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    Exploring the relationship between resilience and grit among nursing students: A correlational research study. Meyer Geralyn,Shatto Bobbi,Kuljeerung Orawan,Nuccio Lisa,Bergen Adam,Wilson Courtney Rae Nurse education today BACKGROUND:Nurse turnover is a critical issue around the world. Finding factors that can increase job persistence in nursing can have a positive impact on both the quality and cost of health care. Resilience and grit have been studied as factors that help an individual persist in the pursuit of their goals. Resilience and grit are related terms that have frequently been used interchangeably, although some studies suggest that they are different constructs. Determining if they are different constructs is important as we seek to develop qualities in new nurses that increase their job persistence and satisfaction. OBJECTIVES:The purpose of this study was to explore the relationship between resilience and grit in pre-licensure nursing students. DESIGN/SETTING:This descriptive correlational study was conducted at a midsize private University in the United States. PARTICIPANTS:The convenience sample consisted of students from 3 pre-licensure programs: Traditional Bachelor of Science in Nursing (TBSN), Accelerated Bachelor of Science in Nursing (ABSN) and Direct Entry Masters of Science in Nursing (DEMSN). The final sample was 348 students: 79% TBSN, 7% ABSN and 14% DEMSN. METHODS:Resilience was measured with the Conner-Davidson Resilience 10 item scale. Grit was measured utilizing the Short Grit Scale. RESULTS:Inspection of the interfactor correlations suggest that resilience and grit scales are distinct, though tend to correlate well. Notably, the relationship between resilience and the persistent effort component of grit was moderate. That correlation was higher than the relationship between the consistent interest component of grit and resilience. CONCLUSION:This study concludes that grit and resilience are related concepts but are not synonymous. Being mindful of the difference in these two attributes may be important in the development of educational offerings in both Schools of Nursing and in new nurse residency programs to increase retention in nursing. 10.1016/j.nedt.2019.104246
    Everyday Resilience: Equipping Faculty With Practical Exercises to Promote Resilience Among Medical Students. Gheihman Galina,Singh Tara A,Cooper Cynthia A,McKeon Bri Anne,Hirsh David A,Simpkin Arabella L MedEdPORTAL : the journal of teaching and learning resources Introduction:Burnout is prevalent in health care. As professionals advocate to increase resilience training as a strategy to reduce burnout, few examples exist of practical resilience programs that equip faculty to help students build and sustain well-being over time. Method:We developed two straightforward, skills-based resilience exercises. Breaking Down Easy taught individuals to identify personal strengths. My Resilience Practice helped individuals identify strategies to cope with daily stressors. We taught these exercises to international faculty in a train-the-trainer workshop format, at two medical education conferences. Faculty applied the exercises, performed pair-share reflections, and discussed opportunities to introduce the exercises in their own institutions. Postsession surveys evaluated the workshop quality and the exercises' ease of use and applicability. Results:Thirty-five faculty and five students participated across two international conferences. Of participants, 83% (33 of 40) completed postsession surveys. On a 5-point Likert scale, participants rated the workshop on average 4.4 for usefulness, 4.6 for applicability, 4.4 for ease of instruction, 4.5 for clarity, and 4.8 for overall quality. Participants found the exercises to be straightforward to use and planned to use them at their institutions with students, residents, and faculty. Discussion:Participants found our workshop to be relevant and effective and shared their intention to incorporate these materials into their teaching with medical students, residents, and faculty. Implementing effective programs to build resilience is critical to increasing well-being and reducing burnout. This, in turn, may enhance patient safety and improve health system outcomes. 10.15766/mep_2374-8265.11076
    Development of resilience in nursing students: A systematic qualitative review and thematic synthesis. Amsrud Kirsten Eika,Lyberg Anne,Severinsson Elisabeth Nurse education in practice 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. 10.1016/j.nepr.2019.102621
    Investigating the Relationships Among Resilience, Social Anxiety, and Procrastination in a Sample of College Students. Ko Chen-Yi Amy,Chang Yuhsuan Psychological reports This study investigated the relationships among resilience, social anxiety, and procrastination in a sample of college students. Specifically, structural equation modeling analyses were applied to examine the effect of resilience on procrastination and to test the mediating effect of social anxiety. The results of this study suggested that social anxiety partially mediated the relationship between resilience and procrastination. Students with higher levels of resilience reported a lower frequency of procrastination behavior, and resilience had an indirect effect on procrastination through social anxiety. The results of this study clarify the current knowledge of the mixed results on resilience and procrastination behaviors and offer practical learning strategies and psychological interventions. 10.1177/0033294118755111
    Academic burnout and depression of Chinese medical students in the pre-clinical years: the buffering hypothesis of resilience and social support. Cheng J,Zhao Y Y,Wang J,Sun Y H Psychology, health & medicine The present study explored whether the two psychosocial resources including resilience and social support serve as moderating factors in the process between academic burnout and depression among medical students, and investigated factors that associated with depression. We applied Learning Burnout Scale of Undergraduates, Beck Depression Inventory-II, Connor-Davidson Resilience Scale, and Social Support Rating Scale as tools for an investigation with 1722 Chinese medical students. Academic burnout positively correlated with depression while resilience and social support negatively related to depression. Hierarchical regression implied that resilience moderated burnout and depression while social support did not show a buffer effect between the same variables. Building resilience and enhancing their social support are essential for preventing depression in their college life. It is also worth noting that resilience can still work against depression even when academic burnout emerged. 10.1080/13548506.2019.1709651
    A multi-level examination of nursing students' resilience in the face of the COVID-19 outbreak: A cross-sectional design. Drach-Zahavy Anat,Goldblatt Hadass,Admi Hanna,Blau Ayala,Ohana Irit,Itzhaki Michal Journal of advanced nursing AIMS:To examine nursing students' stress and coping with the coronavirus disease 2019 (COVID-19) pandemic through an ecological model of resilience. Specifically, to examine the relative contribution of different resilience levels in decreasing nursing students' strain symptoms: at the individual level, resilience trait; at the relational level, students' coping strategies; at the university level, nursing students' perceptions on their university's readiness to handle the virus outbreak; and at the national level, nursing students' trust in policymakers' decisions. DESIGN:The study used a cross-sectional design. METHODS:Undergraduate students of five universities were recruited via an electronic link sent to their emails during the first months of the COVID-19 outbreak: May-July 2020. Of them, 492 participants completed the research questionnaire. RESULTS:Hierarchical Regression Analysis revealed that nursing students' resilience, as a multi-level factor, decreased the students' level of strain symptoms above and beyond their stress levels and control variables. Specifically, the nursing students' trait resilience, perceptions of their university's positive response to the pandemic and trust in their national policymakers were negatively associated with their strain symptoms. Conversely, disengagement-in-emotion coping strategies was positively associated with the students' strain symptoms. CONCLUSIONS:Nursing students' resilience should be seen as a flexible resource that can be developed and influenced by their academic and clinical training, and by the intentions and actions of their university and the nursing administration at the Ministry of Health (MOH). IMPACT:The findings call for the nursing administration at the MOH and for the university deans and department heads to prepare in advance a crisis plan that could be rapidly and effectively implemented when needed. Furthermore, topics such as developing flexible coping strategies should be integrated into the nursing curricula. These would allow students to prepare and cope better with adversity in their routine and in times of crisis. 10.1111/jan.14951
    Resilience, Social Support, and Coping as Mediators between COVID-19-related Stressful Experiences and Acute Stress Disorder among College Students in China. Ye Zhi,Yang Xueying,Zeng Chengbo,Wang Yuyan,Shen Zijiao,Li Xiaoming,Lin Danhua Applied psychology. Health and well-being 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. 10.1111/aphw.12211
    Development and psychometric properties of the Nursing Student Academic Resilience Inventory (NSARI): A mixed-method study. Ali-Abadi Tayyebeh,Ebadi Abbas,Sharif Nia Hamid,Soleimani Mohsen,Ghods Ali Asghar PloS one INTRODUCTION:Resilience has been proposed as a suitable solution to better deal with nursing students in cases of challenges but the complex and multidimensional nature of resilience has made its measurement challenging. This study aimed to develop and validate a new inventory theory-driven labeled Nursing Student Academic Resilience Inventory. METHODS:This study was performed with an exploratory sequential mixed-method design. In the qualitative phase of the study, individual interviews were conducted by including 15 participants to elicit the concept of resilience through purposive sampling. In the quantitative phase, psychometric analysis of the extracted items was performed using face, content, and construct validities (exploratory and confirmatory factor analyses) on a sample size of 405 nursing students. Besides, reliability has been tested using internal consistency and test-retest methods. According to the COSMIN standards, beside two important indicators of validity and reliability, responsiveness and interpretability were also considered. RESULTS:A 6-factor structure (optimism, communication, self-esteem/evaluation, self-awareness, trustworthiness, and self-regulation) with 24 items were extracted in terms of the derived categories from the qualitative phase. In confirmatory factor analysis, the χ2/df ratio was calculated as 2.11 for the NSARI six-factor structure. Suitable values were obtained for the goodness of fit indices (CFI = 0.904, AGFI = 0.885, IFI = 0.906, PCFI = 0.767, and RMSEA = 0.053). In the second-order factor analysis, AVE = 0.70 indicated the existence of both convergent and divergent validities. The Cronbach's alpha and omega coefficients were investigated as (0.66-0.78) and (0.66-0.80), respectively. The AIC was between 0.33 and 0.45 for all factors, which is an acceptable rate. Additionally, an intraclass correlation coefficient (ICC) was obtained as .903 for the whole instrument (CI .846- .946, P <0.0001). CONCLUSION:Multidimensional nature of resilience was supported through exploring its 6-factor structures in the nursing students' field. This tool also showed an acceptable validity and reliability for measuring resilience in the population of nursing students. 10.1371/journal.pone.0252473
    Veterinary Students' Perspectives on Resilience and Resilience-Building Strategies. Moffett Jenny E,Bartram David J Journal of veterinary medical education In recent years, resilience has been lauded as a valuable, even necessary, facet of an effective veterinary practitioner. This study describes a mixed-methods research exploration of the impact of a self-care and mental well-being teaching intervention on the self-reported resilience of 105 first-year veterinary students enrolled at the School of Veterinary Medicine, University of Surrey, UK. Quantitative data were obtained through a questionnaire, the 10-item Connor-Davidson Resilience Scale (CD-RISC 10), which students completed before and after the teaching intervention. The median total score on the scale increased from 27 (IQR=25-30) to 29 (IQR=26-32) (p<.001), a medium effect size (r=-0.28). Student focus groups were held to allow qualitative data analysis of the students' perspectives on the teaching intervention and on the topic of resilience in general. The results of this study suggest that appropriate training in resilience-building strategies can help veterinary students build greater awareness of resilience, and potentially support their development of a more resilient approach in their personal and professional lives. In this study, veterinary students felt that resilience training was a valuable addition to the veterinary curriculum, and that resilience likely plays an important role in achieving a successful veterinary career. The study also suggested that veterinary students utilize a variety of different resilience-building strategies, including drawing on past experiences, seeking help from support networks, and developing an ability to change their perspectives. 10.3138/jvme.0216-046R1
    Resilience-building module for undergraduate nursing students: A mixed-methods evaluation. Chow Ka Ming,Tang Fiona W K,Tang Winnie P Y,Leung Alice W Y Nurse education in practice In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students. 10.1016/j.nepr.2020.102912
