An investigation of academic resilience, resilience, and empathy in pharmacy students: Implications for pharmacy education
DOI:
https://doi.org/10.46542/pe.2024.241.226237Keywords:
Academic resilience, Empathy, Pharmacy education, Pharmacy student, ResilienceAbstract
Background: Resilience supports pharmacists and students in thriving in challenging healthcare and academic environments. Empathy is necessary to provide patient-centred care. Knowledge of how these attributes influence pharmacy students is limited, and correlations between academic resilience, empathy, and academic success continue to be explored.
Methods: This study explores the relationships between levels of academic resilience, resilience, and empathy with the academic achievements of pharmacy students at a Malaysian university. Participants were pharmacy students enrolled from 2020/2021 to 2022/2023. Academic resilience was assessed using the Academic-Pharmacy-Resilience-Scale-16, resilience through the Brief-Resilience-Scale, and empathy with the Kiersma-Chen Empathy-Scale. Scores were related to students’ academic grades. Both descriptive and inferential statistical methods were utilised to analyse associations among variables.
Results: Responses were received from 359 students. The levels of resilience of students were deemed to be moderate. Small, statistically significant variations were found in academic resilience scores across cohorts, resilience scores, and empathy scores in relation to gender. Academic resilience showed a correlation to academic grades.
Conclusion: Academic resilience positively correlated with academic success and was positively influenced by work experience. Strengthening students’ resilience in pharmacy education may support their academic achievement, particularly during times of change like the COVID-19 pandemic.
References
Abubakar, U., Mohd Azli, N. A. S., Hashim, I. A., Adlin Kamarudin, N. F., Abdul Latif, N. A. I., Mohamad Badaruddin, A. R., Zulkifli Razak, M., & Zaidan, N. A. (2021). The relationship between academic resilience and academic performance among pharmacy students. Pharmacy Education, 21, 705‒712. https://doi.org/10.46542/pe.2021.211.705712
Al-Mahrouqi, T., Chan, M. F., Al-Mukhaini, M., Al Shehi, M., Al-Huseini, S., Jahan, F., Al Balushi, N., Panchatcharam, S. M., & Al Alawi, M. (2023). The differential mediating roles of resilience in the relationship between meaningful living and stress among college students during the COVID-19 pandemic. Scientific Reports, 13(1), 11671. https://doi.org/10.1038/s41598-023-38975-0
Alsoufi, A., Alsuyihili, A., Msherghi, A., Elhadi, A., Atiyah, H., Ashini, A., Ashwieb, A., Ghula, M., Ben Hasan, H., Abudabuos, S., Alameen, H., Abokhdhir, T., Anaiba, M., Nagib, T., Shuwayyah, A., Benothman, R., Arrefae, G., Alkhwayildi, A., Alhadi, A., ... Elhadi, M. (2020). Impact of the COVID-19 pandemic on medical education: Medical students' knowledge, attitudes, and practices regarding electronic learning. PLoS ONE, 15(11), e0242905. https://doi.org/10.1371/journal.pone.0242905
American Psychological Association. (2022). Building your resilience. https://www.apa.org/topics/resilience
Andersen, F. A., Johansen, A.-S. B., Søndergaard, J., Andersen, C. M., & Assing Hvidt, E. (2020). Revisiting the trajectory of medical students’ empathy, and impact of gender, specialty preferences and nationality: a systematic review. BMC Medical Education, 20(1), Article 52. https://doi.org/10.1186/s12909-020-1964-5
Austin, E. J., Evans, P., Goldwater, R., & Potter, V. (2005). A preliminary study of emotional intelligence, empathy and exam performance in first year medical students. Personality and Individual Differences, 39(8), 1395‒1405. https://doi.org/10.1016/j.paid.2005.04.014
Banerjee, Y., Akhras, A., Khamis, A. H., Alsheikh-Ali, A., & Davis, D. (2019). 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. JMIR Research Protocols, 8(9), Article e14677. https://doi.org/10.2196/14677
Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2013). Teaching empathy to medical students: An updated, systematic review. Academic Medicine, 88(8), 1171‒1177. https://doi.org/10.1097/ACM.0b013e318299f3e3
Beall, J. W., DeHart, R. M., Riggs, R. M., & Hensley, J. (2015). Perceived stress, stressors, and coping mechanisms among doctor of pharmacy students. Pharmacy, 3(4), 344‒354. https://doi.org/10.3390/pharmacy3040344
Beauvais, A. M., Stewart, J. G., DeNisco, S., & Beauvais, J. E. (2014). Factors related to academic success among nursing students: A descriptive correlational research study. Nurse Education Today, 34(6), 918‒923. https://doi.org/10.1016/j.nedt.2013.12.005
Benabbas, R. (2016). Empathy in Iranian medical students: A comparison by age, gender, academic performance and specialty preferences. Medical Journal of the Islamic Republic of Iran, 30, 439. http://mjiri.iums.ac.ir/article-1-3745-en.html
Berduzco-Torres, N., Medina, P., San-Martín, M., Delgado Bolton, R. C., & Vivanco, L. (2021). Non-academic factors influencing the development of empathy in undergraduate nursing students: A cross-sectional study. BMC Nursing, 20(1), Article 245. https://doi.org/10.1186/s12912-021-00773-2
Brennan, E. J. (2017). Towards resilience and wellbeing in nurses. British Journal of Nursing, 26(1), 43‒47. https://doi.org/10.12968/bjon.2017.26.1.43
Brewer, M. L., van Kessel, G., Sanderson, B., Naumann, F., Lane, M., Reubenson, A., & Carter, A. (2019). Resilience in higher education students: A scoping review. Higher Education Research & Development, 38(6), 1105‒1120. https://doi.org/10.1080/07294360.2019.1626810
Brown, M. E. L., MacLellan, A., Laughey, W., Omer, U., Himmi, G., LeBon, T., & Finn, G. M. (2022). Can stoic training develop medical student empathy and resilience? A mixed-methods study. BMC Medical Education, 22(1), Article 340. https://doi.org/10.1186/s12909-022-03391-x
Calhoun, K. E., Yale, L. A., Whipple, M. E., Allen, S. M., Wood, D. E., & Tatum, R. P. (2020). The impact of COVID-19 on medical student surgical education: Implementing extreme pandemic response measures in a widely distributed surgical clerkship experience. American Journal of Surgery, 220(1), 44‒47. https://doi.org/10.1016/j.amjsurg.2020.04.024
Camiel, L. D., Taglieri, C., Kostka-Rokosz, M., Tataronis, G., & Goldman, J. (2023). Relationship between pharmacy students’ resilience scores and their leadership, work experience, and academic performance. Industry and Higher Education, 37(1), 135‒142. https://doi.org/10.1177/09504222221113491
Cassidy, D., Williams, A., Stanley, D., Mellor, P., Cross, W., & Siegloff, L. (2016). Dispositional mindfulness and employment status as predictors of resilience in third-year nursing students: A quantitative study. Nursing Open, 3(4), 212‒221. https://doi.org/10.1002/nop2.56
Cassidy, S., Mawdsley, A., Langran, C., Hughes, L., & Willis, S. C. (2023). A large-scale multicenter study of academic resilience and well-being in pharmacy education. American Journal of Pharmaceutical Education, 87(2), ajpe8998. https://doi.org/10.5688/ajpe8998
Chen, A. M., Kiersma, M. E., Yehle, K. S., & Plake, K. S. (2015). Impact of the Geriatric Medication Game® on nursing students' empathy and attitudes toward older adults. Nurse Education Today, 35(1), 38‒43. https://doi.org/10.1016/j.nedt.2014.05.005
Chen, T., & Lucock, M. (2022). The mental health of university students during the COVID-19 pandemic: An online survey in the UK. PLoS ONE, 17(1), e0262562. https://doi.org/10.1371/journal.pone.0262562
Chisholm-Burns, M. A., Berg-Poppe, P., Spivey, C. A., Karges-Brown, J., & Pithan, A. (2021). Resilience and first-year pharmacy students' academic performance in a pharmacy math course. American Journal of Pharmaceutical Education, 85(8), 8612. https://doi.org/10.5688/ajpe8612
