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Effective online teaching and learning strategies: interdisciplinary research of student perceptions in higher education

• Published: 24 August 2024

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• Yifat Davidoff   ORCID: orcid.org/0000-0003-1397-5811 1 &
• Wurud Jayusi   ORCID: orcid.org/0000-0003-0754-6703 2  

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Higher Education has serious challenges regarding academic online teaching-learning-evaluation methods and tools. This study examined 980 students from diverse disciplines about their social-emotional-psychological (SEP) perceptions. We also examined the presence and desirability of 14 TLE (teaching-learning-evaluation) tools in the online learning environment. Findings indicate that current academic online learning does not meet students’ social-emotional needs and reveals a significant demand for practical and engaging methods like simulations and interactive platforms. Diverse disciplines expose different needs (e.g., business and engineering students reported a greater lack of empowerment and lowered acquisition of skills than students from disciplines characterized by higher engaging online learning, such as education and social sciences). Diversified teaching methods, interactive platforms, group support and assessment are needed to address diverse needs. This study extends the international understanding of SEP and TLE theoretical and methodological concepts and suggests practical solutions for effective online teaching-learning and evaluation for diverse disciplines.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. The survey itself is available her in English: https://docs.google.com/forms/d/e/1FAIpQLSdZiGRreBhBe6F7xQC8AsRNhSzX30pu9GFHbfvKKJTxRUtTw/viewform .

Abbreviations

Social emotional psychological

Teaching-learning-evaluation

Psychological empowerment

Self-regulated learners

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Acknowledgements

We would also like to thank the following organizations for their support: University of Portsmouth, UK; University of Cape Town; Beit Berl Academic College; David Yellin Academic College; Ben-Gurion University; Tel Aviv University; Haifa University.

This research was funded by the Feldman Foundation, TX by The Centre for Shared Society in Beat Berl College.

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Davidoff, Y., Jayusi, W. Effective online teaching and learning strategies: interdisciplinary research of student perceptions in higher education. Educ Inf Technol (2024). https://doi.org/10.1007/s10639-024-12958-8

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The Importance of Online Learning to Students and Teachers

As technology advances and user experience improves, so too does the popularity of online education. It’s been proven to be a successful method of learning and offers a number of different benefits when compared with traditional education. While it is beneficial, it also has certain challenges. Understanding the advantages of online learning is important because it could help you make big decisions regarding your or your child’s education. In this article, we will discuss the importance of online learning to students and teachers.

Connects students and teachers internationally

Just like Nord Anglia Education’s Global Campus , an advantage of online learning is it can connect students and teachers around the world. With traditional education, location dictates which classes you could sign up for. This isn’t the case with online learning. You can sign up for classes all over the world, providing a more in-depth understanding of the global industry and helping children build their network and develop an international mindset. Gaining different perspectives and learning about different cultures also aids children’s thinking skills. This highlights the importance of online learning for students because it can open the door to new opportunities and help them develop skills that will serve them well in their future careers.

Offers flexible learning hours

When considering the importance of online learning to students and teachers, flexible learning hours are a big influence. Circumstances mean you can’t always follow the traditional classroom education timetable and being able to learn with more flexible hours can be an important benefit. Online learning offers students the opportunity to learn whenever best suits them. This helps them, and their parents, balance their education with their home life. Transport to school and their parents working hours are two examples of external influences that could impact a traditional education, however, with online learning these don’t have to be a problem. Whether it’s 6 AM or 6 PM, giving children the flexibility to learn when they feel motivated may also increase their ability to retain information.

Considers individual learning patterns

Every student learns differently, and in traditional education, children must adapt to the pace of the class or be left behind. One advantage of online learning is that children have more freedom to work at their own pace, which improves their learning experience and helps them build a better understanding with their teacher. This is also important for the teacher because it helps them structure their classes to suit the individual learning requirements of each child. The outcome: improved grades and a more enjoyable experience for the student and the teacher.

Allows children to create their own learning environment

Children learn better and feel more comfortable learning in an environment of their choosing. This isn’t always possible in a classroom but is one of the key advantages of online learning. As a student or a parent, you understand where you work best, whether it’s in the library, at home or anywhere else. Being able to take a laptop or tablet into your ideal working environment helps children maximise their potential and gain the most from their education. Everyone works differently and some students may prefer the classroom, but for those that don’t, this flexibility can have a positive impact on how they absorb information and help them improve their grades.

Provides students with more control over their learning

Traditional learning methods allow the teacher to decide how they will convey information to their students, but online learning provides more flexibility and gives children control over their education. We all learn differently – some of us prefer quiet study, others like interactive tasks and being challenged under pressure. While there are tasks online, one of the advantages is that it gives students time to teach themselves concepts differently. Some students prefer to learn slowly and explore different learning methods, helping them fully retain information. Once they feel prepared, they can then take online tests or ask their parents to challenge them on what they have learnt.

This article should help you understand the importance of online learning to students and teachers, and whether an online learning experience would be beneficial for your child. If you’re considering a virtual education, you can learn more about the experience we provide through Nord Anglia schools on our virtual schools page.

Want more of the latest insights into education? Read our INSIGHTS publication here !

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Benefits of online learning, according to research

Bill Gates is a massive fan of online learning, and says what he values most about it is the level of personalisation it can offer. Gates regularly views lectures from MIT and other unis. “You can get the best lecture in the world, wherever you are, whenever you want,” he tells journalist Ina Fried in an interview . From certificates to PhDs and MBAs, learning from home has never been more accessible. All over the world, more and more people of all ages have flocked to digital education — and many are happy they chose this over traditional face-to-face learning. Research explains why — below we take a look at the main research that have unearthed the specific benefits of online learning:

Greater value

A 2018 Learning House, Inc. and Aslanian Market Research (2018) survey found that 86% of 1,500 graduate online students surveyed believe that the value they obtained from their online degree was the same or even greater than what they thought they were paying for.

Uninterrupted learning

Learning online requires 40% to 60% less employee time than classroom training, according to a study by Brandon Hall . Why? Because the training can be offered whenever the student requires it and avoids disrupting workflow. In turn, this saves time and improves the quality of learning. 

Video learning is becoming increasingly popular — and necessary — way to educate students. Source: Robyn Beck/AFP

Better retention

In a Brandon Hall and Rosenberg report from 2001 , courses offered online are shorter by up to 25 to 60% than traditional programmes. Although short, it’s more impactful and the knowledge retention is found to be higher.

More control over learning pace

A review found that out of 83 studies that replaced some type of teaching with videos, 75% of them found that students learned more with a video component added to traditional in-person classes.

Why is this? It gives students control over how fast they learn, mastering content without getting overwhelmed. When students advance at their own pace, it’s been shown to improve learning in higher education — the benefits of online learning are endless. 

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• Published: 23 August 2024

The role of emotions in academic performance of undergraduate medical students: a narrative review

• Nora Alshareef 1 , 2 ,
• Ian Fletcher 2 &
• Sabir Giga 2  

BMC Medical Education volume  24 , Article number:  907 ( 2024 ) Cite this article

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Metrics details

This paper is devoted to a narrative review of the literature on emotions and academic performance in medicine. The review aims to examine the role emotions play in the academic performance of undergraduate medical students.

Eight electronic databases were used to search the literature from 2013 to 2023, including Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. Using specific keywords and terms in the databases, 3,285,208 articles were found. After applying the predefined exclusion and inclusion criteria to include only medical students and academic performance as an outcome, 45 articles remained, and two reviewers assessed the quality of the retrieved literature; 17 articles were selected for the narrative synthesis.

The findings indicate that depression and anxiety are the most frequently reported variables in the reviewed literature, and they have negative and positive impacts on the academic performance of medical students. The included literature also reported that a high number of medical students experienced test anxiety during their study, which affected their academic performance. Positive emotions lead to positive academic outcomes and vice versa. However, Feelings of shame did not have any effect on the academic performance of medical students.

The review suggests a significant relationship between emotions and academic performance among undergraduate medical students. While the evidence may not establish causation, it underscores the importance of considering emotional factors in understanding student performance. However, reliance on cross-sectional studies and self-reported data may introduce recall bias. Future research should concentrate on developing anxiety reduction strategies and enhancing mental well-being to improve academic performance.