    Resilience in nursing students: An integrative review. Thomas Lisa Jean,Revell Susan Hunter Nurse education today OBJECTIVE:The aim of this integrative review was to investigate the state of knowledge on resilience in nursing students. Specifically the authors sought to define and describe the concept, and identify factors that affect and evaluate strategies to promote resilience in nursing students. DESIGN:Integrative literature review. DATA SOURCES:Cumulative Index to Nursing and Allied Health (CINHAL), Education Resources Information Center (ERIC) and PsychINFO electronic databases were searched for publications between 1990 and 2014. Search terms included resilience, student, nurse, nursing student, hardiness, emotional resilience, research, resili*, and nurse*. REVIEW METHODS:Whittemore and Knafl's integrative approach was utilized to conduct the methodological review. Each article was assessed with an appraisal tool. RESULTS:The search resulted in the inclusion of nine articles. The majority of the literature utilized definitions of resilience from the discipline of psychology. One exception was a definition developed within nursing specific to nursing students. Factors that affect resilience were grouped into three themes: support, time, and empowerment. Strategies to promote resilience in nursing students were found in three of the nine articles, but their methods and findings were disparate. CONCLUSIONS:This review provides information about the concept of resilience in nursing students. Faculty awareness of the importance of resilience in nursing students can better prepare students for the role of the professional nurse. Support from family, friends and faculty impact a student's resilience. Through closely working with students in advisement, the clinical arena and the classroom faculty can promote resilience. 10.1016/j.nedt.2015.10.016
    Generation Z undergraduate students' resilience during the COVID-19 pandemic: a qualitative study. Ang Wei How Darryl,Shorey Shefaly,Lopez Violeta,Chew Han Shi Jocelyn,Lau Ying Current psychology (New Brunswick, N.J.) Resilience has been documented as an essential component in managing stress. However, understanding how undergraduate students with different sociodemographic characteristics perceive resilience remains understudied. This study aimed to explore how undergraduate students in one university define and build resilience during the COVID-19 pandemic. Students' perception and preferences for receiving resilience training were additionally solicited. A descriptive qualitative cross-sectional study was conducted. Twenty-seven students were interviewed using a semi-structured interview guide via Skype instant messaging. The thematic analysis generated five themes: resilience as enduring and withstanding; the building blocks of resilience; resilience: learning or earning; pedagogical considerations for resilience training; and a blended platform for resilience training. Participants described resilience as an enduring and withstanding trait essential for university students. Resilience can be built from intrinsic and extrinsic factors. Intrinsic factors that enhanced resilience included desire to succeed and motivation. Extrinsic factors were relational in nature, and friends, family, teachers, and religion were found to boost resilience. Students had several recommendations in designing resilience training, and they recommended the use of a blended platform. Further, students suggested the use of videos, narratives from resilient individuals, and using reflective practice as a pedagogy in resilience training. Future resilience training should consist of personal and interpersonal factors and should be introduced early during the academic term of students' university life. As the COVID-19 pandemic compounds an already challenging academic climate, this study lends it findings to expand the resilience literature and develop future resilience training. 10.1007/s12144-021-01830-4
    Social capital, social support and perceived stress in college students: The role of resilience and life satisfaction. Kalaitzaki Argyroula,Tsouvelas George,Koukouli Sofia Stress and health : journal of the International Society for the Investigation of Stress The study examined whether online and offline social capital and offline social support are associated with less perceived stress in 403 undergraduate Greek college students through the mediating role of resilience and life satisfaction. Gender differences were also explored. A path analysis explored the relationships among the study variables and multi-group analysis explored gender differences. Perceived stress was predicted indirectly by offline social support and offline bonding social capital through resilience and life satisfaction and directly by online bonding. However, offline bonding was associated with reduced resilience and life satisfaction, whereas social support was associated with increased levels of both. Interestingly, whereas offline bonding was associated with reduced perceived stress through resilience for women, for men it occurred through life satisfaction, and it was primarily resilience for women and life satisfaction for men that predicted reduced perceived stress. It was concluded that different personal ties/relationships are associated with perceived stress through diversified pathways and the pathways are different for men and women. Offline social support between closely tied persons is positively associated and offline bonding is negatively associated with the inner resources for a person to cope with stress, whereas online bonding is beneficial in directly decreasing stress. 10.1002/smi.3008
    Distress and resilience associated with workload of medical students. Kiziela Antanas,Viliūnienė Rima,Friborg Oddgeir,Navickas Alvydas Journal of mental health (Abingdon, England) BACKGROUND:University students face numerous stressors during their study curricula, which require adequate resilience to ensure healthy adaptation. AIMS:To examine how relationships between study workload and mental health problems are moderated by resilience. Secondly, to compare our findings with other studies and assess differences in resilience and distress between medical and non-medical students. METHODS:A prospective quantitative design was used. Participants completed a questionnaire package assessing resilience resources (Resilience Scale for Adults) and mental health (Core-OM: Clinical outcomes in routine evaluation - outcome measure) under three different conditions: heavy, low or regular workload. RESULTS:During heavy workload, significantly higher distress score was found among medical students compared to other students (1.46 vs. 1.25; p < 0.05). Medical students had slightly higher overall resilience scores (5.21 vs. 4.94; p > 0.05). During heavy workload up to 20% of the participants had higher distress score than clinical samples' average from other studies. RSA score and Core-OM scores were inversely dependent (p < 0.0001; r= -0.434). CONCLUSION:Findings suggest that distress mediated by heavy workload does not significantly affect resilience. Many students, especially medical, are experiencing high levels of distress. Resilience is associated with the decrease in distress. 10.1080/09638237.2018.1521922
    Social Networks, Engagement and Resilience in University Students. Fernández-Martínez Elena,Andina-Díaz Elena,Fernández-Peña Rosario,García-López Rosa,Fulgueiras-Carril Iván,Liébana-Presa Cristina International journal of environmental research and public health Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried out on 134 university students. We collected the network structural variables, degree of resilience (CD-RISC 10), and engagement (UWES-S). The computer programs used were excel, UCINET for network analysis, and SPSS for statistical analysis. The analysis revealed results of means of 28.61 for resilience, 2.98 for absorption, 4.82 for dedication, and 3.13 for vigour. The students had two preferred places for sharing information: the classroom and WhatsApp. The greater the value for engagement, the greater the degree of centrality in the friendship network among students who are beginning their university studies. This relationship becomes reversed as the students move to later academic years. In terms of resilience, the highest values correspond to greater centrality in the friendship networks. The variables of engagement and resilience influenced the university students' support networks. 10.3390/ijerph14121488
    Medical student resilience strategies: A content analysis of medical students' portfolios. Prayson Richard A,Bierer S Beth,Dannefer Elaine F Perspectives on medical education INTRODUCTION:Stress and burnout among medical students is a well-recognized concern. A student's ability to employ resilience strategies to self-regulate behaviour is critical to the student's future career as a physician. METHODS:We retrospectively reviewed a sampling of year 1, 2 and 5 portfolio essays focused on the Personal Development competency and performance milestones, written by 49 students from three different classes in a 5-year programme devoted to training physician investigators. Two medical educators used a framework established by Jensen and colleagues (2008) to identify the nature and prevalence of various resilience strategies (valuing the physician role, self-awareness, personal arena, professional arena, professional support and personal support) medical students reported in portfolio essays. RESULTS:All students documented at least one strategy in their essays each year. In all years, the most commonly documented strategies were in the personal arena (95.7% of year 1, 98% of year 2 and 87.8% of year 5 portfolios). The least frequently documented strategy in all years was professional support (42.8% of year 1, 38.8% of year 2, and 28.6% of year 5 portfolios). Year 5 portfolios discussed personal support strategies (79.6%) more frequently than year 1 (53.1%) and year 2 (59.2%) portfolios. DISCUSSION:The results suggest that medical students can identify stressors and articulate resilience strategies that can be employed to potentially address them. 10.1007/s40037-016-0313-1
    Relationship of childhood trauma, psychological resilience, and family resilience among undergraduate nursing students: A cross-sectional study. Dong Chaoqun,Xu Ru,Xu Liuqing Perspectives in psychiatric care PURPOSE:To analyze how family resilience mediates the relationship between childhood trauma and psychological resilience in undergraduate nursing students. DESIGN AND METHODS:A cross-sectional survey design was used to investigate 698 nursing undergraduate students (mean age: 18.77 ± 0.86 years) using the Childhood Trauma Questionnaire, Family Resilience Assessment Scale, and Connor-Davidson Resilience Scale. The mediating effect of family resilience was estimated using structural equation modeling and the bootstrap method. FINDINGS:Both childhood trauma and family resilience were associated with psychological resilience. Family resilience showed a partial mediating effect between childhood trauma and psychological resilience, accounting for 21.5% of the total effect. PRACTICE IMPLICATION:Our findings may help inform family interventions to improve the psychological resilience of nursing students, especially for those with childhood trauma experience. 10.1111/ppc.12626
    Medical students' resilience: a protective role on stress and quality of life in clerkship. Lin Yung Kai,Lin Chia-Der,Lin Blossom Yen-Ju,Chen Der-Yuan BMC medical education BACKGROUND:Resilience refers to the ability to be flexible and adaptive in response to challenges. Medical students in clerkship who are transitioning from medical studies to clinical practice face a variety of workplace demands that can lead to negative learning experiences and poor quality of life. This study explored whether medical students' resilience plays a protective role against the stresses incurred during workplace training and on their professional quality of life during clerkships. METHODS:This was a 1-year prospective web-based questionnaire study comprising one cohort of medical students in their fifth year who were working as clerks as part of their 6-year medical education programme at one medical school in Taiwan between September 2017 and July 2018. Web-based, validated, structured, self-administered questionnaires were used to measure the students' resilience at the beginning of the clerkship and their perceived training stress (i.e. physical and psychological demands) and professional quality of life (i.e. burnout and compassion satisfaction) at each specialty rotation. Ninety-three medical students who responded to our specialty rotation surveys at least three times in the clerkship were included and hierarchical regressions were performed. RESULTS:This study verified the negative effects of medical students' perceived training stress on burnout and compassion satisfaction. However, although the buffering (protective) effects of resilience were observed for physical demands (one key risk factor related to medical students' professional quality of life), this was not the case for psychological demands (another key risk factor). In addition, through the changes in R square (∆R) values of the hierarchical regression building, our study found that medical students' perceived training stresses played a critical role on explaining their burnout but their resilience on their compassion satisfaction. CONCLUSIONS:Medical students' resilience demonstrated a buffering effect on the negative relationship between physical demands and professional quality of life during clerkships. Moreover, different mechanisms (predictive paths) leading to medical students' professional quality of life such as burnout and compassion satisfaction warrant additional studies. 10.1186/s12909-019-1912-4
    Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference? Zhang Mingliang,Zhang Jianmei,Zhang Feng,Zhang Li,Feng Danjun Psychiatry research This study aimed to examine the gender differences in the prevalence of psychological distress, and in the effects of resilience and perceived social support on psychological distress among Chinese college students. A cross-sectional survey was conducted in current study. The psychological distress, resilience, and perceived social support of 1400 university students of China were measured using the Kessler Psychological Distress Scale, the 10-item Connor-Davidson Resilience Scale, and the 12-item Multidimensional Scale of Perceived Social Support, respectively. Multiple group analyses were conducted using structural equation modeling to examine the moderating role of gender in the effects of resilience and perceived social support on psychological distress. The prevalence of psychological distress was 90.86%. Female college students reported a higher prevalence of psychological distress (94.07%) than males (89.11%). Among male college students, the resilience was more strongly associated with psychological distress than perceived social support (-0.18 vs.-0.16). In contrast, among female college students, resilience was not significantly related, but perceived social support was closely related with psychological distress (0.01 vs. -0.31). In conclusion, Chinese female college students are more vulnerable to psychological distress than males. Gender moderates the relationships among resilience, perceived social support, and psychological distress. 10.1016/j.psychres.2018.06.038
    Strategies for Enhancing Resilience in Medical Students: a Group Concept Mapping Analysis. Donohoe Jessica,O'Rourke Margaret,Hammond Sean,Stoyanov Slavi,O'Tuathaigh Colm Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry OBJECTIVE:Research has consistently shown that medical students have greater rates of stress and mental-ill health in comparison with non-medical students. The objective of this study was to investigate the resilience strategies employed by medical students in an Irish medical school to inoculate themselves against the deleterious effects of stress on health and wellbeing. METHODS:Group concept mapping was utilized incorporating qualitative and quantitative methodologies. The stages undertaken by year 3 students at an Irish medical school involved brainstorming/idea generation, categorization, and rating of resilience strategies students employed to manage stress during medical school. The data was analyzed utilizing The Concept System® software through multidimensional scaling and hierarchical clustering. RESULTS:Categories of resilience strategies employed included "friends and family," "de-stress through exercise/sport," "extra-curricular non-medical activities," "self-enabled distraction," "organization," and "enhancing emotional and mental wellbeing." Students rated spending time with "friends and family" to be most effective when seeking to relieve stress, whereas students rated "de-stressing through exercise/sport" as being of greatest importance in relation to inclusion in a resilience-based intervention. Students recognized the value of incorporating strategies to enhance emotional and mental wellbeing into a resilience-promoting program. "Self-enabled distraction" rated poorly on both scales. CONCLUSIONS:Strategies rated by students to be important to incorporate in a stress reduction management program are accessible, are feasible, and can be implemented into the medical curriculum. 10.1007/s40596-020-01208-x
    Quality of Life, Resilience, and Related Factors of Nursing Students During the COVID-19 Pandemic. Keener Tina Antill,Hall Katherine,Wang Kesheng,Hulsey Tara,Piamjariyakul Ubolrat Nurse educator BACKGROUND:COVID-19 and the associated measures to mitigate the spread of the virus have significantly disrupted nursing education. PURPOSE:The purpose of this study was to examine the relationship between quality of life (QoL), resilience, and associated factors among nursing students during the unprecedented COVID-19 pandemic and subsequent social distancing requirements. METHODS:A cross-sectional study using an anonymous survey with nursing students (n = 152) was conducted at a public university in rural Appalachia in April 2020. Instruments included World Health Organization Quality of Life-BREF, Connor Davidson Resilience Scale, demographics and school-related questionnaires, and an open-ended question. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses. RESULTS:Resilience, having online experience, and being well prepared for online learning were associated with each QoL domain. Remarkably, 21% to 54% of nursing student QoL scores indicated poor QoL. CONCLUSIONS:Cultivating resilience among nursing students may improve QoL, help with academic success, and prepare students to sustain the demands associated with the nursing profession. 10.1097/NNE.0000000000000969
    Characteristics of nursing students with high levels of academic resilience: A cross-sectional study. Hwang Eunhee,Shin Sujin Nurse education today BACKGROUND:Academic resilience is an important characteristic that helps nursing students, who must engage in intensive learning and clinical practice, to overcome academic stress and adapt to their school and the clinical field. OBJECTIVES:To determine the characteristics of nursing students with high academic resilience. DESIGN:This study used a cross-sectional design. SETTING:Three universities in South Korea. SUBJECTS:We recruited a convenience sample of 254 nursing students. METHODS:Academic resilience, general characteristics, clinical practice stress, clinical practice satisfaction, and social-affective capability were assessed via self-reported questionnaires. The collected data were analyzed using descriptive statistics, chi-squared test, and analysis of variance with Tukey's post hoc test. RESULTS:The mean academic resilience score was 3.79. A greater proportion of respondents with high levels of academic resilience had good interpersonal relationships (χ = 35.175, p < .001), high academic grades (χ = 30.968, p < .001), a role model (χ = 9.770, p = .033), and high satisfaction with their major (χ = 20.214, p = .001). Significant differences in the subscale scores for clinical practice stress, including burden of clinical tasks (F = 4.727, p = .010), conflict of interpersonal relations (F = 4.889, p = .008), and conflict with patients (F = 7.023, p = .001), were found among the academic resilience groups. We also observed differences in the subscale scores of clinical practice satisfaction, including practice content (F = 4.894, p = .008) and practice environment (F = 8.301, p < .001). Respondents in the high resilience group had higher social-affective capability scores than did those with lower resilience (F = 43.994, p < .001). CONCLUSION:Based on our results, students with high academic resilience are more likely to continue their studies and benefit from programs that strengthen their social-affective capability. We therefore propose that nursing school curriculum focus on enhancing social-affective capability. 10.1016/j.nedt.2018.09.011
    Validation of the 10-item resilience scale with Mexican college students. Lima-Sánchez Dania Nimbe,Navarro-Escalera Alejandra,Fouilloux-Morales Claudia,Tafoya-Ramos Silvia Araceli,Campos-Castolo Esther Mahuina Revista medica del Instituto Mexicano del Seguro Social BACKGROUND:Resilience is the ability to emerge strengthened in an adverse scenario. One population that suffer constant stress are doctors and medical students, which is why it is necessary to have validated instruments to assess resilience. OBJECTIVE:To evaluate the validity and reliability parameters of the 10-item resilience scale, Connor-Davidson (CD-RISC-10), in a Mexican university sample. MATERIAL AND METHODS:A sample of 1333 first-year medical students who agreed to participate in the study was evaluated; sample selection was for convenience, with an average age of 18 years (standard deviation: 1.4 years; 17-39 years). CD-RISC-10 scale was applied to the sample. In a sub-sample, Mexican resilience scale (RESI-M) was applied to assess convergent validity; the Beck Anxiety Inventory and the Beck Depression Inventory were used to divergent validity. RESULTS:A factorial analysis was performed with a factor that explains 96.245 of the total variances. The internal consistency of the scale presented a Cronbach’s alpha of 0.935. The test-retest was r = 0.521, p = 0.01; the correlation with the RESI-M was moderate (r = 0.61, p = 0.0001). The correlation with the Beck Anxiety Inventory was r = −0.214 (p < 0.05) and with the Beck Depression Inventory, r = −199, p < 0.05). CONCLUSIONS:The 10-item Spanish version of the Connor and Davidson CD-RISC had adequate psychometric properties to estimate resilience in medical university students. 10.24875/RMIMSS.M21000033
    The strength of pursuing your values: Valued living as a path to resilience among college students. Ceary Chris D,Donahue John J,Shaffer Katharine Stress and health : journal of the International Society for the Investigation of Stress Although stressful life events (SLEs) frequently relate to negative outcomes, many individuals demonstrate resilience by positively adapting to stressors without significant impairment. Valued living, a key process in the theory underpinning acceptance and commitment therapy is a response style characterized by daily purposeful actions that are linked to important values and may promote resilience in college students. This study examined the main and interactive effects of SLEs and valued living in the prediction of a multidimensional measure of resilience. Results supported a strong positive relationship between resilience and valued living. Further, valued living moderated the association between SLE negative impact scores and resilience (but not the association between cumulative prior year SLEs and resilience). Although SLE negative impact scores were negatively associated with resilience at lower levels of valued living, there was no demonstrated relationship at higher levels of valued living. Implications related to promoting valued living among college students in the service of increasing resilience are discussed. 10.1002/smi.2886
    The relationship between resilience, reflective thinking and professionalism in Australian undergraduate occupational therapy students. George Madeline,Brown Ted,Yu Mong-Lin Scandinavian journal of occupational therapy BACKGROUND:Professionalism is a key attribute that occupational therapy students must establish throughout their education. Resilience and reflective thinking are two skills that may underpin students' professionalism. OBJECTIVE:To investigate whether resilience and reflective thinking are predictive of undergraduate occupational therapy students' professionalism. METHODS:152 occupational therapy undergraduate students completed the (PAT); the (RAU); and the (RTS). Regression analyses with bootstrapping were completed. RESULTS:Regression models revealed that multiple domains of resilience and reflective thinking were predictive of the following professionalism variables: Reliability, Responsibility and Accountability (=0.080,  = 0.002); Lifelong Learning and Adaptability (=0.084,  = 0.01); Relationships with Others (=0.046,  = 0.03); and Citizenship and Professional Engagement (=0.110,  = 0.004). Common independent variables among these models included RTS , RAU and RAU . CONCLUSIONS AND SIGNIFICANCE:This preliminary evidence revealed that when working together, factors of resilience and reflective thinking were predictive of occupational therapy student professionalism. Incorporating a greater focus on these skills into the occupational therapy education curriculum may help enhance student professionalism. Further research on resilience and reflective thinking, and the potential links to professionalism, is recommended. 10.1080/11038128.2021.1908421
