quarta-feira, 16 de abril de 2014

Saúde mental

Dark thoughts: why mental illness is on the rise in academia

University staff battling anxiety, poor work-life balance and isolation aren't finding the support they need

Sad/depressed young woman
 Photograph: Alamy

Mental health problems are on the rise among UK academics amid the pressures of greater job insecurity, constant demand for results and an increasingly marketised higher education system.

University counselling staff and workplace health experts have seen a steady increase in numbers seeking help for mental health problems over the past decade, with research indicating nearly half of academics show symptoms of psychological distress.

"Culture of acceptance"

A recent blog on the Guardian Higher Education Network blog, which highlighted a "culture of acceptance" in universities around mental health issues, has received an unprecedented response, pointing to high levels of distress among academics.

The article, which reported instances of depression, sleep issues, eating disorders, alcoholism, self-harming, and even suicide attempts among PhD students, has been shared hundreds of thousands of times and elicited comments outlining similar personal experiences from students and academics.

But while anecdotal accounts multiply, mental health issues in academia are little-researched and hard data is thin on the ground.

However, a study published in 2013 by the University and College Union (UCU) used health and safety executive measures, assessed against a large sample of over 14,000 university employees, to reveal growing stress levels among academics prompted by heavy workloads, a long hours culture and conflicting management demands. Academics experience higher stress than those in the wider population, the survey revealed.

Tackling perfectionism

Pat Hunt, head of Nottingham University's counselling service for staff and students and a member of the UK body for heads of university counselling services, said all universities were experiencing an increase in mental health problems.

"There are increasing levels of anxiety, both generalised and acute, levels of stress, of depression and levels of what I would call perfectionism," she says.

"By that I mean when someone is aiming for and constantly expecting really high standards, so that even when there is a positive outcome they feel they have fallen short. So instead of internal aspiration helping them to do well it actually hinders them."

Academics are also caught up in a range of cycles, from league tables and student satisfaction surveys to research league tables, that dominate thinking, she adds. In one case, a department's top position in a research profile "became a poisonous thing because everyone then fights to maintain that".

Hunt said higher education should not be stigmatised for the increase in mental health issues, since it reflected a similar increase in wider society. Figures show more working days are now lost to the mental health problems than any other health issue.

Nottingham offers one-to-one and group help to students and staff, including support specifically targeted at men, who make up only a third of those seeking help, a figure likely to reflect the continuing stigma over seeking help for mental illness.

Increased workloads partly to blame

Dr Alan Swann of Imperial College London, chair of the higher education occupational physicians committee, blamed "demands for increased product and productivity" for rising levels of mental health problems among academics.

He says: "They all have to produce results – you are only as good as your research rating or as good as your ability to bring in funding for research."

Swann says most academics are stressed rather than mentally unwell: "They are thinking about their work and the consequences of not being as good as they should be; they're having difficulty switching off and feeling guilty if they're not working seven days a week."

Academics and researchers can become isolated and not realise how "out of kilter" their working lives are, he says.

The intense pressure of doctoral and post-doctoral study, and early-career academia can also reveal existing mental health problems, he adds. Universities, including Imperial, have improved systems to help, yet academia remains "pretty macho".

Uncaring academic environment

"There's still a degree of 'if you can't stand the heat, you shouldn't be here'," says Swann. He says there are "still people in senior positions in academia who actually don't care".

He adds: "But there are measures to counter that and there has been a lot of change for the good. What we have not been able to get rid of are the external pressures from government funding and the academic marketplace."

Research by Gail Kinman, professor of occupational health psychology at the University of Bedfordshire, on behalf of the UCU, offers one of the few pieces of data on mental health problems among academics.

Kinman used the health and safety executive's health and safety at work framework to assess the views of some 20,000 academics, and found "considerably higher" levels of psychological distress than in the population as a whole.

She points to poor work-life balance as a key factor, with academics putting in increasing hours as they attempt to respond to high levels of internal and external scrutiny, a fast pace of change and the notion of students as customers – leading to demands such as 24-hour limit for responses to student queries.

