Dyjur, P., Lindstrom, G., Arguera, N., & Bair, H. (2017). Using mental health and wellness as a framework for course design. Papers on Postsecondary Learning and Teaching: Proceedings of the University of Calgary Conference on Learning and Teaching, 2, 1-9. USING MENTAL HEALTH AND WELLNESS AS A FRAMEWORK FOR COURSE DESIGN Patti Dyjur, Gabrielle Lindstrom, Nahum Arguera, and Haboun Bair University of Calgary Mental health and wellness is a concern, not only for students, but for instructors in higher education as well. Course design can have a positive or negative impact on both student and instructor wellness, especially around stress and anxiety with assessments, workload, and due dates. Factors of course design such as policies and values, academic expectations, learning environment and learning experiences, student assessment, and reflection and resilience can play an important role in supporting wellness. In this paper we provide examples of how each factor can affect wellness, and offer questions that an instructor can consider when designing a course with wellness in mind. INTRODUCTION Although many post-secondary institutions have developed and incorporated much- needed mental health initiatives at the institutional level, there exists a lack of strategies and frameworks developed to ameliorate negative mental health problems at the course level. In this paper we propose a framework that instructors might use during the course design process while keeping mental health and wellness in mind. The framework has five interconnected components that draw upon both wellness and course design literature: policies and values, academic expectations, learning environment and learning experiences, student assessment, and reflection and resilience. After describing each area, we provide one or two examples to highlight its role in mental health and wellness and offer questions for instructors to consider as they incorporate wellness strategies into their course design. We begin by providing an overview of the scholarship surrounding mental health and wellness in higher education and its connection to course design. LITERATURE REVIEW The World Health Organization (2017, para. 1) defines mental health as a “state of well- being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. According to Findlay (2017), individuals within the age group of 15-24 years were more likely to report mood and anxiety disorders than any other age group (24-44 years of age and 44-65 years of age). About 11% of Canadians within this age group (15-24 years) report depression, 14% report suicidal thoughts at some point in their life and about 5% report that their depression has interfered with their ability to attend school (Findlay, 2017). In post-secondary education, possible signs that a student may be struggling in a class include absenteeism, late assignments, anxiety, anger, or disengagement in class (University of Calgary, 2016). It is important to note though that not all students exhibiting such signs have mental health issues. A study by Beiter et al. (2015) found that the top three stressors amongst Dyjur, Lindstrom, Arguera, & Bair 2 college students were academic performance, pressure to succeed, and post-graduation plans. Wang & Patten (2001) found that among the Canadian employed population aged 20-49 years old, work stress was associated with mental health outcomes such as depressive symptoms and other illnesses. Aspects of work stress that were found to be associated with these outcomes were psychological demands, job insecurity, physical exertion, and lack of social support from employers and coworkers. Within the post-secondary context, literature suggests that professors and instructors are vulnerable to stress burnout due to the multiple demands that are placed on them during their careers. These demands may include lack of funding, resources and support services, work overload, poor management practice, insufficient recognition and reward, and job insecurity (Boyd et al., 2011; Catano et al., 2010; Gillespie, Walsh, Winefield, Dua & Stough, 2001; Gupta, Rao, & Mukherjee, 2015; Otero-Lopez, Marino, & Castro Bolano, 2008). Specifically related to work overload, one of the contributing factors that results in a rise of overload and the contribution of stress is the increase in student numbers in classrooms, the changing nature of students, and the introduction of new technologies in teaching. Many instructors are faced with increasing numbers of courses that they are expected to design and teach, introduction of new teaching approaches, and constant advances in research knowledge (Catano et al., 2010; Gillespie et al., 2001). Literature highlights that occupational stress can result in lowered productivity, absenteeism, job dissatisfaction, lower organizational commitment, decrease in teaching standards, and physical and mental health symptoms (Boyd et al., 2011; Catano et al., 2010; Gillespie et al., 2001; Gupta, et al., 2015). Additionally, the University of Calgary (2016) reported that instructors who were struggling could exhibit stress and anxiety, depression, sick leave, and/or long-term disability. Much of the current research advocates for institutional-level services and programs (Beiter et al., 2015), which are imperative. However, the literature also asserts that course design can have an impact on wellness (University of Toronto, 2014). A recent study by Stanton, Zandvliet, Dhaliwal, and Black (2016) has shown that social connection, participation, and flexibility in a course can foster wellness. The researchers noted that deep and purposeful learning were connected to happiness (Stanton et al., 2016). At George Mason University they have adopted a distributed leadership model in which administrators, students, faculty and staff all play a role in promoting wellness through institutional initiatives and financial commitment, student-led initiatives, curricular integration