    Investigating the Relationship Between Resilience, Stress-Coping Strategies, and Learning Approaches to Predict Academic Performance in Undergraduate Medical Students: Protocol for a Proof-of-Concept Study. Banerjee Yajnavalka,Akhras Aya,Khamis Amar Hassan,Alsheikh-Ali Alawi,Davis David JMIR research protocols BACKGROUND:The evolution of an undergraduate medical student into an adept physician is perpetual, demanding, and stressful. Several studies have indicated medical students have a higher predominance of mental health problems than other student groups of the same age, where medical education acts as a stressor and may lead to unfavorable consequences such as depression, burnout, somatic complaints, decrease in empathy, dismal thoughts about quitting medical school, self harm and suicidal ideation, and poor academic performance. It is imperative to determine the association between important psychoeducational variables and academic performance in the context of medical education to comprehend the response to academic stress. OBJECTIVE:The aim of this proof-of-concept study is to determine the relationship between resilience, learning approaches, and stress-coping strategies and how they can collectively predict achievement in undergraduate medical students. The following research questions will be addressed: What is the correlation between the psychoeducational variables resilience, learning approaches, and stress-coping strategies? Can academic performance of undergraduate medical students be predicted through the construction of linear relationships between defined variables employing the principles of empirical modeling? METHODS:Study population will consist of 234 students registered for the MBBS (Bachelor of Medicine, Bachelor of Surgery) at Mohammed Bin Rashid University of Medicine and Health Sciences distributed over 4 cohorts. Newly registered MBBS students will be excluded from the study. Various psychoeducational variables will be assessed using prevalidated questionnaires. For learning approaches assessment, the Approaches and Study Skills Inventory for Students questionnaire will be employed. Resilience and stress-coping strategies will be evaluated using the Wagnild-Young resilience scale and a coping strategies scale derived from Holahan and Moos's Coping Strategies Scale, respectively. Independent variables (resilience, stress-coping strategies, and learning approaches) will be calculated. Scores will be tested for normality by using the Shapiro-Wilk test. An interitem correlational matrix of the dependent and independent variables to test pairwise correlation will be formed using Pearson bivariate correlation coefficients. Regression models will be used to answer our questions with type II analyses of variance in tests involving multiple predictors. Regression analyses will be checked for homogeneity of variance (Levine test) and normality of residuals and multicollinearity (variance inflation factor). Statistical significance will be set at 5% (alpha=.05). Effect sizes will be estimated with 95% CIs. RESULTS:Psychoeducational instruments in the form of validated questionnaire have been identified in relation to the objectives. These questionnaires have been formatted for integration into Google forms such that they can be electronically distributed to the consenting participants. We submitted the proposal to MBRU institutional review board (IRB) for which exemption has been awarded (application ID: MBRU-IRB-2019-013). There is no funding in place for this study and no anticipated start date. Total duration of the proposed research is 12 months. CONCLUSIONS:Psychoeducational instruments used in this study will correlate resilience, stress-coping strategies, and learning approaches to academic performance of undergradudate medical students. To the best of our knowledge, no study exploring the multidimensional association of key psychoeducational variables and academic performance in undergraduate medical students has been pursued. Investigated variables, resilience, learning approaches, and stress-coping strategies, are individual traits, however; students' learning history before they joined MBRU is unknown, so our research will not be able to address this specific aspect. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/14677. 10.2196/14677
    Exploring resilience in nursing and midwifery students: a literature review. McGowan Jennifer E,Murray Karen Journal of advanced nursing AIM:The aim of this study was to explore the concepts of 'resilience' and 'hardiness' in nursing and midwifery students in educational settings and to identify educational interventions to promote resilience. BACKGROUND:Resilience in healthcare professionals has gained increasing attention globally, yet to date resilience and resilience education in nursing and midwifery students remain largely under-researched. DESIGN:An integrative literature review was planned, however, only quantitative evidence was identified therefore, a review of quantitative studies was undertaken using a systematic approach. DATA SOURCES:A comprehensive search was undertaken using Medline, CINAHL, Embase, PsycINFO and Maternity and Infant Care databases January 1980-February 2015. REVIEW METHODS:Data were extracted using a specifically designed form and quality assessed using an appropriate checklist. A narrative summary of findings and statistical outcomes was undertaken. RESULTS:Eight quantitative studies were included. Research relating to resilience and resilience education in nursing and midwifery students is sparse. There is a weak evidence that resilience and hardiness is associated with slightly improved academic performance and decreased burnout. However, studies were heterogeneous in design and limited by poor methodological quality. No study specifically considered student midwives. CONCLUSION:A greater understanding of the theoretical underpinnings of resilience in nursing and midwifery students is essential for the development of educational resources. It is imperative that future research considers both nursing and midwifery training cohorts and should be of strong methodological quality. 10.1111/jan.12960
    Exploring the relationship between resilience and practice education placement success in occupational therapy students. Brown Ted,Yu Mong-Lin,Hewitt Alana E,Isbel Stephen T,Bevitt Thomas,Etherington Jamie Australian occupational therapy journal INTRODUCTION:Practice education is a fundamental component of health professional students' education and many personal, social and professional factors impact on students' performance. This study investigated the relationship between measures of resilience and practice education performance in occupational therapy students. METHODS:A quantitative cross-sectional study was used to collect the data. In all, 149 occupational therapy students completed a self-report questionnaire comprised of demographic questions and two standardised scales: Resilience at University (RAU) and Resilience Scale for Adults (RSA). Students' practice education performance was measured by the Student Practice Evaluation Form-Revised (SPEF-R). Multi-linear regression analyses with bootstrapping were completed to identify resilience factors that were predictive of occupational therapy students' practice performance. RESULTS:Overall, occupational therapy students reported high levels of resilience based on the RAU and RSA subscale scores. "Managing Stress," "Find Your Calling" and "Living Authentically" were strong predictors of a range of key fieldwork performance SPEF-R factors, including "Professional Behaviours," "Self-management Skills," "Co-worker Communication" and "Communication Skills." CONCLUSION:The resilience factors identified as being significant predictors of practice education performance outcomes in occupational therapy students represent notable findings. They suggest that students' capabilities in managing their stress levels, finding meaning in their chosen profession, and engaging self-care daily activities outside of the work environment that are meaningful, authentic and fit with one's personal values and beliefs can act as buffers against the challenges experienced by students who are completing practice education placements. The findings will assist academic and practice educators in identifying and targeting vulnerable students and strengthening resilience strategies through proactive pre-practice placement initiatives. Qualitative studies are recommended to further explore the relationship between resilience and practice education performance in occupational therapy students. 10.1111/1440-1630.12622
    Social-Ecological measure of resilience: an adapted measure for Persian-speaking university students. Amini-Tehrani Mohammadali,Nasiri Mohammad,Sadeghi Raheleh,Hoseini Elahe-Sadat,Jalali Tina,Zamanian Hadi Health promotion perspectives There is no validated instrument for Persian-speaking students to apply the social-ecological resilience theory (SERT), which emphasizes the ecological resources for developing resilience. The study aimed at developing the student social-ecological resilience measure(Student-SERM) in Iran's context. Three separate samples of undergraduates participated in this mixed-methods research from the University of Tehran, Iran. Phase-1 qualitatively explored the resilience features in the university setting, to devise the university-specific subscale (USS). Phase-2piloted the construct validity and reliability of the Student-SERM in 242 undergraduates, who also completed Depression, Anxiety, and Stress Scale (DASS-21). Phase-3, as a cross-validation study, investigated 487 undergraduates, who completed the refined Student-SERM, HospitalAnxiety and Depression Scale (HADS), and three indices screening academic performance, loneliness, and suicide acceptability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Pearson's correlation, and Cronbach's alpha were performed. Phase-1 yielded nine items for USS. In phase-2, EFA indicated the construct validity of the main 20-item measure (RMSEA=0.06 and SRMR=0.04) and the nine-item USS (RMSEA=0.07and SRMR =0.04), and the reliability and convergent/divergent validity were confirmed. In phase-3, EFA (RMSEA=0.07 and SRMR=0.04) and CFA (RMSEA=0.07, CFI=0.89, TLI=0.87,and SRMR=0.07) in two separate subsamples and CFA (RMSEA=0.06, CFI=0.92, TLI=0.90,and SRMR=0.06) in the total sample indicated the construct validity of the refined Student-SERM, including family, peer, culture, growth, and USS subscales. The reliability and convergent/divergent validity were also reconfirmed. The Student-SERM incorporates ecological resources, accounting for the students'resilience. Since the resilience process involves a return to healthy functioning after adversity, further research can examine the application of Student-SERM in high-risk student populations. 10.34172/hpp.2020.34
    Relationship Between Resilience and Self-Rated Health in Dental Hygiene Students and Registered Dental Hygienists. Isobe Ayaka,Izumi Maya,Akifusa Sumio Journal of dental education The aim of this study was to investigate whether two aspects of resilience-acquired and innate resilience-were related to self-rated health status in registered dental hygienists and students. In May through July 2017, 405 students at three dental hygiene programs and 85 registered dental hygienists, all in Fukuoka prefecture in Japan, were invited to participate in a survey including three scales: the Bidimensional Resilience Scale (BRS) to assess innate and acquired resilience, the Stress Response Scale-18 (SRS-18) to assess daily stress responses, and the Sense of Coherence 13-item scale (SOC-13) to assess the sense of coherence. Information about self-rated health status and number of years of clinical experience was also collected. Respondents were 398 students (98.2% response rate) and all 85 dental hygienists (100% response rate). The cohort with a self-rated "healthy" status scored higher on total scale and each domain of the BRS, SRS-18, and SOC-13 scales than the cohort with other self-rated health statuses. These three scales and self-rated health status were significantly correlated with each other. When innate resilience increased by one point, average self-rated health was 1.14-fold higher. In contrast, when the depression/anxiety domain score of SRS-18 increased by one point, self-rated health was 0.84-fold lower. The number of years of clinical experience was also negatively correlated with self-rated health. For these participants, innate resilience was a significant predictor of better self-rated health. To maintain the health of dental hygienists and students, it is important to understand their innate resilience as well as stress responses related to depression/anxiety factors and length of clinical experience. 10.21815/JDE.018.142
    Mediating Role of Resilience on Nursing Faculty and Student QoL during COVID-19. Antill Keener Tina,Wang Kesheng,Hall Katherine,Hulsey Tara,Piamjariyakul Ubolrat Western journal of nursing research COVID-19 greatly impacted nursing education and required nursing faculty and students to quickly adapt to changes caused by disease mitigation. The purpose of this study was to examine the mediating effects of resilience between the influence of demographics and school-related risk factors and nursing faculty and student quality of life (QoL) during the COVID-19 pandemic. A secondary data analysis was conducted using structural equation modeling to examine the mediating role of resilience on latent variables. Resilience had a positive, direct effect on nursing faculty and student QoL. Having a designated home workspace and being well-prepared for online learning had positive, indirect effects on QoL, mediated through resilience. Assisting children with schoolwork had a negative impact on the psychological and environmental QoL domains. Remarkably, having a caregiver role positively influenced the psychological QoL domain. Supporting and promoting faculty and nursing students' health and well-being is imperative during and after the pandemic. 10.1177/01939459211024646
    Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model. Mcdermott Ryon C,Fruh Sharon M,Williams Susan,Hauff Caitlyn,Graves Rebecca J,Melnyk Bernadette M,Hall Heather R Journal of advanced nursing AIM:Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being. DESIGN:A correlational, cross-sectional design was employed. METHOD:Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress. RESULTS:Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate. CONCLUSION:Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate. IMPACT:Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school. 10.1111/jan.14531
    Resilience and sense of coherence in first year medical students - a cross-sectional study. Luibl Lena,Traversari Julia,Paulsen Friedrich,Scholz Michael,Burger Pascal BMC medical education BACKGROUND:A broad range of studies show that medical students often have a significantly deteriorated mental health status. Although starting medical school with values comparable to the population average, only a few semesters later, medical undergraduates show increased rates of psychological risk states and some manifest mental illnesses, such as burnout and depression. In our survey we intentionally assessed mental health parameters from a salutogenetic, i.e. resource-oriented point of view. METHODS:We examined first-year medical students in a cross-sectional study and assessed sense of coherence (SOC) and resilience as parameters from the salutogenesis model by Antonovsky in a structured way using validated, self-administered questionnaires. In total, we examined 236 students of human medicine, dentistry and molecular medicine at the Friedrich-Alexander-University Erlangen-Nürnberg (FAU). RESULTS:Our analyses showed significantly higher values of resilience among male students compared to female students (p < 0.01). In contrast, even though a significant correlation between resilience and SOC was observed, only a non-significantly lower value of SOC was found in female students. Compared to the reference sample our medical students in their first year of study showed significantly lower values for resilience (p < 0.01) and SOC (p < 0.01). CONCLUSION:Resilience and SOC are known to correlate with psychological stress (burnout parameters) and depression. In order to keep protective factors like SOC and resilience in medical students at a good and healthy level we see the necessity to address that problem proactively and educationally. Integrating training focused on the preservation of the students´ own mental health into the medical curriculum from the beginning of university courses, and throughout the whole medical study course, is essential and should be an obligatory training goal. Based on our study results, we also deem it necessary to think about ways to adapt the measures for the gender-specific needs of our students, e.g. dependent on their biological gender. 10.1186/s12909-021-02571-5