Chisholm-Burns, M. A., Spivey, C. A., Sherwin, E., Williams, J., & Phelps, S. (2019). Development of an instrument to measure academic resilience among pharmacy students. American Journal of Pharmaceutical Education, 83(6), 6896. https://doi.org/10.5688/ajpe6896
Chow, K. M., Tang, W. K. F., Chan, W. H. C., Sit, W. H. J., Choi, K. C., & Chan, S. (2018). Resilience and well-being of university nursing students in Hong Kong: A cross-sectional study. BMC Medical Education, 18(1), 13. https://doi.org/10.1186/s12909-018-1119-0
Cleary, M., Visentin, D., West, S., Lopez, V., & Kornhaber, R. (2018). Promoting emotional intelligence and resilience in undergraduate nursing students: An integrative review. Nurse Education Today, 68, 112‒120. https://doi.org/10.1016/j.nedt.2018.05.018
Cuschieri, S. (2019). The STROBE guidelines. Saudi Journal of Anaesthesia, 13(Suppl 1), S31‒S34. https://doi.org/10.4103/sja.SJA_543_18
Degeeter, M. (2016). Measure of empathy change in pharmacy students through a behavior change assignment. Pharmacy Education, 16(1), 1‒5. https://pharmacyeducation.fip.org/pharmacyeducation/article/view/433
Delaney, J. A., & Seeger, J. D. (2013). Sensitivity analysis. In Developing a protocol for observational comparative effectiveness research: A user’s guide. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK126178/
Dyrbye, L. N., Power, D. V., Massie, F. S., Eacker, A., Harper, W., Thomas, M. R., Szydlo, D. W., Sloan, J. A., & Shanafelt, T. D. (2010). Factors associated with resilience to and recovery from burnout: A prospective, multi-institutional study of US medical students. Medical Education, 44(10), 1016‒1026. https://doi.org/10.1111/j.1365-2923.2010.03754.x
Ferri, P., Rovesti, S., Panzera, N., Marcheselli, L., Bari, A., & Di Lorenzo, R. (2017). Empathic attitudes among nursing students: A preliminary study. Acta Biomedica, 88(3-Suppl), 22‒30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357591/
Finn, G. M., Mwandigha, L. M., Paton, L. W., & Tiffin, P. A. (2018). The ability of 'non-cognitive' traits to predict undergraduate performance in medical schools: A national linkage study. BMC Medical Education, 18(1), 93. https://doi.org/10.1186/s12909-018-1201-7
Ghazwani, S., Alshowkan, A., & AlSalah, N. (2023). A study of empathy levels among nursing interns: A cross-sectional study. BMC Nursing, 22(1), 226. https://doi.org/10.1186/s12912-023-01381-y
GraphPad Software. (2023). GraphPad Prism (Version 10.0.0) [Computer software]. San Diego, California, USA. https://www.graphpad.com
Guadagni, V., Umiltà, A., & Iaria, G. (2020). Sleep quality, empathy, and mood during the isolation period of the COVID-19 pandemic in the Canadian population: Females and women suffered the most. Frontiers in Global Women's Health, 1. https://doi.org/10.3389/fgwh.2020.585938
Hagemeier, N. E., Carlson, T. S., Roberts, C. L., & Thomas, M. (2020). A longitudinal analysis of first professional year pharmacy student well-being. American Journal of Pharmaceutical Education, 84(7), ajpe7735. https://doi.org/10.5688/ajpe7735
Halimi, S. N., Mirzaei, A., Rowett, D., Whitfield, K., & Luetsch, K. (2023). Resilience and empathy in pharmacy interns: Insights from a three-year cohort study. Exploratory Research in Clinical and Social Pharmacy, 12, 100333. https://doi.org/10.1016/j.rcsop.2023.100333
Hammoudi Halat, D., Younes, S., Safwan, J., Akiki, Z., Akel, M., & Rahal, M. (2022). Pharmacy students' mental health and resilience in COVID-19: An assessment after one year of online education. European Journal of Investigation in Health, Psychology and Education, 12(8), 1082‒1107. https://doi.org/10.3390/ejihpe12080077
Hartley, M. T. (2011). Examining the relationships between resilience, mental health, and academic persistence in undergraduate college students. Journal of American College Health, 59(7), 596‒604. https://doi.org/10.1080/07448481.2010.515632
Hojat, M. (2007). Empathy in patient care: Antecedents, development, measurement, and outcomes. Springer Science & Business Media.