of wellness, and more (Lucas & Rogers, 2016). We therefore propose that individual instructors have the opportunity to support student wellness at the course level, through course design. Course design is the process of planning and developing what is to be learned in a course, structuring the student learning activities, and creating the assessments of student learning (Biggs & Tang, 2003). It is a highly complex process, requiring an instructor to have expertise in the field of study, a solid understanding of pedagogical approaches, and the ability to evaluate how diverse groups of learners might learn best. When designing a course there are hundreds of decisions to be made along the way, including what content is needed to best support students at that point in their education, what participatory learning activities to include, the number and types of student assessments, and what learning technologies to use, for example. Taken together, these decisions about course design have a huge impact on student and instructor workloads, due dates, stress and anxiety, and wellness (Russell & Topham, 2012). Dyjur, Lindstrom, Arguera, & Bair 3 MENTAL HEALTH AND WELLNESS FRAMEWORK FOR COURSE DESIGN Many course design models strive for a values-neutral approach. Ours is different in that we have deliberately and thoughtfully adopted values, which we feel is a strength of the model. Values underlying our framework include the belief that learning is a partnership between students and instructors. We support and promote the mental health and wellness of both students and instructors within the design of a course. We maintain reasonable expectations regarding student learning given course constraints such as length of time and number of credits. With these values in mind, we present Figure 1, which represents a framework for considerations about course design that could impact on both students’ and instructors’ wellness. The framework draws on both wellness and course design literature. Table 1 includes some questions for instructors to consider when designing courses for mental health and wellness in each of the areas identified in the model. Figure 1. Framework for Designing Courses around Mental Health and Wellness Dyjur, Lindstrom, Arguera, & Bair 4 Table 1 Questions for Instructors to Consider when Designing Courses for Mental Health and Wellness. Facets of Course Design and Wellness Questions for Instructors to Consider when Designing Courses Policies & Values What policies support mental health and wellness at the institutional, faculty, and course levels for students? For instructors? How might academic integrity issues be approached if using a mental health and wellness perspective? How do your course policies support or impede mental health and wellness? What policies exist at all levels to address inclusivity in your course? Academic Expectations How can you structure course outcomes to support mental health and wellness for students? For instructors? How can you maintain reasonable expectations for student learning within the constraints of a course? How can you help students to understand what is expected of them in a course? How might you incorporate student goals for their own learning? Learning Environment & Learning Experiences How might you structure the learning environment to promote mental health and wellness for students? For instructors? How can teaching and learning activities be structured to foster mental health and wellness for students? For instructors? In what ways can social connectedness be incorporated into the learning environment and experiences? What learning experiences might be included in your course to foster student engagement? Student Assessment How can student assessment practices contribute to mental health and wellness for students? For instructors? What student assessment policies exist in the course that might enhance wellness? Are there any that erode wellness? What role might students play in providing one another with feedback? Reflection & Resilience How can you embed opportunities for student reflection throughout the course? At the end of the course? How can you embed opportunities for instructor reflection throughout the course? At the end of the course? Bearing in mind your role as an instructor, how might you promote or support student resilience? Dyjur, Lindstrom, Arguera, & Bair 5 Policies and Values An important consideration when designing a course is the policies and values held at the institutional, faculty, and individual instructor’s level. The working definition for the term policies is the rules and guidelines adopted by the institution, faculty or department, and/or unit. Values refers to the beliefs and ideals about the worth or importance of something, and can be reflected in policies. While an instructor may not have any influence of the institution’s or faculty’s policies and values, they can have a direct impact on student and instructor wellness and can be evaluated during the course design stage. An example of an institutional-level policy that affects course design is accommodation. Many institutions have policies stating that instructors will provide an equitable and supportive learning environment for students with disabilities, as well as supports for instructors in developing it. Policies around plagiarism and academic integrity can be a strong indicator of values. Policies that allow for a developmental approach to plagiarism illustrate different values than highly punitive policies. Questions to consider when designing a course with consideration to the wellness of students and instructors might include: What policies support mental health and wellness at the institutional, faculty, and course levels, for students? For instructors? How might academic integrity issues be approached if using a mental health and wellness perspective? How do your course policies support or impede mental health and wellness? What