    Resilience as a mediator of interpersonal relationships and depressive symptoms amongst 10th to 12th grade students. Lee Tony Szu-Hsien,Wu Ying-Jhen,Chao En,Chang Chun-Wei,Hwang Kwei-Shuai,Wu Wen-Chi Journal of affective disorders BACKGROUND:The aim of this study was to explore the associations among interpersonal relationships, resilience and depressive symptoms, and to examine if resilience is a mediator between interpersonal relationships and depressive symptoms in senior high school students. METHODS:Of 463 randomly selected participants from among 3,900 high school students, 450 (97.19%) consented to and completed a structured 4-part questionnaire consisting of demographic items, Inventory of Adolescent Resilience, Taiwan Relationship Inventory for Children and Adolescents, and Center for Epidemiologic Studies Depression Scale for Children. The associations between interpersonal relations and resilience and their associations with depressive symptoms were analyzed using MPlus 8.0 software for structural equation modeling. RESULTS:Results from structural equation modeling indicate that resilience and interpersonal relationships were negatively associated with students' depressive symptoms, and resilience partially mediated the associations between interpersonal relationships and depressive symptoms after controlling for demographics. CONCLUSION:Findings support that resilience and better interpersonal relationships are protective factors against depressive symptoms in adolescents. The positive association between the two protectors implies that interpersonal relationships might increase resilience and then alleviate depression amongst adolescents. 10.1016/j.jad.2020.09.033
    Factors Affecting Resilience of Nursing, Optometry, Radiography and Medical Laboratory Science Students. Ching Shirley Siu Yin,Cheung Kin International journal of environmental research and public health BACKGROUND:The concern over the high level of stress experienced by students of the caring professions has led to increased attention being paid to the promotion of their resilience. Most earlier studies have focused on the resilience of medical and nursing students. There has been little exploration of the resilience and associated factors of students of other health-care disciplines. The aim of this study was to gather data from students of pre-registration health-care disciplines to identify the factors that influence their resilience. METHOD:Valid questionnaires were used to assess respondents' resilience, self-efficacy, mindfulness, coping and trait positive and negative affect. The data were analyzed using descriptive statistics and univariate and general linear regression. RESULTS:A total of 1320 university students from nursing, medical laboratory science, radiography and optometry were recruited. The results showed that the subjects' resilience scores were lower than those of students in Western countries. We found self-efficacy and denial to be the common predictors for students of all disciplines. CONCLUSION:The resilience of students in the four disciplines was predicted by a combination of predictors. Faculties of universities and clinical mentors should collaborate in building resilience in their health-care students and support them to grow both personally and professionally during their careers. 10.3390/ijerph18083867
    Undergraduate nursing students' resilience, challenges, and supports during corona virus pandemic. Hamadeh Kerbage Samira,Garvey Loretta,Willetts Georgina,Olasoji Michael International journal of mental health nursing 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. 10.1111/inm.12896
    Resilience, stress and burnout in student midwives. Eaves Jane L,Payne Nicola Nurse education today BACKGROUND:There is a lack of research on resilience in midwifery, yet this may be a factor that can help prevent burnout and intention to leave the profession. OBJECTIVES:To explore the relationship between perceived stress, resilience and burnout and the intention to leave midwifery within Midwifery students. DESIGN:A Quantitative study with a cross-sectional survey design. SETTING:A London University in the UK. PARTICIPANTS:150 BSc student midwives, aged between 18 and 44, studying at University participated in this study. This included 72 students in year one, 26 in year two and 52 in year three. METHODS:Participants completed the Perceived Stress Scale, the Oldenburg Burnout Inventory and the Resilience Scale-14 to examine their self-reported stress levels, burnout (emotional exhaustion and disengagement) and level of resilience. Intentions to quit the profession were also measured. RESULTS:All variables were significantly correlated but in multiple regression analyses only stress predicted disengagement, and stress and year of study predicted emotional exhaustion. High stress and reduced resilience predicted intentions to quit midwifery. Resilience did not act as a moderator. Thus the findings suggest that resilience did not protect students from high levels of stress leading to burnout or wanting to quit, although resilience did help to reduce intentions to quit. CONCLUSION:Student stress levels are not moderated by resilience and resilience played no role in reducing burnout. However, resilience may help students to persevere in the profession rather than leaving their studies. In order to minimise burnout and stress we need to consider alternative ways of enhancing the current workforce to reduce the decline in midwives entering the profession. 10.1016/j.nedt.2019.05.012
    Predicting self-compassion in UK nursing students: Relationships with resilience, engagement, motivation, and mental wellbeing. Kotera Yasuhiro,Cockerill Vicky,Chircop James,Kaluzeviciute Greta,Dyson Sue Nurse education in practice Self-compassion, being kind towards oneself, has been identified as a key protective factor of mental health. This is consistent with students' experiences in the study of nursing, which attracts many students in the United Kingdom. Despite the importance of self-compassion, knowledge in how to enhance self-compassion is under-researched: approaches commonly entail meditative exercises. To suggest alternative approaches, relationships between self-compassion and more established constructs need to be appraised. Accordingly, this study evaluated predictors of self-compassion, examining its relationships with more established constructs examined in other healthcare student populations: resilience, engagement, motivation and mental well-being. An opportunity sample of 182 UK nursing students at a university in East Midlands completed self-report measures about these constructs. Correlation and regression analyses were conducted. Self-compassion was positively related to resilience, engagement, intrinsic motivation and mental well-being, while negatively related to amotivation. Resilience and mental well-being were identified as significant predictors of self-compassion. As resilience and mental well-being are relatively familiar to many nursing lecturers and students, educators can incorporate a self-compassion component into the existing resilience training and/or mental well-being practices. 10.1016/j.nepr.2021.102989
    Physical Activity and Resilience among College Students: The Mediating Effects of Basic Psychological Needs. Xu Shanshan,Liu Zongyu,Tian Siyu,Ma Zhiyao,Jia Cunxian,Sun Guoxiao International journal of environmental research and public health Considering the significance of resilience in coping with adversity, how to improve college students' resilience is worthy of attention. Previous studies have revealed that physical activity can promote resilience; however, few studies examined the mediating factors between them. The purpose of this study was to investigate the effect of physical activity on resilience, as well as the mediating effects of competence need, autonomy need, and relatedness need between physical activity and resilience. The study involved 2375 college students (1110 males and 1265 females), with an average age of 20.25 years ( = 2.04). Participants completed the International Physical Activity Questionnaire Short Form, Basic Needs Satisfaction in General Scale, and Connor-Davidson Resilience Scale. Results showed that physical activity was positively associated with resilience, and the three basic needs played significant mediating roles between physical activity and resilience. The indirect effect of competence need was significantly greater than that of autonomy need and relatedness need. To conclude, physical activity plays an important role in resilience among college students, and the satisfaction of competence, autonomy, and relatedness needs mediates the relationship between physical activity and resilience, among which, competence need appears as the strongest mediator. 10.3390/ijerph18073722
    Resilience enhancement among student nurses during clinical practices: A participatory action research study. Liang Hwey-Fang,Wu Kuang-Ming,Hung Chang-Chiao,Wang Ying-Hsiang,Peng Niang-Huei Nurse education today BACKGROUND:Clinical practice is an essential component of nursing students' preparation for applying theoretical knowledge in a real-life setting. However, students often experience clinical practice as extremely stressful, which may disrupt their clinical performance, impact the quality of patient care they provide as well as their own physical and psychological health, and hinder their continuation into nursing careers. Resilience, understood as the capability to overcome challenges, is critical for these students. PURPOSE:To develop and implement a resilience enhancement (RE)-based project for Taiwanese nursing students during their Last Mile practicum. DESIGN AND METHODS:A participatory action research (PAR) approach was used in which ongoing planning, action, and reflection informed real-time progress. Twenty-eight nursing students in clinical practice participated in the study. A six-workshop RE project was completed over the course of two months. Evaluation methods involved group discussion, individual interviews, and reflective diaries. Content analysis was applied to the data. RESULTS:Through a PAR-based project, participants achieved positive results. Three outcome themes were identified: Increasing self-exploration, Furthering confidence and competency, and Constructing resilience. CONCLUSIONS:The PAR-based RE project helped students to develop resilience by enhancing their nursing knowledge and skills and practicing positive thinking and behavior. CLINICAL RELEVANCE:The findings can be a reference for nursing educators in designing RE programs for students during clinical practice to increase their professional competence and provide psychological supports. 10.1016/j.nedt.2019.01.004
    Learning and teaching approaches promoting resilience in student nurses: An integrated review of the literature. Walsh Pauline,Owen Patricia A,Mustafa Nageen,Beech Roger Nurse education in practice Undergraduate nursing students face challenges that can result in stress leading to impaired performance, physical illness, high turnover and sickness absence (Kinman and Jones 2001). Students therefore require skills and knowledge to help them cope with the challenges of learning professional practice. This paper explores the concept of resilience, with an emphasis on how educational programmes can foster resilient practices among student nurses. Educators can facilitate resilience by incorporating resilience teaching and training that includes, the core concepts of resilience: self-efficacy, reflective ability and self-confidence. Critical appraisal and synthesis of the literature resulted in the identification of three themes: attributes, programmes and transition. The following five key learning and teaching methods were identified as supporting the development of resilience: peer activities; reflective practice; directed study; problem based learning/enquiry based learning and experiential learning Having resilience and resilient qualities is an integral part of nursing, having a positive impact upon the health and well-being of the nurse as practitioner. Resilient qualities and behaviours can be developed through the facilitation of appropriate learning and teaching interventions. 10.1016/j.nepr.2020.102748