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Introduction

Studying medicine is a multi-dimensional process involving acquiring medical knowledge, clinical skills, and professional attitudes. Previous research has found that emotions play a significant role in this process [ 1 , 2 ]. Different types of emotions are important in an academic context, influencing performance on assessments and evaluations, reception of feedback, exam scores, and overall satisfaction with the learning experience [ 3 ]. In particular, medical students experience a wide range of emotions due to many emotionally challenging situations, such as experiencing a heavy academic workload, being in the highly competitive field of medicine, retaining a large amount of information, keeping track of a busy schedule, taking difficult exams, and dealing with a fear of failure [ 4 , 5 , 6 ].Especially during their clinical years, medical students may experience anxiety when interacting with patients who are suffering, ill, or dying, and they must work with other healthcare professionals. Therefore, it is necessary to understand the impact of emotions on medical students to improve their academic outcomes [ 7 ].

To distinguish the emotions frequently experienced by medical students, it is essential to define them. Depression is defined by enduring emotions of sadness, despair, and a diminished capacity for enjoyment or engagement in almost all activities [ 4 ]. Negative emotions encompass unpleasant feelings such as anger, fear, sadness, and anxiety, and they frequently cause distress [ 8 ]. Anxiety is a general term that refers to a state of heightened nervousness or worry, which can be triggered by various factors. Test anxiety, on the other hand, is a specific type of anxiety that arises in the context of taking exams or assessments. Test anxiety is characterised by physiological arousal, negative self-perception, and a fear of failure, which can significantly impair a student’s ability to perform well academically [ 9 , 10 ]. Shame is a self-conscious emotion that arises from the perception of having failed to meet personal or societal standards. It can lead to feelings of worthlessness and inadequacy, severely impacting a student’s motivation and academic performance [ 11 , 12 ]. In contrast, positive emotions indicate a state of enjoyable involvement with the surroundings, encompassing feelings of happiness, appreciation, satisfaction, and love [ 8 ].

Academic performance generally refers to the outcomes of a student’s learning activities, often measured through grades, scores, and other formal assessments. Academic achievement encompasses a broader range of accomplishments, including mastery of skills, attainment of knowledge, and the application of learning in practical contexts. While academic performance is often quantifiable, academic achievement includes qualitative aspects of a student’s educational journey [ 13 ].

According to the literature, 11–40% of medical students suffer from stress, depression, and anxiety due to the intensity of medical school, and these negative emotions impact their academic achievement [ 14 , 15 ]. Severe anxiety may impair memory function, decrease concentration, lead to a state of hypervigilance, and interfere with judgment and cognitive function, further affecting academic performance [ 16 ]. However, some studies have suggested that experiencing some level of anxiety has a positive effect and serves as motivation that can improve academic performance [ 16 , 17 ].

Despite the importance of medical students’ emotions and their relation to academic performance, few studies have been conducted in this area. Most of these studies have focused on the prevalence of specific emotions without correlating with medical students’ academic performance. Few systematic reviews have addressed the emotional challenges medical students face. However, there is a lack of comprehensive reviews that discuss the role of emotions and academic outcomes. Therefore, this review aims to fill this gap by exploring the relationship between emotions and the academic performance of medical students.

Aim of the study

This review aims to examine the role emotions play in the academic performance of undergraduate medical students.

A systematic literature search examined the role of emotions in medical students’ academic performance. The search adhered to the concepts of a systematic review, following the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [ 18 ]. Then, narrative synthesise was done to analyse the retrieved literature and synthesise the results. A systematic literature search and narrative review provide complete coverage and flexibility to explore and understand findings. Systematic search assures rigour and reduces bias, while narrative synthesis allows for flexible integration and interpretation. This balance improves review quality and utility.

Eligibility criteria

Inclusion criteria.

The study’s scope was confined to January 2013 to December 2023, focusing exclusively on undergraduate medical students. The research encompassed articles originating within medical schools worldwide, accepting content from all countries. The criteria included only full-text articles in English published in peer-reviewed journals. Primary research was considered, embracing quantitative and mixed-method research. The selected studies had to explicitly reference academic performance, test results, or GPA as key outcomes to address the research question.

Exclusion criteria

The study excluded individuals beyond the undergraduate medical student demographic, such as students in other health fields and junior doctors. There was no imposed age limit for the student participants. The research specifically focused on articles within medical schools, excluding those from alternative settings. It solely considered full-text articles in English-language peer-reviewed journals. Letters or commentary articles were excluded, and the study did not limit itself to a particular type of research. Qualitative studies were excluded from the review because they did not have the quantitative measures required to answer the review’s aim. This review excluded articles on factors impacting academic performance, those analysing nursing students, and gender differences. The reasons and numbers for excluding articles are shown in Table  1 .

Information sources

Eight electronic databases were used to search the literature. These were the following: Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. The databases were chosen from several fields based on relevant topics, including education, academic evaluation and assessment, medical education, psychology, mental health, and medical research. Initially, with the help of a subject librarian, the researcher used all the above databases; the databases were searched with specific keywords and terms, and the terms were divided into the following concepts emotions, academic performance and medical students. Google Scholar, EBSCOhost, and the reference list of the retrieved articles were also used to identify other relevant articles.

Search strategy

This review started with a search of the databases. Eight electronic databases were used to search the literature from 2013 to 2023. Specific keywords and terms were used to search the databases, resulting in 3,285,208 articles. After removing duplicates, letters and commentary, this number was reduced to 1,637 articles. Exclusion and inclusion criteria were then applied, resulting in 45 articles. After two assessors assessed the literature, 17 articles were selected for the review. The search terms are as follows:

Keywords: Emotion, anxiety, stress, empathy, test anxiety, exam anxiety, test stress, exam stress, depression, emotional regulation, test scores, academic performance, grades, GPA, academic achievement, academic success, test result, assessment, undergraduate medical students and undergraduate medical education.

Emotions: TI (Emotion* OR Anxiety OR Stress OR empathy) OR emotion* OR (test anxiety or exam anxiety or test stress or exam stress) OR (depression) OR AB ((Emotion* OR Anxiety OR Stress OR empathy) OR emotion* OR (test anxiety or exam anxiety or test stress or exam stress)) (MH “Emotions”) OR (MH “Emotional Regulation”) DE “EMOTIONS”.

Academic performance: TI (test scores or academic performance or grades or GPA) OR (academic achievement or academic performance or academic success) OR (test result* OR assessment*) OR AB (test scores or academic performance or grades or GPA) OR (academic achievement or academic performance or academic success) OR test result* OR assessment*.

Medical Students: TI (undergraduate medical students OR undergraduate medical education) OR AB (undergraduate medical students OR undergraduate medical education), TI “medical students” OR AB “medical students” DE “Medical Students”.

Selection process

This literature review attempts to gather only peer-reviewed journal articles published in English on undergraduate medical students’ negative and positive emotions and academic performance from January 2013 to December 2023. Their emotions, including depression, anxiety, physiological distress, shame, happiness, joy, and all emotions related to academic performance, were examined in quantitative research and mixed methods.

Moreover, to focus the search, the author specified and defined each keyword using advanced search tools, such as subject headings in the case of the Medline database. The author used ‘MeSH 2023’ as the subject heading, then entered the term ‘Emotion’ and chose all the relevant meanings. This method was applied to most of the keywords.

Studies were included based on predefined criteria related to study design, participants, exposure, outcomes, and study types. Two independent reviewers screened each record, and the report was retrieved. In the screening process, reviewers independently assessed each article against the inclusion criteria, and discrepancies were resolved through consensus during regular team meetings. In cases of persistent disagreement, a third reviewer was consulted. Endnote library program was used for the initial screening phase. This tool was used to identify duplicates, facilitated the independent screening of titles and abstracts and helped to retrieve the full-text articles. The reasons for excluding the articles are presented in Table  1 .

Data collection process

Two independent reviewers extracted data from the eligible studies, with any discrepancies resolved through discussion and consensus. If the two primary reviewers could not agree, a third reviewer served as an arbitrator. For each included study, the following information was extracted and recorded in a standardised database: first author name, publication year, study design, sample characteristics, details of the emotions exposed, outcome measures, and results.