policies exist at all levels to address inclusivity in your course? Academic Expectations Academic expectations refer to the knowledge and skills that students should be able to attain within a course, as well as the routine non-graded tasks that students are expected to do in the course to further their learning. Thus, it goes broader than the traditional course outcomes to include informal expectations such as preparing for class. An example of how academic expectations could have an effect on wellness is whether or not there are a reasonable number of course outcomes, with a reasonable scope for student learning. Courses with unreasonable expectations for student learning can be a burden for both instructors and students. Some questions to prompt you to consider mental health and wellness when planning the academic expectations of a course are: How can you structure course outcomes to support mental health and wellness for students? For instructors? How can you maintain reasonable expectations for student learning within the constraints of a course (for example, a three-credit course)? How can you help students to understand what is expected of them in a course? How might you incorporate student goals for their own learning? Learning Environment and Learning Experiences The working definition being used for learning environment is the setting, educational approach, and conditions for learning. It therefore includes more than just the physical space, but also relates to the conditions of learning within that space. Learning experiences refers to the teaching and learning activities that contribute to student learning in a course. Literature on mental health and wellness indicates that the learning environment and learning experiences in a Dyjur, Lindstrom, Arguera, & Bair 6 course are key to both student and instructor wellness (Schreiner, 2016; University of Toronto, 2014). An example of how the learning environment can promote wellness in the classroom is consideration for a positive, supportive learning environment. Classrooms that encourage multiple perspectives and openness for others’ ideas are more open to diversity and inclusiveness. Learning environments that encourage social connectedness have also been shown to promote wellness (Schreiner, 2016). When designing a course with mental health and wellness in mind, some questions to consider are: How might you structure the learning environment to promote mental health and wellness for students? For instructors? How can teaching and learning activities be structured to foster mental health and wellness for students? For instructors? In what ways can social connectedness be incorporated into the learning environment and experiences? What learning experiences might be included in your course to foster student engagement? Student Assessment Student assessment can be defined as a “continuous process designed to track and improve student learning in educational contexts of which student achievement is utilized as evidence of quality in programming excellence in higher education” (Praslova, 2010). In addition to graded work, it includes formative assessment in which students receive feedback on their academic performance with the goal of improving it (Yorke, 2003). Since there is so much riding on student assessment, it can be a major cause of stress for students as well as a burden for instructors. One example of how student assessment can affect wellness is related to the number of graded assessments in the course. If there are an excessive number of assessments, the instructor is perpetually marking and providing feedback. However, if there are too few assignments, each one is heavily weighted; students who do poorly on even one assignment have little opportunity to improve their grade in the course. Some of the questions to prompt thinking about wellness when planning student assessments include: How can student assessment practices contribute to mental health and wellness for students? For instructors? What student assessment policies exist in the course that might enhance wellness? Are there any that erode wellness? What role might students play in providing one another with feedback? Reflection and Resilience The working definition being used for reflection is the thought or conscious attention to everyday practice or events. Resilience can be defined as “the protective factors, processes, and mechanisms that, despite experiences with stressors shown to carry significant risk for developing psychopathology, contribute to a good outcome” (Hjemdal et al., 2006, p. 84). In an educational context, it can be defined as the likelihood of students to be successful in school despite adverse experiences in the learning, social and emotional domains (Wang, Haertel & Walberg, 1994). Reflection and resilience are beneficial to students and instructors in that they can provide insight into difficulties with a course, and how to cope with them in positive ways. Reflection and resilience can be beneficial in promoting wellness when students receive a poor grade. Resilient students will try to determine how to do better, whereas less resilient students have fewer coping strategies. Likewise, instructors who receive poor student evaluations Dyjur, Lindstrom, Arguera, & Bair 7 could react in a variety of ways depending on how reflective and resilient they are. Instructors who are building reflection and resilience in their students could incorporate activities such as a debrief session after exams and assignments have been returned. The purpose of the activity would be to identify concepts that were problematic for students and examine common misconceptions. Instructors could prompt student thinking with questions such as: What was unclear to you? What aspects of the assignment did you do well on, and what might you do next time around to improve (Silberman, 1996)? Students could think individually before discussing in small