are various approaches to present the results, including a narrative, graphical or tabular summary, or meta-analysis. When meta-analysis is not possible, a set of alternative methods for synthesizing research is available. On the basis of the research question and objectives, narrative, tabular and/or visual approaches can be used for data synthesis. There are some special considerations when conducting meta-analysis for questions related to risk and correlation. These include, but are not limited to, causal inference.Systematic review and meta-analysis of studies related to etiology is an emerging methodology in the field of evidence synthesis. These reviews can provide useful information for healthcare professionals and policymakers on the burden of disease. The standardized Joanna Briggs Institute approach offers a rigorous and transparent method to conduct reviews of etiology.
The purpose of this study was to explore the transitional experiences of graduate nurses who had previously trained as enrolled nurses. A small survey design was utilised to collect data using in-depth interviews. Two themes emerged from the data, 'values dissonance' and 'role adjustment'. Results indicate that the transition from student to registered nurse is as stressful and labile for this student cohort as has been reported with regard to graduate transition generally. Industry expectations of these graduates must be aligned to their perceptions and abilities. Nursing graduates who previously trained as enrolled nurses require the same degree of guidance, support and understanding afforded other graduates upon entry into the workforce.
This study investigated the differences between demographic, enrollment, academic, and self-directed learning characteristics of completers and noncompleters in online courses at one community college. The study also obtained students' self-reported reasons for not completing their coursework. No significant differences were found in the characteristics of age, gender, ethnicity, financial aid eligibility, grade point average, and total hours enrolled; significant differences were found in gender, academic readiness, and completers enrolled in more online courses than noncompleters.