Academic performance as an outcome for medical students was defined to include the following: Exam scores (e.g., midterm, final exams), Clinical assessments (e.g., practical exams, clinical rotations), Overall grade point average (GPA) or any other relevant indicators of academic achievement.

Data were sought for all outcomes, including all measures, time points, and analyses within each outcome domain. In cases where studies reported multiple measures or time points, all relevant data were extracted to provide a comprehensive overview of academic performance. If a study reported outcomes beyond the predefined domains, inclusion criteria were established to determine whether these additional outcomes would be included in the review. This involved assessing relevance to the primary research question and alignment with the predefined outcome domains.

Quality assessment

The quality and risk of bias in included studies were assessed using the National Institute of Health’s (NIH) critical appraisal tool. The tool evaluates studies based on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other biases. Two independent reviewers assessed the risk of bias in each included study. Reviewers worked collaboratively to reach a consensus on assessments. Discrepancies were resolved through discussion and consensus. In cases of persistent disagreement, a third reviewer was consulted.

To determine the validity of eligible articles, all the included articles were critically appraised, and all reviewers assessed bias. The validity and reliability of the results were assessed by using objective measurement. Each article was scored out of 14, with 14 indicating high-quality research and 1 indicating low-quality research. High-quality research, according to the NIH (2013), includes a clear and focused research question, defines the study population, features a high participation rate, mentions inclusion and exclusion criteria, uses clear and specific measurements, reports results in detail, lists the confounding factors and lists the implications for the local community. Therefore, an article was scored 14 if it met all criteria of the critical appraisal tool. Based on scoring, each study was classified into one of three quality categories: good, fair or poor. The poorly rated articles mean their findings were unreliable, and they will not be considered, including two articles [ 16 , 19 ]. Seventeen articles were chosen after critical appraisal using the NIH appraisal tool, as shown in Table  2 .

Effect measures

For each outcome examined in the included studies, various effect measures were utilised to quantify the relationship between emotions and academic performance among undergraduate medical students. The effect measures commonly reported across the studies included prevalence rat, correlation coefficients, and mean differences. The reviewer calculated the effect size for the studies that did not report the effect. The choice of effect measure depended on the nature of the outcome variable and the statistical analysis conducted in each study. These measures were used to assess the strength and direction of the association between emotional factors and academic performance.

The synthesis method

The findings of individual studies were summarised to highlight crucial characteristics. Due to the predicted heterogeneity, the synthesis involved pooling effect estimates and using a narrative method. A narrative synthesis approach was employed in the synthesis of this review to assess and interpret the findings from the included studies qualitatively. The narrative synthesis involved a qualitative examination of the content of each study, focusing on identifying common themes. This synthesis was employed to categorise and interpret data, allowing for a nuanced understanding of the synthesis. Themes related to emotions were identified and extracted for synthesis. Control-value theory [ 20 ] was used as an overarching theory, providing a qualitative synthesis of the evidence and contributing to a deeper understanding of the research question. If the retrieved articles include populations other than medical, such as dental students or non-medical students, the synthesis will distinguish between them and summarise the findings of the medical students only, highlighting any differences or similarities.

The Control-Value Theory, formulated by Pekrun (2006), is a conceptual framework that illustrates the relationship between emotions and academic achievement through two fundamental assessments: control and value. Control pertains to the perceived ability of a learner to exert influence over their learning activities and the results they achieve. Value relates to a student’s significance to these actions and results. The theory suggests that students are prone to experiencing good feelings, such as satisfaction and pride when they possess a strong sense of control and importance towards their academic assignments. On the other hand, individuals are prone to encountering adverse emotions (such as fear and embarrassment) when they perceive a lack of control or worth in these particular occupations. These emotions subsequently impact students’ motivation, learning strategies, and, eventually, their academic achievement. The relevance of control-value theory in reviewing medical student emotions and their influence on academic performance is evident for various reasons. This theory offers a complete framework that facilitates comprehending the intricate connection between emotions and academic achievement. It considers positive and negative emotions, providing a comprehensive viewpoint on how emotions might influence learning and performance. The relevance of control and value notions is particularly significant for medical students due to their frequent exposure to high-stakes tests and difficult courses. Gaining insight into the students’ perception of their power over academic assignments and the importance they attach to their medical education might aid in identifying emotional stimuli and devising remedies. Multiple research has confirmed the theory’s assertions, showing the critical influence of control and value evaluations on students’ emotional experiences and academic achievements [ 21 , 22 ].

Data extraction

For this step, a data extraction sheet was developed using the data extraction template provided by the Cochrane Handbook. To ensure the review is evidence-based and bias-free, the Cochrane Handbook strongly suggests that more than one reviewer review the data. Therefore, the main researcher extracted the data from the included studies, and another reviewer checked the included, excluded and extracted data. Any disagreements were resolved via discussion by a third reviewer. The data extraction Table  2 identified all study features, including the author’s name, the year of publication, the method used the aim of the study, the number and description of participants, data collection tools, and study findings.

Finalisation of references and study characteristics

Prisma sheet and the summary of final studies that have been used for the review.

When the keywords and search terms related to emotions, as mentioned above, in the eight databases listed, 3,285,208 articles were retrieved. After using advanced search and subject headings, the number of articles increased to 3,352,371. Similarly, searching for the second keyword, ‘academic performance,’ using all the advanced search tools yielded 8,119,908 articles. Searching for the third keyword, ‘medical students’, yielded 145,757 articles. All terms were searched in article titles and abstracts. After that, the author combined all search terms by using ‘AND’ and applied the time limit from 2013 to 2023; the search narrowed to 2,570 articles. After duplicates, letters and commentary were excluded, the number was reduced to 1,637 articles. After reading the title and abstract to determine relevance to the topic and applying the exclusion and inclusion criteria mentioned above, 45 articles remained; after the quality of the retrieved literature was assessed by two reviewers, 17 articles were selected for the review. The PRISMA flow diagram summarising the same is presented in Fig.  1 . Additionally, One article by Ansari et al. (2018) was selected for the review; it met most inclusion and exclusion criteria except that the outcome measure is cognitive function and not academic performance. Therefore, it was excluded from the review. Figure  1 shows the Prisma flow diagram (2020) of studies identified from the databases.

Prisma flow diagram (2020)

Study characteristics

Table  2 , summarising the characteristics of the included studies, is presented below.

Findings of the study

Country of the study.

Many of the studies were conducted in developing countries, with the majority being conducted in Europe ( n  = 4), followed by Pakistan ( n  = 2), then Saudi Arabia ( n  = 2), and the United States ( n  = 2). The rest of the studies were conducted in South America ( n  = 1), Morocco ( n  = 1), Brazil ( n  = 1), Australia ( n  = 1), Iran ( n  = 1), South Korea ( n  = 1) and Bosnia and Herzegovina ( n  = 1). No included studies were conducted in the United Kingdom.

Study design

Regarding study design, most of the included articles used a quantitative methodology, including 12 cross-sectional studies. There were two randomised controlled trials, one descriptive correlation study, one cohort study, and only one mixed-method study.

Population and study setting

Regarding population and setting, most of the studies focused on all medical students studying in a medical school setting, from first-year medical students to those in their final year. One study compared medical students with non-medical students; another combined medical students with dental students.

The study aims varied across the included studies. Seven studies examined the prevalence of depression and anxiety among medical students and their relation to academic performance. Four studies examined the relationship between test anxiety and academic performance in medical education. Four studies examined the relationship between medical students’ emotions and academic achievements. One study explored the influence of shame on medical students’ learning.

Study quality

The studies were assessed for quality using tools created by the NIH (2013) and then divided into good, fair, and poor based on these results. Nine studies had a high-quality methodology, seven achieved fair ratings, and only three achieved poor ratings. The studies that were assigned the poor rating were mainly cross-sectional studies, and the areas of weakness were due to the study design, low response rate, inadequate reporting of the methodology and statistics, invalid tools, and unclear research goals.

Outcome measures

Most of the outcome measures were heterogenous and self-administered questionnaires; one study used focus groups and observation ward assessment [ 23 ]. All the studies used the medical students’ academic grades.

Results of the study

The prevalence rate of psychological distress in the retrieved articles.