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002). Empathy in medical students as related to academic performance, clinical competence, and gender. Medical Education, 36(6), 522‒527. https://doi.org/10.1046/j.1365-2923.2002.01234.x
Hwang, E., & Shin, S. (2018). Characteristics of nursing students with high levels of academic resilience: A cross-sectional study. Nurse Education Today, 71, 54‒59. https://doi.org/10.1016/j.nedt.2018.09.011
Jang, S. S., Seo, J. H., Cho, G. J., Hong, S. C., & Woo, H. O. (2010). Correlation of communication skills for emotional empathy and academic achievement on clinical performance examinations. Korean Journal of Medical Education, 22(2), 121‒130. https://doi.org/10.3946/kjme.2010.22.2.121
Kaulback, M., Barker, N., & Yocom, D. (2021). Experiencing empathy through a polypharmacy simulation experience in baccalaureate nursing education. Clinical Simulation in Nursing, 59, 94‒97. https://doi.org/10.1016/j.ecns.2021.06.004
Kiersma, M. E., Chen, A. M. H., Yehle, K. S., & Plake, K. S. (2013). Validation of an empathy scale in pharmacy and nursing students. American Journal of Pharmaceutical Education, 77(5), Article 94. https://doi.org/10.5688/ajpe77594
Kotze, M., & Kleynhans, R. (2013). Psychological well-being and resilience as predictors of first-year students' academic performance. Journal of Psychology in Africa, 23(1), 51‒60. https://doi.org/10.1080/14330237.2013.10820593
Lekan, D. A., Ward, T. D., & Elliott, A. A. (2018). Resilience in baccalaureate nursing students: An exploration. Journal of Psychosocial Nursing and Mental Health Services, 56(7), 46‒55. https://doi.org/10.3928/02793695-20180619-06
Martin, A. (2013). Academic buoyancy and academic resilience: Exploring ‘everyday’ and ‘classic’ resilience in the face of academic adversity. School Psychology International, 34(5), 488‒500. https://doi.org/10.1177/0143034312472759
Medina, M. S., Plaza, C. M., Stowe, C. 34D., Robinson, E. T., DeLander, G., Beck, D. E., Melchert, R. B., Supernaw, R. B., Roche, V. F., Gleason, B. L., Strong, M. N., Bain, A., Meyer, G. E., Dong, B. J., Rochon, J., & Johnston, P. (2013). Center for the advancement of pharmacy education 2013 educational outcomes. American Journal of Pharmaceutical Education, 77(8), Article 162. https://doi.org/10.5688/ajpe778162
Mirzaei, A., Carter, S. R., Patanwala, A. E., & Schneider, C. R. (2022). Missing data in surveys: Key concepts, approaches, and applications. Research in Social & Administrative Pharmacy, 18(2), 2308‒2316. https://doi.org/10.1016/j.sapharm.2021.03.009
Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The role of empathy in health and social care professionals. Healthcare (Basel), 8(1), 26. https://doi.org/10.3390/healthcare8010026
Nunes, P., Williams, S., Sa, B., & Stevenson, K. (2011). A study of empathy decline in students from five health disciplines during their first year of training. International Journal of Medical Education, 2, 12‒17. https://doi.org/10.5116/ijme.4d47.ddb0
Passi, V. (2014). Developing resilience throughout the continuum of medical education. Perspectives on Medical Education, 3(5), 329‒331. https://doi.org/10.1007/s40037-014-0140-1