Internalised values hard to shake

There are examples of good practice within universities which could be shared across the sector, Kinman says, but, as an independently-minded group who are strongly committed to their work, academics are not always straightforward to support. "We don't like being told 'you can't email at two in the morning'. You can't impose solutions from other sectors – academics are quite different and there's no 'one size fits all'."

And internalised values are hard to shake. Nadine Muller, lecturer in English literature and cultural history at Liverpool John Moores University, suggests that academia promotes the blurring of lines between the personal and the professional – often described as "doing what you love".

"This means that doctoral and early-career scholars are seldom trained in how to firmly draw that line and value themselves beyond their work," says Muller.

UCU says issues relating to mental health are frequently encountered by its representatives. General secretary Sally Hunt says sufferers experience particular prejudice at work. "Further and higher education workers who experience issues relating to mental health face ignorance, discrimination and stigma from their managers and colleagues.

"Negative and inflexible attitudes can often exclude those with mental health conditions from being able to do their job. Often these attitudes can intimidate a person away from feeling able to disclose their mental health condition at all."

John Hamilton, head of safety, health and wellbeing at Leeds Metropolitan University, says academics' problems are often a question of burnout, which he defines as a "significant disengagement" with an employer, in which a staff member no longer feels in charge of their role.

Some universities, including his own, are working hard to offer support, he says, but while many could "definitely do more", there remains a fundamental problem that some academics simply do not like the changes in their sector that have taken place over the last 20 years. "For some, it's going to be a case of 'I'm sorry, but this is the way it is, this is the political landscape'. So there's an element of putting up with it."

If academics already in post must wrestle with the stresses of fast change, what of their successors? Edward Pinkney, a mental health consultant working in education, says: "Institutions have a broader civic duty to educate potential academics about the university environment, so that prospective academics can make a more informed decision about whether or not to proceed.

"As universities become increasingly businesslike, there's a growing need for them to be independently monitored to ensure that they are not just meeting basic standards of support for their members, but also that they are providing an accurate representation of academic life and not misselling it."

Mental health in academia: experiences from around the world

PhD in health sciences at a Canadian university

"At the beginning of my PhD, the director of the department gave our entire cohort a lecture about not getting pregnant and told one of my friends when she applied for maternity leave that the PhD should be a time of celibacy. Some of our supervisors publicly and proudly exchanged stories of failed marriages as if this was the ultimate proof of their devotion to research. Others gossiped about promising colleagues who 'would have achieved so much more' had they not had children. All of these subtle and not so subtle hints guaranteed that no graduate student, especially those with families, would ever sacrifice enough for their research and would thus, by implication, always be a failure in some respect."

Lecturer at the Open University, UK

"I had only been working for the university for two years when I suffered a severe breakdown and was hospitalised. It was very difficult indeed to even contemplate going back to work but thanks to transition counselling from the union I was able to resume work after nine months. The transition counselling was invaluable for a number of reasons; it was linked to work so helped me to begin to think about going back; it carried on during my first few weeks back in the workplace, so it was invaluable in dealing with my feelings at returning to that environment again; and it enabled me to see my mental health problem as being no different to any physical one. One of the hardest things to face after a breakdown is facing the stigma (both real and perceived) that occurs in the workplace. The union gave practical and psychological support, without which I would not have been able to return work."

University of Maine School of Law, US

"During my three years of law school, I had to come to grips with my acceptance of and seeking treatment for depression and PTSD. I've been lucky to have had a lot of support from close friends, but I've never shared these issues with the faculty. The law school culture is effectively one along the lines of 'suck it up'. When I worked in the law school clinic, I actually hid and lied to my professor about the fact that I was struggling with suicidal thoughts because I was afraid of simply being booted out of a clinic I loved. While a very large amount of law students I have known have coped with mental health issues and even school-related nervous breakdowns, it's not talked about, or even admitted beyond close friends."