Depression and anxiety are the most common forms of psychological distress examined concerning academic outcomes among medical students. Studies consistently show concerningly high rates, with prevalence estimates ranging from 7.3 to 66.4% for anxiety and 3.7–69% for depression. These findings indicate psychological distress levels characterised as moderate to high based on common cut-off thresholds have a clear detrimental impact on academic achievement [ 16 , 24 , 25 , 26 ].

The studies collectively examine the impact of psychological factors on academic performance in medical education contexts, using a range of effect sizes to quantify their findings. Aboalshamat et al. (2015) identified a small effect size ( η 2 = 0.018) for depression’s impact on academic performance, suggesting a modest influence. Mihailescu (2016) found a significant negative correlation between levels of depression/anxiety (rho=-0.14, rho=-0.19), academic performance and GPA among medical students. Burr and Beck Dallaghan (2019) reported professional efficacy explaining 31.3% of the variance in academic performance, indicating a significant effect size. However, Del-Ben (2013) et al. did not provide the significant impact of affective changes on academic achievement, suggesting trivial effect sizes for these factors.

In conclusion, anxiety and depression, both indicators of psychological discomfort, are common among medical students. There is a link between distress and poor academic performance results, implying that this relationship merits consideration. Table  3 below shows the specific value of depression and anxiety in retrieved articles.

Test anxiety

In this review, four studies examined the relationship between test anxiety and academic performance in medical education [ 27 , 28 , 29 , 30 ]. The studies found high rates of test anxiety among medical students, ranging from 52% [ 27 ] to as high as 81.1% [ 29 ]. Final-year students tend to experience the highest test anxiety [ 29 ].

Test anxiety has a significant negative correlation with academic performance measures and grade point average (GPA) [ 27 , 28 , 29 ]. Green et al. (2016) found that test anxiety was moderately negatively correlated with USMLE score ( r = − 0.24, p  = 0.00); high test anxiety was associated with low USMLE scores in the control group, further suggesting that anxiety can adversely affect performance. The findings that a test-taking strategy course reduced anxiety without improving test scores highlight the complex nature of anxiety’s impact on performance.

Nazir et al. (2021) found that excellent female medical students reported significantly lower test anxiety than those with low academic grades, with an odds ratio of 1.47, indicating that students with higher test anxiety are more likely to have lower academic grades. Kim’s (2016) research shows moderate correlations between test anxiety and negative achievement emotions such as anxiety and boredom, but interestingly, this anxiety does not significantly affect practical exam scores (OSCE) or GPAs. However, one study found that examination stress enhanced academic performance with a large effect size (W = 0.78), with stress levels at 47.4% among their sample, suggesting that a certain stress level before exams may be beneficial [ 30 ].

Three papers explored shame’s effect on medical students’ academic achievement [ 24 , 31 , 32 ]. Hayat et al. (2018) reported that academic feelings, like shame, significantly depend on the academic year. shame was found to have a slight negative and significant correlation with the academic achievement of learners ( r =-0.15). One study found that some medical students felt shame during simulations-based education examinations because they had made incorrect decisions, which decreased their self-esteem and motivation to learn. However, others who felt shame were motivated to study harder to avoid repeating the same mistakes [ 23 ].

Hautz (2017) study examined how shame affects medical students’ learning using a randomised controlled trial where researchers divided the students into two groups: one group performed a breast examination on mannequins and the other group on actual patients. The results showed that students who performed the clinical examination on actual patients experienced significantly higher levels of shame but performed better in examinations than in the mannequin group. In the final assessments on standardised patients, both groups performed equally well. Therefore, shame decreased with more clinical practice, but shame did not have significant statistics related to learning or performance. Similarly, Burr and Dallaghan (2019) reported that the shame level of medical students was (40%) but had no association with academic performance.

Academic performance, emotions and medical students

Three articles discussed medical students’ emotions and academic performance [ 23 , 24 , 32 ]. Burr and Dallaghan (2019) examine the relationship between academic success and emotions in medical students, such as pride, hope, worry, and shame. It emphasises the links between academic accomplishment and professional efficacy, as well as hope, pride, worry, and shame. Professional efficacy was the most significant factor linked to academic performance, explaining 31.3% of the variance. The importance of emotions on understanding, processing of data, recall of memories, and cognitive burden is emphasised throughout the research. To improve academic achievement, efforts should be made to increase student self-efficacy.

Hayat et al. (2018) found that positive emotions and intrinsic motivation are highly connected with academic achievement, although emotions fluctuate between educational levels but not between genders. The correlations between negative emotions and academic achievement, ranging from − 0.15 to -0.24 for different emotions, suggest small but statistically significant adverse effects.

Behren et al.‘s (2019) mixed-method study found that students felt various emotions during the simulation, focusing on positive emotions and moderate anxiety. However, no significant relationships were found between positive emotions and the student’s performance during the simulation [ 23 ].

This review aims to investigate the role of emotions in the academic performance of undergraduate medical students. Meta-analysis cannot be used because of the heterogeneity of the data collection tools and different research designs [ 33 ]. Therefore, narrative synthesis was adopted in this paper. The studies are grouped into four categories as follows: (1) The effect of depression and anxiety on academic performance, (2) Test anxiety and academic achievement, (3) Shame and academic performance, and (4) Academic performance, emotions and medical students. The control-value theory [ 20 ], will be used to interpret the findings.

The effect of depression and anxiety on academic performance

According to the retrieved research, depression and anxiety can have both a negative and a positive impact on the academic performance of medical students. Severe anxiety may impair memory function, decrease concentration, lead to a state of hypervigilance, interfere with judgment and cognitive function, and further affect academic performance [ 4 ]. Most of the good-quality retrieved articles found that anxiety and depression were associated with low academic performance [ 16 , 24 , 25 , 26 ]. Moreira (2018) and Mihailescu (2016) found that higher depression levels were associated with more failed courses and a lower GPA. However, they did not find any association between anxiety level and academic performance.

By contrast, some studies have suggested that experiencing some level of anxiety reinforces students’ motivation to improve their academic performance [ 16 , 34 ]. Zalihic et al. (2017) conducted a study to investigate anxiety sensitivity about academic success and noticed a positive relationship between anxiety level and high academic scores; they justified this because when medical students feel anxious, they tend to prepare and study more, and they desire to achieve better scores and fulfil social expectations. Similarly, another study found anxiety has a negative impact on academic performance when excessive and a positive effect when manageable, in which case it encourages medical students and motivates them to achieve higher scores [ 35 ].

In the broader literature, the impact of anxiety on academic performance has contradictory research findings. While some studies suggest that having some level of anxiety can boost students’ motivation to improve their academic performance, other research has shown that anxiety has a negative impact on their academic success [ 36 , 37 ]. In the cultural context, education and anxiety attitudes differ widely across cultures. High academic pressure and societal expectations might worsen anxiety in many East Asian societies. Education is highly valued in these societies, frequently leading to significant academic stress. This pressure encompasses attaining high academic marks and outperformance in competitive examinations. The academic demands exerted on students can result in heightened levels of anxiety. The apprehension of not meeting expectations can lead to considerable psychological distress and anxiety, which can appear in their physical and mental health and academic achievement [ 38 , 39 ].

Test anxiety and academic achievement

The majority of the studies reviewed confirm that test anxiety negatively affects academic performance [ 27 , 28 , 29 ]. Several studies have found a significant correlation between test anxiety and academic achievement, indicating that higher levels of test anxiety are associated with lower exam scores and lower academic performance [ 40 , 41 ]. For example, Green et al. (2016) RCT study found that test anxiety has a moderately significant negative correlation with the USMLE score. They found that medical students who took the test-taking strategy course had lower levels of test anxiety than the control group, and their test anxiety scores after the exam had improved from the baseline. Although their test anxiety improved after taking the course, there was no significant difference in the exam scores between students who had and had not taken the course. Therefore, the intervention they used was not effective. According to the control-value theory, this intervention can be improved if they design an emotionally effective learning environment, have a straightforward instructional design, foster self-regulation of negative emotions, and teach students emotion-oriented regulation [ 22 ].