groups, and then bring their observations to a large class discussion. Such activities would develop students’ ability to reflect on their learning and where they might improve. Questions for consideration when designing a course to include reflection and resilience are: How can you embed opportunities for student reflection on their strengths and challenges throughout the course? At the end of the course? How can you embed opportunities for instructor reflection throughout the course? At the end of the course? Bearing in mind your role as an instructor, how might you promote or support student resilience? CONCLUSION In this paper we have outlined a framework that can be used when designing a course with student and instructor wellness in mind. The instructor’s decisions about policies and values, academic expectations, learning environment and learning experiences, student assessment, and reflection and resilience play an important role in supporting wellness. We have included examples to provide a starting point for incorporating wellness in course design. Additionally, we have outlined questions to prompt instructors to think about how to incorporate wellness strategies into course design. While institutional-level programs and initiatives that focus on mental health and wellness are very much needed, we also need to focus on strategies at the course level to enhance wellness for both students and instructors. ACKNOWLEDGEMENTS The authors gratefully acknowledge the support of Ykje Piera, University of Calgary, for constructing the figure in this paper. REFERENCES Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173(2015), 90-96. Biggs, J., & Tang, C. (2011). Teaching for quality learning at university (4th ed.). Maidenhead: Society for Research into Higher Education & Open University Press. Boyd, C. M., Bakker, A. B., Pignata, S., Winefield, A. H., Gillespie, N., & Stough, C. (2011). A longitudinal test of the job demands-resource model among Australian university academics. Applied Psychology: An International Review, 60(1), 112-140. Catano, V., Francis, L., Haines, T., Kirpalani, H., Shannon, H., Stringer, B., & Lozanzki, L. (2010). Occupational stress in Canadian universities: A national survey. International Journal of Stress Management, 17(3), 232-258. Dyjur, Lindstrom, Arguera, & Bair 8 Findlay, L. (2017). Depression and suicidal ideation among Canadians aged 15-24 (Catalogue no.82-003-X). Retrieved from Statistics Canada: http://www.statcan.gc.ca/pub/82-003- x/2017001/article/14697-eng.htm Gillespie, N. A., Walsh, M., Winefields, A. H., Dua, J., & Stough, C. (2001). Occupational stress in universities: Staff perceptions of the causes, consequences and moderators of stress. Work & Stress, 15(1), 53-72. Gupta, V., Rao, E., & Mukherjee, R. (2015). Occupational stress amongst faculty members: A review of literature. International Journal of Research and Development – A Management Review, 4(2), 18-27. Hjemdal, O., Friborg, O., Stiles, T. C., Martinussen, M., & Rosenvinge, J. H. (2006). A new scale for adolescent resilience: Grasping the central protective resources behind healthy development. Measurement & Evaluation in Counseling and Development, 39(2), 84-96. Lucas, N., & Rogers, P. (2016). The well-being university. In D. W. Harward (Ed.), Well-being and Higher Education (pp. 191-197). Washington DC: Bringing Theory to Practice. Otero-López, J. M., Santiago Mariño, M. J., & Castro Bolaño, C. (2008). An integrating approach to the study of burnout in university professors. Psicothema, 20(4), 766-772. Praslova, L. (2010). Adaptation of Kirkpatrick’s four level model of training criteria to assessment of learning outcomes and program evaluation in higher education. Educational Assessment, Evaluation and Accountability, 22, 215-225. doi: 10.1007/s11092-010-9098-7 Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99(16), 2192-2217. Russell, G., & Topham, P. (2012). The impact of social anxiety on student learning and well- being in higher education. Journal of Mental Health, 21(4), 375-385. Scott, K. (2017). Anxiety-filled reflections from a professor on the emotional spectrum. Transformative Dialogues, 10(2), 1-5. Schreiner, L. (2016). Thriving: Expanding the goal of higher education. In D. W. Harward (Ed.), Well-being and Higher Education (pp. 135-148). Washington, DC: Bringing Theory to Practice. Silberman, M. (1996). Active learning: 101 strategies to teach any subject. Boston: Allyn and Bacon. Stanton, A., Zandvliet, D., Dhaliwal, R., & Black, T. (2016). Understanding students’ experiences of well being in learning environments. Higher Education Studies, 6(3), 90- 99. University of Calgary. (2016). Campus mental health strategy: Creating a community of caring. Retrieved from https://www.ucalgary.ca/provost/files/provost/15-unv-018- mental_health_strategy_final.pdf University of Toronto. (2014). Report of the provostial advisory committee on student mental health: The University of Toronto student mental health strategy and framework. Retrieved from: http://www.provost.utoronto.ca/Assets/Provost+Digital+Assets/REPORT+OF+THE+PR OVOSTIAL+ADVISORY+COMMITTEE+ON+STUDENT+MENTAL+HEALTH.pdf Wang, J., & Patten, S. B. (2001). Perceived work stress and major depression in the Canadian employed population, 20–49 years old. Journal of Occupational Health Psychology, 6, 283–289. doi:10.1037/1076-8998.6 .4.283 28 Dyjur, Lindstrom, Arguera, & Bair 9 Wang, M. C., Haertel, G. D., & Walberg, H. J. (1994). Educational resilience in inner cities. In M. C. Wang & E. W. Gordon (Eds.), Educational resilience in inner-city America: Challenges and prospects (pp. 45-72). Mahwah, NJ: Lawrence Erlbaum. World Health Organization. (2017). Mental Health: A state of well-being. Retrieved from http://www.who.int/features/factfiles/mental_health/en/ Yorke, M. (2003) Formative assessment in higher education: Moves towards theory and the enhancement of pedagogic practice. Higher Education, 45, 477-501.