PhD in chemistry, Bangor University, Wales

"In 2010 I started a PhD in chemistry. A year on, and the pressure began to build, reaching the point where I had a nervous breakdown. I spent time going to counselling for help, but then decided to take a 10-month break from the research I was doing. Upon returning I was able to work for a few months before falling back into depression because I felt I had no chance of gaining the qualification I desired. I eventually got to the stage where I felt I was going nowhere and cleared my desk late one Saturday, saying nothing to anyone that I was leaving. While suffering from depression, I felt isolated, as everyone around me was able to get on with their PhDs. I felt I was the problem. I feel I received some support for my issues but more could have been done to ease me back into full-time study after returning."

PhD in molecular biology, Uppsala University, Sweden

"My university and department supported me after I admitted I had been diagnosed with depression. In the beginning I took advantage of studenthälsan, the university's student health centre. Their team of psychologists and psychiatrists helped me to find the right long-term support. Later, my depression worsened and I was offered a private psychologist at the cost of the department. Yes, my PhD studies are still a demanding job full of stress, mentally as well as physically, but I am glad that in the days where death was the only solution to everything, my colleagues, supervisors and other officials became friends that just wanted to help me."

The Guardian now wants to find out more about the problem.
This survey should take no more than a few minutes to complete, and in doing so you will contribute towards much-needed research into this area.
Thank you for your time. We will publish our findings on the Network soon.

Best wishes,

The Guardian Higher Education Network

terça-feira, 15 de abril de 2014

Student participation

Daydreaming or Deep in Thought? Using Formative Assessment to Evaluate Student Participation

By Carolyn Ives

Many instructors will argue that student participation in class is important. But what's the difference between participation and engagement? What does good participation or engagement look like? How can you recognize it? And how can you tell if a student is not engaged?

Typically, instructors see a student who willingly participates as one who is engaged, and research shows that students who are engaged often take active roles in their own learning (Weaver and Qi, qtd. in Rogers, 2013, p. 11). However, research also debates whether we can actually see engagement: there isn't always a clear relationship between mental and physical engagement. Meaningful engagement may be happening, even when it isn't visible (Mayer, 2009, qtd. in Rogers, 2013, p. 12). 


This is just one of the many challenges that faculty face while trying to evaluate class participation. Other factors can also make this difficult: 

  • Difficulty in assessing engagement or participation by observation alone;
  • Attendance issues, particularly in large classes;
  • Varied emphasis on participation from course to course;
  • Varied types of participation;
  • Difficulty of documenting student participation in a reliable way;
  • Concern about biases; and
  • Concern about unfair penalization of shy or introverted students.

With all these challenges, some instructors opt not to assign grades to participation at all. In fact, Bean and Peterson (1998, p. 33) note "assessment and measurement scholars almost universally advise against grading participation" (Rogers, 2013, p. 11) because of the difficulty in creating consistent methods of evaluation. Other complicating factors include the fact that the promise of a higher grade does not necessarily ensure greater participation, and some forms of participation are more desirable than others. Some kinds are even disruptive: students who speak simply in an effort to achieve high participation grades are not always assets to classroom discussion.
Formative assessment strategies So, then, how can instructors facilitate student engagement and helpful participation? There are a few strategies that can help, many of which you can find discussed in more detail in other Faculty Focus articles, such as the creation of a supportive classroom environment that is skilfully facilitated and discussion-based, the creation of clear expectations around student preparation and student roles in the classroom, and creating student buy-in (Czekanski and Wolf, 2013, p. 11-12; Weimer and Walvoord, 2013). All of these strategies are helpful, but the most useful method I have found to evaluate student participation is the inclusion of formative assessment techniques in my classes.

Formative assessment may take a variety of forms (such as practice quizzes, one-minute papers, clearest/muddiest point exercises, various kinds of group work in the class, etc.), but it provides students with opportunities to practice skills or test knowledge in a "safe" way. It usually consists of low-stakes and/or ungraded (or peer- or self-evaluated) activities, and these can be combined to comprise all or part of a participation grade. You can make it do double (or triple or quadruple) duty by allowing the formative assessment activities to scaffold into your summative assessments, by using formative assessment activities to provide you with student feedback about how the course is going, and by using it to create a reflective culture of assessment that is focused on learning rather than solely on grades.