Additionally, according to this theory, students who perceive exams as difficult are more likely to experience test anxiety because test anxiety results from a student’s negative appraisal of the task and outcome values, leading to a reduction in their performance. This aligns with Kim’s (2016) study, which found that students who believed that the OSCE was a problematic exam experienced test anxiety more than other students [ 9 , 22 , 42 ].

In the wider literature, a meta-analysis review by von der Embse (2018) found a medium significant negative correlation ( r =-0.24) between test anxiety and test performance in undergraduate educational settings [ 43 ] . Also, they found a small significant negative correlation ( r =-0.17) between test anxiety and GPA. This indicates that higher levels of test anxiety are associated with lower test performance. Moreover, Song et al. (2021) experimental study examined the effects of test anxiety on working memory capacity and found that test anxiety negatively correlated with academic performance [ 44 ]. Therefore, the evidence from Song’s study suggests a small but significant effect of anxiety on working memory capacity. However, another cross-sectional study revealed that test anxiety in medical students had no significant effect on exam performance [ 45 ]. The complexities of this relationship necessitate additional investigation. Since the retrieved articles are from different countries, it is critical to recognise the possible impact of cultural differences on the impact of test anxiety. Cultural factors such as different educational systems, assessment tools and societal expectations may lead to variances in test anxiety experience and expression across diverse communities [ 46 , 47 ]. Culture has a substantial impact on how test anxiety is expressed and evaluated. Research suggests that the degree and manifestations of test anxiety differ among different cultural settings, emphasising the importance of using culturally validated methods to evaluate test anxiety accurately. A study conducted by Lowe (2019) with Canadian and U.S. college students demonstrated cultural variations in the factors contributing to test anxiety. Canadian students exhibited elevated levels of physiological hyperarousal, but U.S. students had more pronounced cognitive interference. These variations indicate that the cultural environment has an influence on how students perceive and respond to test anxiety, resulting in differing effects on their academic performance in different cultures. Furthermore, scholars highlight the significance of carrying out meticulous instruments to assess test anxiety, which are comparable among diverse cultural cohorts. This technique guarantees that the explanations of test scores are reliable and can be compared across different populations. Hence, it is imperative to comprehend and tackle cultural disparities in order to create efficient interventions and assistance for students who encounter test anxiety in diverse cultural environments. Therefore, there is a need for further studies to examine the level of test anxiety and cultural context.

Shame and academic performance

The review examined three studies that discuss the impact of feelings of shame on academic performance [ 23 , 24 , 48 ]. Generally, shame is considered a negative emotion which involves self-reflection and self-evaluation, and it leads to rumination and self-condemnation [ 49 ]. Intimate examinations conducted by medical students can induce feelings of shame, affecting their ability to communicate with patients and their clinical decisions. Shame can increase the avoidance of intimate physical examinations and also encourage clinical practice [ 23 , 24 , 48 ].

One study found that some medical students felt shame during simulations-based education examinations because they had made incorrect decisions, which decreased their self-esteem and motivation to learn. However, others who felt shame were motivated to study harder to avoid repeating the same mistakes [ 23 ]. Shame decreased with more clinical practice, but shame did not affect their learning or performance [ 48 ]. The literature on how shame affects medical students’ learning is inconclusive [ 31 ].

In the broader literature, shame is considered maladaptive, leading to dysfunctional behaviour, encouraging withdrawal and avoidance of events and inhibiting social interaction. However, few studies have been conducted on shame in the medical field. Therefore, more research is needed to investigate the role of shame in medical students’ academic performance [ 49 ]. In the literature, there are several solutions that can be used to tackle the problem of shame in medical education; it is necessary to establish nurturing learning settings that encourage students to openly discuss their problems and mistakes without the worry of facing severe criticism. This can be accomplished by encouraging medical students to participate in reflective practice, facilitating the processing of their emotions, and enabling them to derive valuable insights from their experiences, all while avoiding excessive self-blame [ 50 ]. Offering robust mentorship and support mechanisms can assist students in effectively managing the difficulties associated with intimate examinations. Teaching staff have the ability to demonstrate proper behaviours and provide valuable feedback and effective mentoring [ 51 ]. Training and workshops that specifically target communication skills and the handling of sensitive situations can effectively equip students to handle intimate tests, hence decreasing the chances of them avoiding such examinations due to feelings of shame [ 52 ].

The literature review focused on three studies that examined the relationship between emotions and the academic achievements of medical students [ 23 , 24 , 32 ].

Behren et al. (2019) mixed-method study on the achievement emotions of medical students during simulations found that placing students in challenging clinical cases that they can handle raises positive emotions. Students perceived these challenges as a positive drive for learning and mild anxiety was considered beneficial. However, the study also found non-significant correlations between emotions and performance during the simulation, indicating a complex relationship between emotions and academic performance. The results revealed that feelings of frustration were perceived to reduce students’ interest and motivation for studying, hampered their decision-making process, and negatively affected their self-esteem, which is consistent with the academic achievement emotions literature where negative emotions are associated with poor intrinsic motivation and reduced the ability to learn [ 3 ].

The study also emphasises that mild anxiety can have positive effects, corroborated by Gregor (2005), which posits that moderate degrees of anxiety can improve performance. The author suggests that an ideal state of arousal (which may be experienced as anxiety) enhances performance. Mild anxiety is commonly seen as a type of psychological stimulation that readies the body for upcoming challenges, frequently referred to as a “fight or flight” response. Within the realm of academic performance, this state of heightened arousal can enhance concentration and optimise cognitive functions such as memory, problem-solving skills, and overall performance. However, once the ideal point is surpassed, any additional increase in arousal can result in a decline in performance [ 53 ]. This is additionally supported by Cassady and Johnson (2002), who discovered that a specific level of anxiety can motivate students to engage in more comprehensive preparation, hence enhancing their performance.

The reviewed research reveals a positive correlation between positive emotions and academic performance and a negative correlation between negative emotions and academic performance. These findings align with the control–value theory [ 8 , 22 ], which suggests that positive emotions facilitate learning through mediating factors, including cognitive learning strategies such as strategic thinking, critical thinking and problem-solving and metacognitive learning strategies such as monitoring, regulating, and planning students’ intrinsic and extrinsic motivation. Additionally, several studies found that extrinsic motivation from the educational environment and the application of cognitive and emotional strategies improve students’ ability to learn and, consequently, their academic performance [ 23 , 24 , 32 ]. By contrast, negative emotions negatively affect academic performance. This is because negative emotions reduce students’ motivation, concentration, and ability to process information [ 23 , 24 , 32 ].

Limitations of the study

This review aims to thoroughly investigate the relationship between emotions and academic performance in undergraduate medical students, but it has inherent limitations. Overall, the methodological quality of the retrieved studies is primarily good and fair. Poor-quality research was excluded from the synthesis. The good-quality papers demonstrated strengths in sampling techniques, data analysis, collection and reporting. However, most of the retrieved articles used cross-section studies, and the drawback of this is a need for a more causal relationship, which is a limitation in the design of cross-sectional studies. Furthermore, given the reliance on self-reported data, there were concerns about potential recall bias. These methodological difficulties were noted in most of the examined research. When contemplating the implications for practice and future study, the impact of these limitations on the validity of the data should be acknowledged.

The limitation of the review process and the inclusion criteria restricted the study to articles published from January 2013 to December 2023, potentially overlooking relevant research conducted beyond this timeframe. Additionally, the exclusive focus on undergraduate medical students may constrain the applicability of findings to other health fields or educational levels.

Moreover, excluding articles in non-English language and those not published in peer-reviewed journals introduces potential language and publication biases. Reliance on electronic databases and specific keywords may inadvertently omit studies using different terms or indexing. While the search strategy is meticulous, it might not cover every relevant study due to indexing and database coverage variations. However, the two assessors’ involvement in study screening, selection, data extraction, and quality assessment improved the robustness of the review and ensured that it included all the relevant research.

In conclusion, these limitations highlight the need for careful interpretation of the study’s findings and stress the importance of future research addressing these constraints to offer a more comprehensive understanding of the nuanced relationship between emotions and academic performance in undergraduate medical education.