    Efficacy of a self-applied online program to promote resilience and coping skills in university students in four Spanish-speaking countries: study protocol for a randomized controlled trial. Palma-Gómez Araceli,Herrero Rocío,Baños Rosa,García-Palacios Azucena,Castañeiras Claudia,Fernandez Gabriela Lidia,Llull Dario Martín,Torres Lorena Cudris,Barranco Libia Alvis,Cárdenas-Gómez Leonardo,Botella Cristina BMC psychiatry BACKGROUND:There is evidence of a high prevalence of depression and anxiety in university students. Therefore, college time is a key period where prevention of mental disorders through interventions that promote resilience and mental health can be relevant. Currently, there are interventions available, but these are insufficient for those who need them. Online interventions are tools that can facilitate global accessibility and are easy for young people to use. CORE (Cultivating Our Resilience) is a self-administered online program, based on Ryff's psychological well-being model, to promote resilience and coping skills in university students at risk of developing symptoms of depression or anxiety. The objective is to evaluate the effectiveness of this intervention protocol in comparison with an active control condition targeting healthy lifestyle, and a waiting list control condition. The study will be conducted in four populations of Spanish-speaking university students (Spain, Argentina, Colombia, and Mexico). METHODS:The study design is a randomized controlled trial (RCT). At least 324 university students will be randomly assigned to three conditions: 1) CORE, a 6-week training program to improve resilience; 2) HLP, a 6-week training to promote a healthy lifestyle; and 3) WL, waiting list control condition. The primary outcome measure will be the Connor-Davidson resilience scale. Additionally, measures of anxiety, depression, quality of life and socio-demographic variables (age, sex, incomes, marital status, among others) will be collected. Participants will be evaluated at pre-treatment, after each module, 6 weeks after allocation, and at 3-month follow-up. Intention-to-treat and per-protocol analyses will be performed. DISCUSSION:The results of this study will contribute to research on Internet-administered interventions and the implementation of a protocol that includes a series of components designed to improve resilience and coping skills, increase psychological well-being, and prevent depression and anxiety disorders in Spanish-speaking university students. In addition, avenues will be opened up for new research on the effectiveness of these interventions focused on the prevention and promotion of mental health in Spanish-speaking countries. TRIAL REGISTRATION:Registered at ClinicalTrials.gov NCT03903978 on April 2, 2019. 10.1186/s12888-020-02536-w
    The relationship between stress, resilience, and quality of life in Chinese high school students. Sun Yueyi,Pan Wei,Zhang Yi,Xu Guangxing,Xi Juzhe,Bao Qingfang,Bian Xiaohua Annals of palliative medicine BACKGROUND:Stress is an important factor affecting the dynamic process of resilience. This study aimed to explore the role of stress levels in the relationship between resilience and health consequences by investigating high school students undergoing the National College Entrance Examination (CEE), which often involves intense stressful conditions for students in China, at different stages. METHODS:The CD-RISC [Conner-Davidson Resiliency Scale] and SF-36 [the short form 36 health survey questionnaire, one measurement of the quality of life (QoL)] were used to investigate 435 high school students, including 208 students in grade two (low stress group) and 227 students in grade three (high stress group). RESULTS:This study found that the SF-36 scores under high-stress conditions were significantly lower than those under low-stress conditions, however there were no significant differences in the mental resilience scores. Additionally, under low-stress conditions, mental resilience was found to be significantly correlated with various factors of SF-36, but no significant correlation was observed under high-stress conditions. It was also discovered that stress levels can mediate the relationship between psychological resilience and QoL (the quality of life). CONCLUSIONS:Stress level is an important factor affecting the expression of resilience. This study also discussed the integration of the concept of resilience. 10.21037/apm-21-929
    Resilience as a mediator in the relationship between stress-associated with the Covid-19 pandemic, life satisfaction, and psychological well-being in student nurses: A cross-sectional study. Labrague Leodoro J Nurse education in practice AIM:This study examined the direct and indirect effects of stress associated with the pandemic on student nurses' life satisfaction and psychological well-being through the intermediary role of resilience. BACKGROUND:The coronavirus disease 2019 (COVID-19) outbreak has brought additional stress to those in nursing programs, who were already under high pressure. This has resulted in increased mental and psychological issues in student nurses. The role of resilience as a mediator reducing the effects of pandemic-associated stress on student nurses' outcomes remains unexplored. DESIGN:Cross-sectional study. METHODS:This was an online survey that used four standardized scales and was completed by 301 student nurses in the Philippines. The data were collected from September 2020 to October 2020. RESULTS:Filipino student nurses experienced stress associated with the pandemic at a high level; however, their resilience, life satisfaction and psychological well-being were found to be moderate to high. Increased pandemic-associated stress was associated with reduced life satisfaction and poorer psychological well-being. Further, resilience was found to reduce the negative effects of pandemic-associated stress on the life satisfaction and psychological well-being of student nurses. CONCLUSIONS:This study highlights the importance of building resilience in student nurses during the coronavirus pandemic to sustain their mental and psychological well-being and improve their life satisfaction. 10.1016/j.nepr.2021.103182
    The influence of interpersonal relationships on school adaptation among Chinese university students during COVID-19 control period: Multiple mediating roles of social support and resilience. Zhang Xing,Huang Peng-Fei,Li Bi-Qin,Xu Wen-Jian,Li Wen,Zhou Bin Journal of affective disorders BACKGROUND:Owing to the government's effective epidemic control measures, universities in some areas of China gradually resumed offline teaching six months after the COVID-19 outbreak. Although attention should now be paid to the experiences of students after they returned to campus, few studies have explored the factors and mechanisms that have influenced these students' school adaptation. The present study investigated the multiple roles of social support and resilience in mediating associations the relationship between Chinese university students' interpersonal relationships and their school adaptation during COVID-19 control period. METHODS:A cross-sectional survey was conducted with 4534 Chinese university students (Mage = 19.70, SD = 1.14) at two universities in Jiangxi provinces. The independent variable was interpersonal relationships; mediating variables were social support and resilience; and the dependent variable was school adaptation. Multiple mediation analysis was performed using the MPlus software. RESULTS:Controlling for demographic variables, the quality of students' interpersonal relationships was significantly and positively related to their school adaptation, with students' ratings of social support and resilience mediating these associations. More interestingly, social support and resilience played multiple mediating roles in the relationship between interpersonal relationships and school adaptation. LIMITATIONS:The age stage of the sample and the methods in which the data were collected may affect the generalizability of the results. CONCLUSIONS:During COVID-19 control period, interpersonal relationships can influence school adaptation either directly or indirectly by enhancing social support or resilience (parallel mediation) or by activating resilience via the experience of social support (serial mediation). This study's results emphasize the role of interpersonal relationships, as well as the contributions of positive external and internal factors on students' school adaptation during the epidemic control period. Accordingly, these findings may have implications for the mental health education of college students in the post-epidemic era. 10.1016/j.jad.2021.02.040
    Bounce back- bounce forward: Midwifery students experience of resilience. Clohessy Nicole,McKellar Lois,Fleet Julie Nurse education in practice Resilience is considered a vital characteristic and has gained attention in midwifery practice and education. In particular, midwifery students face challenges during their education in both academic and clinical components of the program. There is need for greater understanding and strategies to develop resilience in the midwifery student population. The aim of this study is to gain insight into how midwifery students conceptualise resilience, and explore how education might support the development of resilience. A focus group was conducted as part of a broader study underpinned by a concept analysis methodology to explore the students understanding of resilience. Participants included six third year midwifery students from one university. Thematic analysis was used to analyse the data. Four key themes were identified. Resilience contextualised to midwifery was triggered by exposure to adversity; resilience was identified as the ability to bounce back and move forward, and was seen to be important for midwifery students. The concept of resilience appears to play an important role in student success. Evidence suggests resilience can be developed and education providers have a role to foster student's resilience. Findings offer strategies to strengthen resilient behaviour for the midwifery student population and provide a basis for further research. 10.1016/j.nepr.2019.04.011
    Psychological resilience and positive coping styles among Chinese undergraduate students: a cross-sectional study. Wu Yu,Yu Wenzhou,Wu Xiuyun,Wan Huihui,Wang Ying,Lu Guohua BMC psychology BACKGROUND:Psychological resilience and coping strategies have been found to be related to various psychological and mental health problems. Evaluations of the relationship between resilience and coping style among university students are important for developing effective health promotion strategies focused on resilience intervention to benefit students' health and well-being. The relationship between psychological resilience and coping styles has usually been examined among adults and patients. Very few studies have investigated the relationship between resilience and coping style in university students. The present study aimed to investigate the associations between psychological resilience, students' characteristics (gender, major and grade) and coping styles among undergraduate students. METHODS:A cross-sectional survey was conducted among undergraduate students in Shandong Province, China. Undergraduate students were randomly selected from 6 universities in 3 cities of the province using a stratified random sampling method. The questionnaire included questions on the participants' demographic information, including gender, grade and major, measures of psychological resilience and coping style. Coping style was measured by the Simplified Coping Style Questionnaire (SCSQ). The Asian Resilience Scale (ARS) was applied to evaluate undergraduates' psychological resilience. Multivariable regression analysis was used to examine the relationships between resilience, students' characteristics and positive coping styles. RESULTS:A sample of 1743 undergraduates was analysed. The mean psychological resilience score was 70.41. The mean score for positive coping style was 24.72. Multiple regression analysis showed that three factors of psychological resilience, mood control, self-plasticity and coping flexibility, were all significant factors for positive coping styles (regression coefficient = 0.34, 0.35, 0.14, p < 0.01 for the three factors, respectively). Medical students and females had higher scores for positive coping styles than non-medical students and males (p < 0.01). CONCLUSIONS:The research revealed that females and medical students are more likely than males and non-medical students to adopt positive coping styles. Higher psychological resilience is associated with a better positive coping style. The findings suggest that psychological education and health promotion programmes that target strengthening psychological resilience among undergraduate students may help foster positive coping styles to benefit their mental health and psychological well-being. 10.1186/s40359-020-00444-y
    A Curriculum to Teach Resilience Skills to Medical Students During Clinical Training. Bird Amber,Tomescu Oana,Oyola Sonia,Houpy Jennifer,Anderson Irsk,Pincavage Amber MedEdPORTAL : the journal of teaching and learning resources Introduction:Burnout in medical students is extensive and a critical issue. It is associated with increased rates of depression, suicide, and poor perception of the educational environment. Enhancing resilience, the ability to adapt well in the face of adversity, is a potential tool to mitigate burnout and improve medical student wellness. Methods:Our resilience curriculum consisted of facilitated workshops to cultivate resilience in medical students during their core clerkship rotations. This curriculum served as an introduction to the concept of resilience and taught skills to cultivate resilience and promote wellness. The sessions allowed for identification of and reflection on stressors in the clinical learning environment, including straining team dynamics, disappointment, and uncertainty. Educational sessions included resilience skill-building exercises for managing expectations, letting go of negative emotions, dealing with setbacks, and finding meaning in daily work. Associated materials included lesson plans for small-group facilitators, learner pre- and postcurriculum surveys, and a social media activity guide. Results:This curriculum was delivered to 144 clerkship students at two academic institutions over the 2017-2018 academic year. Sessions were well received by medical students, with the majority of students stating that the sessions should continue. The majority of attendees found the sessions valuable and learned new ways to approach challenges. Discussion:Students valued connecting with peers and feeling less alone through their participation. A challenge was constructing a setting conducive to comfortable reflection for all learners. Not all students found these sessions necessary. Sessions may have improved resilience levels. 10.15766/mep_2374-8265.10975