So how does it work? When I use formative assessment strategies to assess student participation, I allocate a certain number of points to each formative assessment activity; this allocation depends on the percentage I've allocated to participation in the course and how many assessments I use. For some activities, I give full points for completion; for others, I actually grade the activity itself. The formative assessments are all subject to my regular assignments policies, and students must be in class to participate in the activities.

My results have been overwhelmingly positive. By no longer relying on attendance and my observations in class to grade participation, these formative assessment activities have delivered a number of benefits for both my students and me:
  • They encourage attendance;
  • They allow even very shy students to earn participation grades;
  • If I design the formative assessment to scaffold into summative evaluation, students see the value of it and are likely to participate in a meaningful way;
  • Because most of the formative assessment activities are worth points, students are more likely to take the activities seriously and put forth the effort;
  • They allow learners to demonstrate knowledge in multiple ways;
  • They provide tangible evidence of student engagement (or not) and learning (or not);
  • They encourage students to reflect on their own learning, especially if the formative assessment techniques require any self-evaluation;
  • They tell me about how well my students are learning the material, and provide me with feedback about how my course is progressing.

Participation can be a challenge to grade because it often contains many different elements that instructors need to consider, sometimes on the fly. Many strategies can help, including the creation of clear expectations in the form of a rubric, as well as other other classroom techniques as mentioned. However, of all the options I've tried, I have found the use of formative assessment my best option for assessing engagement and participation as it can help to create a culture of self-reflection and assessment that is focused on learning rather than on only grades. 

Czekanski, Kathleen E. and Zane Robinson Wolf. (2013). Encouraging and evaluating class participation. Journal of University Teaching & Learning Practice, 10 (1). Retrieved 7 July 2013 from ERIC database.

Rogers, Susan L. (2013). Calling the question: Do college instructors actually grade participation? College Teaching, 61, 11-22. Retrieved 7 July 2013 from ERIC database.

Weimer, M. and Walvoord, B. (2013). Grading Strategies for the College Classroom. Madison, WI: Magna Publications.

* Carolyn Ives is the Curriculum Planning and Development Coordinator at the Centre for the Advancement of Faculty Excellence at MacEwan University, Canada.

domingo, 13 de abril de 2014

Medical Schools

FAIMER® and WFME Announce the Launch of the World Directory of Medical Schools


The Foundation for Advancement of International Medical Education and Research (FAIMER) and the World Federation for Medical Education (WFME) are pleased to announce an important milestone in their collaboration to develop the World Directory of Medical Schools. The World Directory is now available at www.wdoms.org. This new resource, developed in collaboration with the World Health Organization and the University of Copenhagen, is the result of a March 2012 agreement to merge the organizations’ respective directories—FAIMER’s International Medical Education Directory (IMED) and WFME’s Avicenna Directory—to produce a single comprehensive resource on undergraduate medical education worldwide.

The world’s medical schools number more than 2,000. Collecting and maintaining data on these schools is a large and complex endeavor. The merger of IMED and the Avicenna Directory has combined FAIMER and WFME’s existing data sets and streamlined their data collection efforts. The new World Directory offers enhanced information such as enrollment and curriculum data for schools that offer multiple medical programs or tracks. In the future, additional features, such as information about program recognition or accreditation, will be added to meet the needs of medical regulatory authorities, certifying bodies, and researchers. The availability of current, high-quality information on undergraduate medical education in the form of a centralized resource will advance research on the quality of medical education and efforts to improve medical education, with the ultimate goal of improving public health.
During the transition to the new World Directory of Medical Schools, IMED and the Avicenna Directory will remain open for a year, to ensure that medical regulatory authorities and other users of these directories have continuity of the essential service that they provide. The World Directory, however, will take over as the definitive list of medical schools in the world, and IMED and Avicenna will be discontinued in 2015.


FAIMER is a leader in improving world health. By creating educational opportunities, conducting research, and providing data resources, it serves international communities of educators, researchers, regulators, and policy makers—each a potential change agent for better health care. Through worldwide activities, FAIMER combines its own expertise with that of local experts to create meaningful and sustained improvements in the systems that produce health care providers and deliver health care.