Conclusion and future research

The review exposes the widespread prevalence of depression, anxiety and test anxiety within the medical student population. The impact on academic performance is intricate, showcasing evidence of adverse and favourable relationships. Addressing the mental health challenges of medical students necessitates tailored interventions for enhancing mental well-being in medical education. Furthermore, it is crucial to create practical strategies considering the complex elements of overcoming test anxiety. Future research should prioritise the advancement of anxiety reduction strategies to enhance academic performance, focusing on the control-value theory’s emphasis on creating an emotionally supportive learning environment. Additionally, Test anxiety is very common among medical students, but the literature has not conclusively determined its actual effect on academic performance. Therefore, there is a clear need for a study that examines the relationship between test anxiety and academic performance. Moreover, the retrieved literature did not provide effective solutions for managing test anxiety. This gap highlights the need for practical solutions informed by Pekrun’s Control-Value Theory. Ideally, a longitudinal study measuring test anxiety and exam scores over time would be the most appropriate approach. it is also necessary to explore cultural differences to develop more effective solutions and support systems tailored to specific cultural contexts.

The impact of shame on academic performance in medical students was inconclusive. Shame is a negative emotion that has an intricate influence on learning outcomes. The inadequacy of current literature emphasises the imperative for additional research to unravel the nuanced role of shame in the academic journeys of medical students.

Overall, emotions play a crucial role in shaping students’ academic performance, and research has attempted to find solutions to improve medical students’ learning experiences; thus, it is recommended that medical schools revise their curricula and consider using simulation-based learning in their instructional designs to enhance learning and improve students’ emotions. Also, studies have suggested using academic coaching to help students achieve their goals, change their learning styles, and apply self-testing and simple rehearsal of the material. Moreover, the study recommended to improve medical students’ critical thinking and autonomy and changing teaching styles to support students better.

Data availability

all included articles are mentioned in the manuscript, The quality assessment of included articles are located in the supplementary materials file no. 1.

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NA made substantial contributions throughout the systematic review process and was actively involved in writing and revising the manuscript. NA’s responsible for the design of the study, through the acquisition, analysis, and interpretation of data, to the drafting and substantive revision of the manuscript. NA has approved the submitted version and is personally accountable for her contributions, ensuring the accuracy and integrity of the work. IF was instrumental in screening the literature, extracting data, and conducting the quality assessment of the included studies. Additionally, IF played a crucial role in revising the results and discussion sections of the manuscript, ensuring that the interpretation of data was both accurate and insightful. IF has approved the submitted version and has agreed to be personally accountable for his contributions, particularly in terms of the accuracy and integrity of the parts of the work he was directly involved in. SG contributed significantly to the selection of papers and data extraction, demonstrating critical expertise in resolving disagreements among authors. SG’s involvement was crucial in revising the entire content of the manuscript, enhancing its coherence and alignment with the study’s objectives. SG has also approved the submitted version and is personally accountable for his contributions, committed to upholding the integrity of the entire work.

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Alshareef, N., Fletcher, I. & Giga, S. The role of emotions in academic performance of undergraduate medical students: a narrative review. BMC Med Educ 24 , 907 (2024). https://doi.org/10.1186/s12909-024-05894-1

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74th session of the WHO Regional Committee for Europe

Alarming decline in adolescent condom use, increased risk of sexually transmitted infections and unintended pregnancies, reveals new WHO report

Copenhagen, 29 August 2024

New report reveals high rates of unprotected sex among adolescents across Europe, with significant implications for health and safety

An urgent report from the WHO Regional Office for Europe reveals that condom use among sexually active adolescents has declined significantly since 2014, with rates of unprotected sex worryingly high. This is putting young people at significant risk of sexually transmitted infections (STIs) and unplanned pregnancies. The new data were published as part of the multi-part Health Behaviour in School-aged Children (HBSC) study, which surveyed over 242 000 15-year-olds across 42 countries and regions in 2014–2022.

Far-reaching consequences of unprotected sex

Overall, the report highlights that a substantial proportion of sexually active 15-year-olds are engaging in unprotected sexual intercourse, which WHO warns can have far-reaching consequences for young people, including unintended pregnancies, unsafe abortions and an increased risk of contracting STIs. The high prevalence of unprotected sex indicates significant gaps in age-appropriate comprehensive sexuality education, including sexual health education, and access to contraceptive methods.

Worrying decline in condom use

Compared to 2014 levels, the new data show a significant decline in the number of adolescents reporting condom use during last sexual intercourse. From the data, it is clear that the decrease in condom use is pervasive, spanning multiple countries and regions, with some experiencing more dramatic reductions than others.

The report underscores the urgent need for targeted interventions to address these concerning trends and promote safer sexual practices among young people within the wider context of equipping them with the foundation they need for optimal health and well-being.

“While the report’s findings are dismaying, they are not surprising,” noted Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Age-appropriate comprehensive sexuality education remains neglected in many countries, and where it is available, it has increasingly come under attack in recent years on the false premise that it encourages sexual behaviour, when the truth is that equipping young persons with the right knowledge at the right time leads to optimal health outcomes linked to responsible behaviour and choices. We are reaping the bitter fruit of these reactionary efforts, with worse to come, unless governments, health authorities, the education sector and other essential stakeholders truly recognize the root causes of the current situation and take steps to rectify it. We need immediate and sustained action, underpinned by data and evidence, to halt this cascade of negative outcomes, including the likelihood of higher STI rates, increased health-care costs, and – not least – disrupted education and career paths for young persons who do not receive the timely information and support they need.”

Key findings from the report

• Decline in condom use: the proportion of sexually active adolescents who used a condom at last intercourse fell from 70% to 61% among boys and 63% to 57% among girls between 2014 and 2022.
• High rates of unprotected sex: almost a third of adolescents (30%) reported using neither a condom nor the contraceptive pill at last intercourse, a figure that has barely changed since 2018.
• Socioeconomic differences: adolescents from low-affluence families were more likely to report not using a condom or the contraceptive pill at last sexual intercourse than their peers from more affluent families (33% compared with 25%).
• Contraceptive pill use: the report indicates that contraceptive pill use during last sexual intercourse remained relatively stable between 2014 and 2022, with 26% of 15-year-olds reporting that they or their partners used the contraceptive pill at their last sexual intercourse.

Need for comprehensive sexuality education

The findings underscore the importance of providing comprehensive sexual health education and resources for young people. “As teenagers, having access to accurate information about sexual health is vital,” said Éabha, a 16-year-old from Ireland. “We need education that covers everything from consent to contraception, so we can make informed decisions and protect ourselves.”

“Comprehensive sexuality education is key to closing these gaps and empowering all young people to make informed decisions about sex at a particularly vulnerable moment in their lives, as they transition from adolescence to adulthood,” said Dr András Költő of the University of Galway, the lead author of the report. “But education must go beyond just providing information. Young people need safe spaces to discuss issues like consent, intimate relationships, gender identity and sexual orientation, and we – governments, health and education authorities, and civil society organizations – should help them develop crucial life skills including transparent, non-judgmental communication and decision-making.”

Roadmap for action, despite worrying trends

While the findings are sobering, they also offer a roadmap for the way ahead.

The report calls for sustainable investments in age-appropriate comprehensive sexuality education, youth-friendly sexual and reproductive health services, and enabling policies and environments that support adolescent health and rights.

“The findings of this report should serve as a catalyst for action. Adolescents deserve the knowledge and resources to make informed decisions about their sexual health. We have the evidence, the tools and the strategies to improve adolescent sexual health outcomes. What we need, though, is the political will and the resources to make it happen,” said Dr Margreet de Looze of Utrecht University, one of the report’s co-authors.

Call to action for policy-makers and educators

The WHO Regional Office for Europe calls upon policy-makers, educators and health-care providers to prioritize adolescent sexual health by:

• Investing in comprehensive sexuality education: implementing and funding evidence-based sexuality education programmes in schools that cover a wide range of topics, including contraception, STIs, consent, healthy relationships, gender equality and LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, plus) issues. In this, the International Technical Guidance on Sexuality Education, produced by a consortium of United Nations agencies and partners, is key.
• Enhancing access to youth-friendly sexual health services: ensuring that adolescents everywhere have access to confidential, non-judgmental and affordable sexual health services that meet their specific needs and preferences.
• Promoting open dialogue: encouraging open and honest conversations about sexual health within families, schools and communities to reduce stigma and increase awareness.
• Training educators: providing specialized training for teachers and health-care providers to deliver effective and inclusive sex education. Such resources should be made available in both school and out-of-school settings.
• Conducting further research: investigating the underlying reasons for the decline in condom use and the variations in sexual health behaviours across different populations to inform targeted interventions. This includes analysing messages and other content adolescents are exposed to across social media and online platforms, given their reach and impact.