    Resilience and Psychological Distress in Psychology and Medical Students. Bacchi Stephen,Licinio Julio Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry OBJECTIVE:The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. METHODS:A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. RESULTS:Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p < 0.001). Students supported resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. CONCLUSIONS:Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups. 10.1007/s40596-016-0488-0
    An analysis of resilience in dental students using the Resilience Scale for Adults. Smith Carlos S,Carrico Caroline K,Goolsby Susie,Hampton Alena C Journal of dental education OBJECTIVES:Resilience is the ability to bounce back or recover from major life stressors. The aim of this study was to investigate resilience in dental students and how it may or may not vary across demographic characteristics such as gender, socioeconomic status, race/ethnicity, self-reported health, and parental educational level. METHODS:Data were collected from 151 dental students at Virginia Commonwealth University School of Dentistry with an anonymous survey that included the Resilience Scale for Adults (RSA) and various demographic variables. Associations between RSA and variables of interest were assessed using linear models. RESULTS:Dental students demonstrated relatively high levels of resilience. Resilience was significantly associated with gender (with females showing more resilience than males (P = 0.0395)), race (P = 0.0025), overall health (P = 0.0101), and mental health (P < 0.0001). Results from Exploratory Factor Analysis (EFA) supported a 5-factor solution that explained 82.6% of the variability of resilience in the sample of dental students. The 5 factors were nearly identical to the 5 subscales originally described by the RSA demonstrating validity in this population. Overall health ratings were significantly related to resilience, suggesting that perceived resilience in dental students may protect against negative health outcomes. This study can inform internal and external support systems of dental students as well as institutional programmatic development to better support their educational experiences. 10.1002/jdd.12041
    Medical student resilience and stressful clinical events during clinical training. Houpy Jennifer C,Lee Wei Wei,Woodruff James N,Pincavage Amber T Medical education online BACKGROUND:Medical students face numerous stressors during their clinical years, including difficult clinical events. Fostering resilience is a promising way to mitigate negative effects of stressors, prevent burnout, and help students thrive after difficult experiences. However, little is known about medical student resilience. OBJECTIVE:To characterize medical student resilience and responses to difficult clinical events during clinical training. DESIGN:Sixty-two third-year (MS3) and 55 fourth-year (MS4) University of Chicago medical students completed surveys in 2016 assessing resilience (Connor Davidson Resilience Scale, CD-RISC 10), symptoms of burnout, need for resilience training, and responses to difficult clinical events. RESULTS:Medical student mean resilience was lower than in a general population sample. Resilience was higher in males, MS4s, those without burnout symptoms, and students who felt able to cope with difficult clinical events. When students experienced difficult events in the clinical setting, the majority identified poor team dynamics among the most stressful, and agreed their wellbeing was affected by difficult clinical events. A majority also would prefer to discuss these events with their team later that day. Students discussed events with peers more than with attendings or residents. Students comfortable discussing stress and burnout with peers had higher resilience. Most students believed resilience training would be helpful and most beneficial during MS3 year. CONCLUSIONS:Clinical medical student resilience was lower than in the general population but higher in MS4s and students reporting no burnout. Students had some insight into their resilience and most thought resilience training would be helpful. Students discussed difficult clinical events most often with peers. More curricula promoting medical student resilience are needed. 10.1080/10872981.2017.1320187
    Characteristics of Veterinary Students: Perfectionism, Personality Factors, and Resilience. Holden Chelsey L Journal of veterinary medical education Perfectionism is a topic relevant to veterinary medicine and has previously been found to be related to higher levels of stress and poorer mental health outcomes. However, many aspects of perfectionism have yet to be researched among veterinary students. This research investigates the relationship between perfectionism and the "Big Five" personality factors. Additionally, the relationship between resilience and neuroticism is addressed. This research includes a sample of 99 veterinary students enrolled at a College of Veterinary Medicine in the southeastern United States. Students completed the Multidimensional Perfectionism Inventory (MPI), the Big Five Inventory (BFI), and the Brief Resilience Scale (BRS). Results show that perfectionism is significantly correlated with personality factors; specifically, self-oriented perfectionism and socially prescribed perfectionism are associated with neuroticism, socially prescribed perfectionism is associated with agreeableness, and self-oriented perfectionism is associated with conscientiousness. Neuroticism was found to have a significant negative correlation with resilience. Findings indicate that veterinary mental health professionals and educators should consider implementing specific strategies to help students develop a healthy balance in their perfectionistic beliefs and have targeted interventions to promote student resilience. 10.3138/jvme.0918-111r
    Examining nursing students' wellness and resilience: An exploratory study. Spurr Shelley,Walker Keith,Squires Vicki,Redl Nicole Nurse education in practice Undergraduate nursing students report high levels of stress which can negatively impact their overall wellness, and their academic and clinical performance. Despite this knowledge, there are few studies that have examined the well-being of nursing students and their ability to demonstrate resilience. Therefore, the purpose of this exploratory study was to examine resilience and wellness, together with the key factors that promote a well-being in nursing students from mid-western Canadian university. The sample of 196 undergraduate nursing students completed an online Nursing Well-being and Resilience Survey. Findings indicated that most nursing students had good health; however, many presented with anxiety and/or depression and a decreased sense of wellness in the physical, spiritual, and emotional domain. Other significant findings included participants >26 years old having lower burnout scores, higher ego-resilience and well-being scores compared to students ages 20 to 25; and, 2) there were differences between campus locations in terms of Professional Quality of life (compassion satisfaction, burnout, and traumatic stress) and sense of well-being. Understanding how resilience and wellness are influenced throughout the nursing program is a first step in developing targeted wellness initiatives for different nursing student populations. 10.1016/j.nepr.2021.102978
    Mediating effect of resilience on association among stress, depression, and anxiety in Indonesian nursing students. Devi Hilda Mazarina,Purborini Nurul,Chang Hsiu-Ju Journal of professional nursing : official journal of the American Association of Colleges of Nursing BACKGROUND:Studies on beneficial effects of resilience among nursing students are scarce, particularly in the context of Indonesian cultural characteristics and family socioeconomic status. Consequently, whether resilience affects the associations between clinical practice-related stress and mental health problems remains unknown. PURPOSE:We aimed to reveal whether resilience mediates the associations among stress, depression, and anxiety. METHODS:In this study, 336 nursing students were recruited and completed the Connor-Davidson Resilience Scale and the Depression, Anxiety, and Stress questionnaires. Students' economic status was assessed using the Self-Reported Questionnaire Family Socioeconomic Status. Data were collected in mid-2016 and analyzed using Pearson's correlation, independent t-test, one-way ANOVA, and simple linear regression with a mediation test. RESULTS:Results demonstrated that resilience had a partial mediating effect on depression (B = 0.044) and anxiety (B = 0.017) after controlling for student age, living situation, and living allowance. These results indicated that resilience affects stress, depression, and anxiety. CONCLUSION:Resilience is thus a crucial mediator of the relationship of clinical practice-related stress with depression and anxiety in nursing students. A well-balanced relationship between academic demands, private life, and financial support can counteract the influence of depression and anxiety in this population. 10.1016/j.profnurs.2021.04.004
    The mediating effect of resilience on the relationship between the academic burnout and psychological well-being of medical students. Yu Jihye,Chae Sujin Korean journal of medical education PURPOSE:This study aimed to examine the medicating effect of resilience on the relationship between academic burnout and psychological well-being of medical students. METHODS:The participants were a group of 97 medical students. Scales measuring Maslach Burnout Inventory-Student Survey, Ryff's Psychological Well-Being, and Korean Resilience Quotient-53 were utilized. The data were analyzed by descriptive statistics, correlation analysis, t-test, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA). RESULTS:According to the study results, the medical students' psychological well-being was negatively correlated with their academic burnout and positively correlated with their resilience; the degree of academic burnout experienced by the first and second year preclinical students was greater than that experienced by the third and fourth year clinical students; the male students' average score for cynicism was higher than that of the female students; and the significant effects of academic burnout on the medical students' psychological well-being were mediated by resilience. CONCLUSION:It was confirmed that medical students' academic burnout and resilience are significant factors that explain their psychological well-being; resilience is also an important variable in improving psychological well-being. This suggests that education and counseling support are needed to increase medical students' resilience in order to increase their psychological well-being. 10.3946/kjme.2020.149
    Coping Styles for Mediating the Effect of Resilience on Depression Among Medical Students in Web-Based Classes During the COVID-19 Pandemic: Cross-sectional Questionnaire Study. Zhao Lina,Sznajder Kristin,Cheng Dan,Wang Shimeng,Cui Can,Yang Xiaoshi Journal of medical Internet research BACKGROUND:Due to strict, nationwide, comprehensive COVID-19 protective measures, including home quarantine, all Chinese medical students began taking web-based classes beginning in the spring semester of 2020. Home quarantine, web-based classes, and the stress surrounding the COVID-19 pandemic may have triggered an increased incidence of mental health problems among medical students. Although there have been increasing amounts of literature on depression among medical students, studies focusing on positive psychological resources, such as resilience during the COVID-19 pandemic, still need to be expanded. OBJECTIVE:This study aims to assess depression among medical students who are taking web-based classes during the COVID-19 pandemic and to investigate the role of coping styles as mediators between resilience and depression. METHODS:A cross-sectional study of 666 medical students involving stratified sampling in Shenyang, Liaoning Province, China, was completed between March 20 and April 10, 2020. The participants responded to a self-administered, smartphone-based questionnaire, which included the Patient Health Questionnaire-9, Simplified Coping Style Questionnaire, and Ego Resilience 89 Scale. Hierarchical linear regression and structural equation modeling were used in this study. RESULTS:The prevalence of depression among the participants was 9.6% (64/666) in this study. The regression analysis revealed that grade (the year in which the medical student was in training) (P=.013), how well students adapted to web-based classes (P<.001), their levels of resilience (P=.04), and their coping styles were independent predictors for depression (P<.001). Resilience and positive coping styles were negatively related to depression (resilience: P=.04; positive coping styles: P<.001), and negative coping styles were positively related to depression (P<.001). The structural equation modeling analysis showed that the effect of resilience on depression was partially mediated by coping styles (P=.007). CONCLUSIONS:In this study, it was found that the prevalence of depression was slightly low and coping styles mediated the association between resilience and depression among medical students during the COVID-19 pandemic. These findings have significant implications for future studies. Future studies and interventions should aim to improve resilience and promote positive coping styles. 10.2196/25259