FAIMER is a non-profit foundation of the Educational Commission for Foreign Medical Graduates (ECFMG®) with headquarters in Philadelphia in the United States.

For more information, visit the FAIMER website at www.faimer.org.

About WFME

WFME is the global organization concerned with education and training of medical doctors. WFME’s mission is to strive for better health care for all mankind; WFME’s primary objective is to enhance the quality of medical education worldwide, with promotion of the highest scientific and ethical standards in medical education. This objective is met through the development of standards in medical education, by the promotion of accreditation of medical schools, with the development of databases on medical education, through projects on the future of medicine and medical education, and through other publications and partnerships.

The central office of WFME is in Copenhagen, Denmark. WFME is a non-governmental organization in official relation with the World Health Organization. WFME is an umbrella organization for the world's six regional associations for medical education.

For more information, visit the WFME website at www.wfme.org.

sábado, 12 de abril de 2014


How to Create an Interesting Infographic

Photo Credit: net_efekt via Compfight cc

Infographics are a great way to teach information. They are fun and easy to read when done right.  Next time you want to share some information don’t use boring text – use an infographic instead!

Step 1: Research the ins and outs of your topic

First start with an idea and pick a topic you know about. Infographics can be fun and lighthearted or stark and serious. It all depends on your goal. Go to places like Google, Wikipedia or your local library to find as many little-known facts about the topic as possible.

This is where your QuestionPro tool can really come in handy.  You can decide to do a single survey with several questions, a set of shorter, related surveys that you combine to tell a story, or you may use a combination of polls, surveys and secondary research.

The key to a great infographic isn’t any single piece of information or great design, it’s the insights that it brings out.  A great infographic truly hinges on the objectives of what you intend to communicate to your readers.


Step 2: Work out the concept and story

Decide if you want to share your info as a story, as a factual timeline, or something in between.  Professional infographics are usual made with Adobe Illustrator. However that is not the only way to make them. You can also use any of the tools that are outlined here.

The absolute easiest way to get started is to use your native QuestionPro Infographic.  We’ve pulled all the key data together for you and for 80% of your management or meeting applications, this will be fine.  But if you’re looking to create a sharable marketing document, simply start by working out the concept on a plain document or PowerPoint.


Step 3: Get creative with graphics

After you have an outline done you can plug in graphic that showcase the information. You can use pie charts, images or your own illustrations if you have any. Adding your own personal items and personality will add some spice to your infographic.  One really interesting thing is that you can actually use graphics as your chart.  I’ve seen someone use a guitar fretboard and neck as a time line or an upbrella as a pie chart.  Let your imagination run free when it comes to this part of your infographic.


Step 4: Dig deep into the data for interesting factoids

One of the things that can really make an infographic awesome is adding shocking statistics and other information that typically goes under the radar. Add humor whenever possible by using silly pictures can also add a lot to your infographic.


Step 5: Share strategically with a broad community

After you have your infographic all set and ready to go it’s time to promote it. Be sure to share it on all of your social media sites including your blog. Ask a few peers to spread the word for you too. If the right people see it then it will have a better chance to go viral.

Just keep in mind that not every infographic will go viral. There are a lot of factors that come into play such as the time of day you post it, the people who see it and how well you have constructed it.

Don’t be dismayed if it doesn’t spread like wildfire. Just get to creating another one and eventually you will create a winner. And when you do create a winner it will be well worth the effort because the traffic surge can be truly massive.

quarta-feira, 9 de abril de 2014

Fluxos de aprendizagem


De instituições de ensino a fluxos de aprendizagem

Para uma mudança se concretizar, diversos fatores alinhados entram em ação. É isso o que mostra o mapa De Instituições de Ensino a Fluxos de Aprendizagem (livre tradução para From Educational Institutions to Learning Flows), criado pelo centro de pesquisa Institute for the Future, que mostra como as tendências em educação para a próxima década não se encerram em caixas herméticas, mas estão interconectadas em novos fluxos de aprendizagem.