“Ultimately, what we are seeking to achieve for young persons is a solid foundation for life and love,” said Dr Kluge. “Sexual and reproductive health and rights, informed by the right knowledge at the right time along with the right health and well-being services, is critical. By empowering adolescents to make informed decisions about their sexual health, we ultimately safeguard and improve their overall well-being. This is what all parents and families should want for their children, everywhere.”

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Bhanu Bhatnagar

Press & Media Relations Officer WHO Regional Office for Europe

Joseph Hancock

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A focus on adolescent sexual health in Europe, central Asia and Canada: Health Behaviour in School-aged Children international report from the 2021/2022 survey

Health Behaviour in School-aged Children (HBSC) study

The Savvy Scientist

Experiences of a London PhD student and beyond

What is the Significance of a Study? Examples and Guide

If you’re reading this post you’re probably wondering: what is the significance of a study?

No matter where you’re at with a piece of research, it is a good idea to think about the potential significance of your work. And sometimes you’ll have to explicitly write a statement of significance in your papers, it addition to it forming part of your thesis.

In this post I’ll cover what the significance of a study is, how to measure it, how to describe it with examples and add in some of my own experiences having now worked in research for over nine years.

If you’re reading this because you’re writing up your first paper, welcome! You may also like my how-to guide for all aspects of writing your first research paper .

Looking for guidance on writing the statement of significance for a paper or thesis? Click here to skip straight to that section.

What is the Significance of a Study?

For research papers, theses or dissertations it’s common to explicitly write a section describing the significance of the study. We’ll come onto what to include in that section in just a moment.

However the significance of a study can actually refer to several different things.

Working our way from the most technical to the broadest, depending on the context, the significance of a study may refer to:

• Within your study: Statistical significance. Can we trust the findings?
• Wider research field: Research significance. How does your study progress the field?
• Commercial / economic significance: Could there be business opportunities for your findings?
• Societal significance: What impact could your study have on the wider society.
• And probably other domain-specific significance!

We’ll shortly cover each of them in turn, including how they’re measured and some examples for each type of study significance.

But first, let’s touch on why you should consider the significance of your research at an early stage.

Why Care About the Significance of a Study?

No matter what is motivating you to carry out your research, it is sensible to think about the potential significance of your work. In the broadest sense this asks, how does the study contribute to the world?

After all, for many people research is only worth doing if it will result in some expected significance. For the vast majority of us our studies won’t be significant enough to reach the evening news, but most studies will help to enhance knowledge in a particular field and when research has at least some significance it makes for a far more fulfilling longterm pursuit.

Furthermore, a lot of us are carrying out research funded by the public. It therefore makes sense to keep an eye on what benefits the work could bring to the wider community.

Often in research you’ll come to a crossroads where you must decide which path of research to pursue. Thinking about the potential benefits of a strand of research can be useful for deciding how to spend your time, money and resources.

It’s worth noting though, that not all research activities have to work towards obvious significance. This is especially true while you’re a PhD student, where you’re figuring out what you enjoy and may simply be looking for an opportunity to learn a new skill.

However, if you’re trying to decide between two potential projects, it can be useful to weigh up the potential significance of each.

Let’s now dive into the different types of significance, starting with research significance.

Research Significance

What is the research significance of a study.

Unless someone specifies which type of significance they’re referring to, it is fair to assume that they want to know about the research significance of your study.

Research significance describes how your work has contributed to the field, how it could inform future studies and progress research.

Where should I write about my study’s significance in my thesis?

Typically you should write about your study’s significance in the Introduction and Conclusions sections of your thesis.

It’s important to mention it in the Introduction so that the relevance of your work and the potential impact and benefits it could have on the field are immediately apparent. Explaining why your work matters will help to engage readers (and examiners!) early on.

It’s also a good idea to detail the study’s significance in your Conclusions section. This adds weight to your findings and helps explain what your study contributes to the field.

On occasion you may also choose to include a brief description in your Abstract.

What is expected when submitting an article to a journal

It is common for journals to request a statement of significance, although this can sometimes be called other things such as:

• Impact statement
• Significance statement
• Advances in knowledge section

Here is one such example of what is expected:

Impact Statement:  An Impact Statement is required for all submissions.  Your impact statement will be evaluated by the Editor-in-Chief, Global Editors, and appropriate Associate Editor. For your manuscript to receive full review, the editors must be convinced that it is an important advance in for the field. The Impact Statement is not a restating of the abstract. It should address the following: Why is the work submitted important to the field? How does the work submitted advance the field? What new information does this work impart to the field? How does this new information impact the field? Experimental Biology and Medicine journal, author guidelines

Typically the impact statement will be shorter than the Abstract, around 150 words.

Defining the study’s significance is helpful not just for the impact statement (if the journal asks for one) but also for building a more compelling argument throughout your submission. For instance, usually you’ll start the Discussion section of a paper by highlighting the research significance of your work. You’ll also include a short description in your Abstract too.

How to describe the research significance of a study, with examples

Whether you’re writing a thesis or a journal article, the approach to writing about the significance of a study are broadly the same.

I’d therefore suggest using the questions above as a starting point to base your statements on.

• Why is the work submitted important to the field?
• How does the work submitted advance the field?
• What new information does this work impart to the field?
• How does this new information impact the field?

Answer those questions and you’ll have a much clearer idea of the research significance of your work.

When describing it, try to clearly state what is novel about your study’s contribution to the literature. Then go on to discuss what impact it could have on progressing the field along with recommendations for future work.

Potential sentence starters

If you’re not sure where to start, why not set a 10 minute timer and have a go at trying to finish a few of the following sentences. Not sure on what to put? Have a chat to your supervisor or lab mates and they may be able to suggest some ideas.

• This study is important to the field because…
• These findings advance the field by…
• Our results highlight the importance of…
• Our discoveries impact the field by…

Now you’ve had a go let’s have a look at some real life examples.

Statement of significance examples

A statement of significance / impact:

Impact Statement This review highlights the historical development of the concept of “ideal protein” that began in the 1950s and 1980s for poultry and swine diets, respectively, and the major conceptual deficiencies of the long-standing concept of “ideal protein” in animal nutrition based on recent advances in amino acid (AA) metabolism and functions. Nutritionists should move beyond the “ideal protein” concept to consider optimum ratios and amounts of all proteinogenic AAs in animal foods and, in the case of carnivores, also taurine. This will help formulate effective low-protein diets for livestock, poultry, and fish, while sustaining global animal production. Because they are not only species of agricultural importance, but also useful models to study the biology and diseases of humans as well as companion (e.g. dogs and cats), zoo, and extinct animals in the world, our work applies to a more general readership than the nutritionists and producers of farm animals. Wu G, Li P. The “ideal protein” concept is not ideal in animal nutrition.  Experimental Biology and Medicine . 2022;247(13):1191-1201. doi: 10.1177/15353702221082658

And the same type of section but this time called “Advances in knowledge”:

Advances in knowledge: According to the MY-RADs criteria, size measurements of focal lesions in MRI are now of relevance for response assessment in patients with monoclonal plasma cell disorders. Size changes of 1 or 2 mm are frequently observed due to uncertainty of the measurement only, while the actual focal lesion has not undergone any biological change. Size changes of at least 6 mm or more in  T 1  weighted or  T 2  weighted short tau inversion recovery sequences occur in only 5% or less of cases when the focal lesion has not undergone any biological change. Wennmann M, Grözinger M, Weru V, et al. Test-retest, inter- and intra-rater reproducibility of size measurements of focal bone marrow lesions in MRI in patients with multiple myeloma [published online ahead of print, 2023 Apr 12].  Br J Radiol . 2023;20220745. doi: 10.1259/bjr.20220745

Other examples of research significance

Moving beyond the formal statement of significance, here is how you can describe research significance more broadly within your paper.