    Assessing the Mental Health, Physical Activity Levels, and Resilience of Today's Junior College Students in Self-Financing Institutions. Chow Susan Ka Yee,Choi Edward Kwok Yiu International journal of environmental research and public health In recent decades, the number of adolescents and young adults with poor mental health has been increasing, particularly among students in tertiary institutions. This study investigates the physical activities, resilience, and mental health status of junior college students in Hong Kong. The questionnaire consisted of demographic characteristics, the Positive Mental Health Scale, the Brief Resilience Scale, and the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Four hundred and sixteen students participated in the study. The results showed a moderate positive correlation ( = 0.485) between resilience and mental health, and a low positive correlation ( = 0.258) between resilience and physical activity. The one-way analysis of variance (ANOVA) with a post hoc test showed that arts students engaged in more physical activity than students from other disciplines. A multiple regression analysis was used to examine the predictors of a positive mental health status. The significant predictors are: resilience (β = 0.704; 95% CI = 0.575-0.833; < 0.001), physical activity score (β = 0.032; 95% CI = 0.016-0.048; < 0.001), the male gender (β = 1.035, 95% CI = 0.171-1.900; < 0.05), and students' enrollment in a health science discipline (β = 1.052, 95% CI = 0.175-1.930; < 0.05). Preventive measures, such as strengthening resilience, a broad curriculum and taking note of the demographic and cognitive characteristics of students are essential for improving the mental health of freshmen in colleges. 10.3390/ijerph16173210
    Exploring the relationship between medical student basic psychological need satisfaction, resilience, and well-being: a quantitative study. Neufeld Adam,Malin Greg BMC medical education BACKGROUND:There is increasing acknowledgment that medical training is stressful for students and can impact their well-being. An important aspect of this is self-determination and basic psychological need satisfaction. A better understanding of how medical student perceptions of the learning environment impacts their basic psychological needs for motivation, resilience, and well-being may help to create learning environments that support the needs of medical students and help them become better healthier physicians. We aim to add to the literature on this topic by examining this relationship through the lens of Self-Determination Theory. METHODS:A total of 400 students from all 4 years of the medical program at our institution were invited to complete an anonymous online survey, measuring basic need satisfaction/frustration (autonomy, competence, relatedness) within the learning environment, resilience, and psychological well-being. We used analysis of variance to assess the effect of gender, age, and year on all variables, with t-tests to compare subgroups. Structural equation modelling was performed to test a hypothesized model in which support of medical students' basic needs would positively relate to their resilience and well-being. RESULTS:The response rate was 183/400 (46%). After data cleaning, 160 remained: 67 males (42%) and 93 females (58%). There were 67 first years (42%), 35 second years (22%), 30 third years (19%), and 28 fourth years (18%). The sample mean age was 25.8 years (SD = 4.1). A well-fitting model was confirmed to fit the data, χ = 3.15, df = 3, p = 0.369, RMSEA = 0.018, SRMR = 0.022, CFI = 0.999. Autonomy and relatedness satisfaction exerted direct effects on well-being. Competence satisfaction did so indirectly, through its direct effect on resilience. Female medical students had lower resilience scores compared to their male peers. CONCLUSIONS:When medical students perceived their learning environment as supportive to their basic needs, it was associated with an increase in their psychological well-being. Satisfaction of competence, but not autonomy or relatedness, predicted an increase in their resilience. Fostering medical students' basic needs for motivation, especially competence, is recommended to support their resilience and well-being. Further research is required to generalize these results further. 10.1186/s12909-019-1847-9
    The relationships between resilience and student personal factors in an undergraduate medical program. Findyartini Ardi,Greviana Nadia,Putera Azis Muhammad,Sutanto Reynardi Larope,Saki Vernonia Yora,Felaza Estivana BMC medical education BACKGROUND:Resilience is an essential aspect of wellbeing that plays a major role in undergraduate medical education. Various personal and social factors are known to affect resilience. Empirical evidence remains limited regarding resilience and the personal factors that affect it among undergraduate medical students in an Asian setting. Therefore, this study aims to identify undergraduate medical students' level of resilience and its relationships to personal factors in Indonesia. METHODS:This cross-sectional study was conducted among undergraduate medical students in years 1-6. Respondents were asked to complete three validated questionnaires: the Connor-Davidson Resilience Scale (CD-RISC) to measure resilience, the Brief-COPE to assess coping mechanisms, and the Big Five Personality Test to measure five personality dimensions. Descriptive and Pearson's correlation analyses were completed to explore relationships between each variable. Regression analysis was completed to analyze the extent to which coping mechanisms, personality, and academic achievement explained the variation in resilience scores. RESULTS:A total of 1040 respondents completed the questionnaires (a 75.42% response rate). Students in both preclinical and clinical stages had quite good levels of resilience and higher scores on adaptive coping mechanisms than on maladaptive coping mechanisms. Adaptive and maladaptive coping mechanisms, Big Five Personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), and students' academic achievement explained 46.9% of students' resilience scores. CONCLUSIONS:Although the resilience scores in this study were comparable to resilience scores among undergraduate medical students in other settings, we found that coping mechanisms, personality traits, and academic performance may predict resilience among medical students. 10.1186/s12909-021-02547-5
    Strengthening internal resources to promote resilience among prelicensure nursing students. Hughes Vickie,Cologer Sophia,Swoboda Sandy,Rushton Cynda Journal of professional nursing : official journal of the American Association of Colleges of Nursing Resilience is a complex construct that is not universally defined, but reflects the ability of a person, community, or system to positively adapt to adversity in a way that promotes growth and well-being. Developing resilient nurses is a promising strategy to reduce nurse burnout and improving retention. The purpose of this paper is to review selected literature, synthesize, and interpret the findings that point toward promising practices that educators can employ to support student resilience. Four prominent prelicensure nursing student internal protective factors associated with resilience and derived from the literature include self-efficacy, optimism, emotional intelligence, and self-stewardship/self-care. Interventions to promote nursing student resilience is not well developed, however, there are promising evidence to inform concepts and interventions to guide the development, skills, practices, and strategies for nurse educators. Educational strategies to enhance student nurse internal protective factors include reflection, positive reframing, problem-based learning, and mindfulness. Specific examples of each educational modality applied to prelicensure student nurse resilience are provided. Integrative strategies to support and cultivate internal protective factors to strengthen student resilience are paramount to nursing education and clinical nursing practice. 10.1016/j.profnurs.2021.05.008
    A pragmatic clinical trial examining the impact of a resilience program on college student mental health. Akeman Elisabeth,Kirlic Namik,Clausen Ashley N,Cosgrove Kelly T,McDermott Timothy J,Cromer Lisa D,Paulus Martin P,Yeh Hung-Wen,Aupperle Robin L Depression and anxiety BACKGROUND:One in three college students experience significant depression or anxiety interfering with daily functioning. Resilience programs that can be administered to all students offer an opportunity for addressing this public health problem. The current study objective was to assess the benefit of a brief, universal resilience program for first-year college students. METHOD:First-year students at a private, midwestern university participated. This trial used a pragmatic design, delivering the intervention within university-identified orientation courses and was not randomized. The four-session resilience program included goal-building, mindfulness, and resilience skills. The comparison was orientation-as-usual. Primary outcomes included PROMIS® Depression and Anxiety and Connor-Davidson Resilience Scale. Secondary and exploratory outcomes included the Perceived Stress Scale, Emotion Regulation, and Cognitive Behavioral Therapy (CBT) Skills Questionnaires, and Freiburg Mindfulness Inventory. Time by treatment interactions at post-training and semester-end were examined using linear mixed models. RESULTS:Analysis included 252 students, 126 who completed resilience programming and a matched comparison sample. Resilience programming did not relate to improvements in depression at post-training (CI: -2.53 to 1.02; p = .404, d =-0.08), but did at semester-end (95% CI: -4.27 to -0.72; p = .006, d = -0.25) and improvements in perceived stress were observed at post-training (CI: -3.31 to -0.44; p = .011, d = -0.24) and semester-end (CI: -3.30 to -0.41; p = .013, d = -0.24). Emotion regulation, mindfulness, and CBT skills increased, with CBT skills mediating clinical improvements. CONCLUSIONS:Universal implementation of a brief, resilience intervention may be effective for improving college student mental health. 10.1002/da.22969
    Strategies for enhancing medical student resilience: student and faculty member perspectives. Farquhar Julia,Kamei Robert,Vidyarthi Arpana International journal of medical education Objectives:To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. Methods:In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process. They then compared the themes to discern similarities and differences between these groups. Results:Themes from the student suggestions for increasing resilience included "Perspective changes with time and experience", "Defining effective advisors," and "Individual paths to resiliency". Faculty-identified themes were "Structured activities to change student perspectives," "Structured teaching of coping strategies", and "Institution-wide social support". Students described themselves as individuals building their own resilience path and preferred advisors who were not also evaluators. Faculty, however, suggested systematic, structural ways to increase resilience. Conclusions:Students and advisors identified some common, and many distinct strategies for enhancing medical student resilience. Student/advisor discrepancies may exemplify a cultural shift in Singapore's medical education climate, where students value increased individualism and autonomy in their education. As medical schools create interventions to enhance resilience and combat potential student burnout, they should consider individually-tailored as well as system-wide programs to best meet the needs of their students and faculty. 10.5116/ijme.5a46.1ccc
    Effective educator-student relationships in nursing education to strengthen nursing students' resilience. Froneman Kathleen,Du Plessis Emmerentia,Koen Magdelene P Curationis BACKGROUND:Little research has been conducted in private nursing schools with regard to the educator-student relationship to strengthen the resilience of nursing students and to improve the educator-student relationship. An effective educator-student relationship is a key factor to ensure a positive learning climate where learning can take place and resilience can be strengthened. PURPOSE:The purpose was to explore and describe nursing students' view on the basic elements required for an effective educator-student relationship to strengthen their resilience and the educator-student relationship. METHOD:This study followed an explorative, descriptive and contextual qualitative design in a private nursing education institution in the North West Province. Purposive sampling was used. The sample consisted of 40 enrolled nursing auxiliary students. The World Café Method was used to collect data, which were analysed by means of content analysis. RESULTS:The following five main themes were identified and included: (1) teaching-learning environment, (2) educator-student interaction, (3) educator qualities, (4) staying resilient and (5) strategies to strengthen resilience. CONCLUSION:Students need a caring and supportive environment; interaction that is constructive, acknowledges human rights and makes use of appropriate non-verbal communication. The educator must display qualities such as love and care, respect, responsibility, morality, patience, being open to new ideas, motivation, willingness to 'go the extra mile' and punctuality. Students reported on various ways how they manage to stay resilient. It thus seems that basic elements required in an effective educator-student relationship to strengthen the resilience of students include the environment, interaction, educator and student's qualities and resilience. 10.4102/curationis.v39i1.1595