Segundo o estudo, uma combinação de fatores está rompendo as barreiras da aprendizagem e tem feito com que uma série de ambientes institucionais tradicionais se aproximem de contextos cotidianos. A difusão de tecnologias de conexão móvel e a proliferação de conteúdos abertos são apontadas pela pesquisa como as principais causas dessa transformação. Além disso, elas são potencializadas quando somadas aos novos modos de trabalho do mundo contemporâneo, que estão demandando um profissional com habilidades mais relacionadas com a vida como um todo do que apenas com a academia. Isso reforça o aprendizado como fluxo contínuo, fora dos muros da escola.

De instituições de ensino a fluxos de aprendizagem crédito msk.nina / Fotolia.com

Para destacar as tendências que irão moldar a forma de aprendizagem da próxima década, o Instituto realizou workshops com especialistas, entrevistas e análises de sinais. Como produto final do estudo, produziu um infográfico organizado em torno de cinco grandes temas: aprendizagem integrada e incorporada, novas fundações, conteúdos abertos, trabalho com estrutura social e simbiose entre pessoas e softwares. Ao redor das grandes discussões, debates orbitais foram alocados na imagem, na maior parte das vezes dando exemplos de ferramentas e aplicativos que contribuem para cada um dos grandes temas.

Das cinco iniciais, o Porvir selecionou três tendências que estão mais relacionadas com o que vem sendo abordado no contexto brasileiro. Confira o resultado:

quinta-feira, 3 de abril de 2014

Social Networking

The Use of Social Networking Sites for Public Health Practice and Research: A Systematic Review

Daniel Capurro1,2, MD, PhD; Kate Cole2, MPH; Maria I Echavarría3, MPH; Jonathan Joe2, BS; Tina Neogi4, MD, MPH; Anne M Turner2,5, MD, MPH, MLIS
1Evidence Based Healthcare Program, Department of Internal Medicine, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
2Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, United States
3Department of Global Health, School of Medicine, University of Washington, Seattle, WA, United States
4Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, United States
5Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States
Corresponding Author:
Daniel Capurro, MD, PhD

Evidence Based Healthcare Program
Department of Internal Medicine, Escuela de Medicina
Pontificia Universidad Catolica de Chile
Lira 63
Santiago, 8330044
Phone: 56 223543030
Fax: 56 223543030
Email: dcapurro [at] med.puc.cl


Background: Social networking sites (SNSs) have the potential to increase the reach and efficiency of essential public health services, such as surveillance, research, and communication.
Objective: The objective of this study was to conduct a systematic literature review to identify the use of SNSs for public health research and practice and to identify existing knowledge gaps.
Methods: We performed a systematic literature review of articles related to public health and SNSs using PubMed, EMBASE, and CINAHL to search for peer-reviewed publications describing the use of SNSs for public health research and practice. We also conducted manual searches of relevant publications. Each publication was independently reviewed by 2 researchers for inclusion and extracted relevant study data.
Results: A total of 73 articles met our inclusion criteria. Most articles (n=50) were published in the final 2 years covered by our search. In all, 58 articles were in the domain of public health research and 15 were in public health practice. Only 1 study was conducted in a low-income country. Most articles (63/73, 86%) described observational studies involving users or usages of SNSs; only 5 studies involved randomized controlled trials. A large proportion (43/73, 59%) of the identified studies included populations considered hard to reach, such as young individuals, adolescents, and individuals at risk of sexually transmitted diseases or alcohol and substance abuse. Few articles (2/73, 3%) described using the multidirectional communication potential of SNSs to engage study populations.
Conclusions: The number of publications about public health uses for SNSs has been steadily increasing in the past 5 years. With few exceptions, the literature largely consists of observational studies describing users and usages of SNSs regarding topics of public health interest. More studies that fully exploit the communication tools embedded in SNSs and study their potential to produce significant effects in the overall population’s health are needed.
(J Med Internet Res 2014;16(3):e79)

public health informatics; public health; social network; health communication