Prado, A. D. S., Kohls, E., Baldofski, S., Bianchi, A. S., Trindade, L. I. P., Freitas, J. L., & Rummel-Kluge, C. (2023). How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination. PLoS ONE, 18(4), e0284190. https://doi.org/10.1371/journal.pone.0284190
Price, R. A. (2023). A review of resilience in higher education: Toward the emerging concept of designer resilience. Studies in Higher Education, 48(1), 83‒99. https://doi.org/10.1080/03075079.2022.2112027
Ramos-Martín, J., Pérez-Berlanga, J. M., Oliver, J., & Moreno-Küstner, B. (2023). Non-lethal suicidal behavior in university students of Spain during COVID-19. Frontiers in Psychiatry, 14, Article 1155171. https://doi.org/10.3389/fpsyt.2023.1155171
Raosoft. (2004). Raosoft sample size calculator. Raosoft, Inc. Retrieved October 1, 2023, from http://www.raosoft.com/samplesize.html
Robertson, H. D., Elliott, A. M., Burton, C., Iversen, L., Murchie, P., Porteous, T., & Matheson, C. (2016). Resilience of primary healthcare professionals: A systematic review. British Journal of General Practice, 66(647), e423‒e433. https://doi.org/10.3399/bjgp16X685261
Shapiro, J. (2011). The paradox of teaching empathy in medical education. The MIT Press. https://doi.org/10.7551/mitpress/9780262016612.003.0016
Shoemaker, H. L., Howell, K. H., Jamison, L. E., Walker, H. E., & Wamser-Nanney, R. (2022). Relational factors associated with posttraumatic stress among emerging adults of color exposed to community violence. Violence and Victims, 37(2), 277‒293. https://doi.org/10.1891/vv-d-20-00027
Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15(3), 194‒200. https://doi.org/10.1080/10705500802222972
Smith, B. W., Tooley, E. M., Christopher, P. J., & Kay, V. S. (2010). Resilience as the ability to bounce back from stress: A neglected personal resource? The Journal of Positive Psychology, 5(3), 166‒176. https://doi.org/10.1080/17439760.2010.482186
Spiro, H. (2009). Commentary: The practice of empathy. Academic Medicine, 84(9), 117‒1179. https://doi.org/10.1097/ACM.0b013e3181b18934
Thomas, T. A., & Maree, D. (2022). Student factors affecting academic success among undergraduate students at two South African higher education institutions. South African Journal of Psychology, 52(1), 99‒111. https://doi.org/10.1177/0081246320986287
Toussaint, L., & Webb, J. R. (2005). Gender differences in the relationship between empathy and forgiveness. The Journal of Social Psychology, 145(6), 673‒685. https://doi.org/10.3200/socp.145.6.673-686
Waddimba, A. C., Bennett, M. M., Fresnedo, M., Ledbetter, T. G., & Warren, A. M. (2021). Resilience, well-being, and empathy among private practice physicians and advanced practice providers in Texas: A structural equation model study. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 5(5), 928‒945. https://doi.org/10.1016/j.mayocpiqo.2021.08.009
Williams, B., Brown, T., Boyle, M., McKenna, L., Palermo, C., & Etherington, J. (2014). Levels of empathy in undergraduate emergency health, nursing, and midwifery students: A longitudinal study. Advances in Medical Education and Practice, 5, 299‒306. https://doi.org/10.2147/AMEP.S66681