Describing research impact in an Abstract of a paper:

Three-dimensional visualisation and quantification of the chondrocyte population within articular cartilage can be achieved across a field of view of several millimetres using laboratory-based micro-CT. The ability to map chondrocytes in 3D opens possibilities for research in fields from skeletal development through to medical device design and treatment of cartilage degeneration. Conclusions section of the abstract in my first paper .

In the Discussion section of a paper:

We report for the utility of a standard laboratory micro-CT scanner to visualise and quantify features of the chondrocyte population within intact articular cartilage in 3D. This study represents a complimentary addition to the growing body of evidence supporting the non-destructive imaging of the constituents of articular cartilage. This offers researchers the opportunity to image chondrocyte distributions in 3D without specialised synchrotron equipment, enabling investigations such as chondrocyte morphology across grades of cartilage damage, 3D strain mapping techniques such as digital volume correlation to evaluate mechanical properties  in situ , and models for 3D finite element analysis  in silico  simulations. This enables an objective quantification of chondrocyte distribution and morphology in three dimensions allowing greater insight for investigations into studies of cartilage development, degeneration and repair. One such application of our method, is as a means to provide a 3D pattern in the cartilage which, when combined with digital volume correlation, could determine 3D strain gradient measurements enabling potential treatment and repair of cartilage degeneration. Moreover, the method proposed here will allow evaluation of cartilage implanted with tissue engineered scaffolds designed to promote chondral repair, providing valuable insight into the induced regenerative process. The Discussion section of the paper is laced with references to research significance.

How is longer term research significance measured?

Looking beyond writing impact statements within papers, sometimes you’ll want to quantify the long term research significance of your work. For instance when applying for jobs.

The most obvious measure of a study’s long term research significance is the number of citations it receives from future publications. The thinking is that a study which receives more citations will have had more research impact, and therefore significance , than a study which received less citations. Citations can give a broad indication of how useful the work is to other researchers but citations aren’t really a good measure of significance.

Bear in mind that us researchers can be lazy folks and sometimes are simply looking to cite the first paper which backs up one of our claims. You can find studies which receive a lot of citations simply for packaging up the obvious in a form which can be easily found and referenced, for instance by having a catchy or optimised title.

Likewise, research activity varies wildly between fields. Therefore a certain study may have had a big impact on a particular field but receive a modest number of citations, simply because not many other researchers are working in the field.

Nevertheless, citations are a standard measure of significance and for better or worse it remains impressive for someone to be the first author of a publication receiving lots of citations.

Other measures for the research significance of a study include:

• Accolades: best paper awards at conferences, thesis awards, “most downloaded” titles for articles, press coverage.
• How much follow-on research the study creates. For instance, part of my PhD involved a novel material initially developed by another PhD student in the lab. That PhD student’s research had unlocked lots of potential new studies and now lots of people in the group were using the same material and developing it for different applications. The initial study may not receive a high number of citations yet long term it generated a lot of research activity.

That covers research significance, but you’ll often want to consider other types of significance for your study and we’ll cover those next.

Statistical Significance

What is the statistical significance of a study.

Often as part of a study you’ll carry out statistical tests and then state the statistical significance of your findings: think p-values eg <0.05. It is useful to describe the outcome of these tests within your report or paper, to give a measure of statistical significance.

Effectively you are trying to show whether the performance of your innovation is actually better than a control or baseline and not just chance. Statistical significance deserves a whole other post so I won’t go into a huge amount of depth here.

Things that make publication in  The BMJ  impossible or unlikely Internal validity/robustness of the study • It had insufficient statistical power, making interpretation difficult; • Lack of statistical power; The British Medical Journal’s guide for authors

Calculating statistical significance isn’t always necessary (or valid) for a study, such as if you have a very small number of samples, but it is a very common requirement for scientific articles.

Writing a journal article? Check the journal’s guide for authors to see what they expect. Generally if you have approximately five or more samples or replicates it makes sense to start thinking about statistical tests. Speak to your supervisor and lab mates for advice, and look at other published articles in your field.

How is statistical significance measured?

Statistical significance is quantified using p-values . Depending on your study design you’ll choose different statistical tests to compute the p-value.

A p-value of 0.05 is a common threshold value. The 0.05 means that there is a 1/20 chance that the difference in performance you’re reporting is just down to random chance.

• p-values above 0.05 mean that the result isn’t statistically significant enough to be trusted: it is too likely that the effect you’re showing is just luck.
• p-values less than or equal to 0.05 mean that the result is statistically significant. In other words: unlikely to just be chance, which is usually considered a good outcome.

Low p-values (eg p = 0.001) mean that it is highly unlikely to be random chance (1/1000 in the case of p = 0.001), therefore more statistically significant.

It is important to clarify that, although low p-values mean that your findings are statistically significant, it doesn’t automatically mean that the result is scientifically important. More on that in the next section on research significance.

How to describe the statistical significance of your study, with examples

In the first paper from my PhD I ran some statistical tests to see if different staining techniques (basically dyes) increased how well you could see cells in cow tissue using micro-CT scanning (a 3D imaging technique).

In your methods section you should mention the statistical tests you conducted and then in the results you will have statements such as:

Between mediums for the two scan protocols C/N [contrast to noise ratio] was greater for EtOH than the PBS in both scanning methods (both  p  < 0.0001) with mean differences of 1.243 (95% CI [confidence interval] 0.709 to 1.778) for absorption contrast and 6.231 (95% CI 5.772 to 6.690) for propagation contrast. … Two repeat propagation scans were taken of samples from the PTA-stained groups. No difference in mean C/N was found with either medium: PBS had a mean difference of 0.058 ( p  = 0.852, 95% CI -0.560 to 0.676), EtOH had a mean difference of 1.183 ( p  = 0.112, 95% CI 0.281 to 2.648). From the Results section of my first paper, available here . Square brackets added for this post to aid clarity.

From this text the reader can infer from the first paragraph that there was a statistically significant difference in using EtOH compared to PBS (really small p-value of <0.0001). However, from the second paragraph, the difference between two repeat scans was statistically insignificant for both PBS (p = 0.852) and EtOH (p = 0.112).

By conducting these statistical tests you have then earned your right to make bold statements, such as these from the discussion section:

Propagation phase-contrast increases the contrast of individual chondrocytes [cartilage cells] compared to using absorption contrast. From the Discussion section from the same paper.

Without statistical tests you have no evidence that your results are not just down to random chance.

Beyond describing the statistical significance of a study in the main body text of your work, you can also show it in your figures.

In figures such as bar charts you’ll often see asterisks to represent statistical significance, and “n.s.” to show differences between groups which are not statistically significant. Here is one such figure, with some subplots, from the same paper:

In this example an asterisk (*) between two bars represents p < 0.05. Two asterisks (**) represents p < 0.001 and three asterisks (***) represents p < 0.0001. This should always be stated in the caption of your figure since the values that each asterisk refers to can vary.

Now that we know if a study is showing statistically and research significance, let’s zoom out a little and consider the potential for commercial significance.

Commercial and Industrial Significance

What are commercial and industrial significance.

Moving beyond significance in relation to academia, your research may also have commercial or economic significance.

Simply put:

• Commercial significance: could the research be commercialised as a product or service? Perhaps the underlying technology described in your study could be licensed to a company or you could even start your own business using it.
• Industrial significance: more widely than just providing a product which could be sold, does your research provide insights which may affect a whole industry? Such as: revealing insights or issues with current practices, performance gains you don’t want to commercialise (e.g. solar power efficiency), providing suggested frameworks or improvements which could be employed industry-wide.

I’ve grouped these two together because there can certainly be overlap. For instance, perhaps your new technology could be commercialised whilst providing wider improvements for the whole industry.

Commercial and industrial significance are not relevant to most studies, so only write about it if you and your supervisor can think of reasonable routes to your work having an impact in these ways.

How are commercial and industrial significance measured?

Unlike statistical and research significances, the measures of commercial and industrial significance can be much more broad.

Here are some potential measures of significance:

Commercial significance:

• How much value does your technology bring to potential customers or users?
• How big is the potential market and how much revenue could the product potentially generate?
• Is the intellectual property protectable? i.e. patentable, or if not could the novelty be protected with trade secrets: if so publish your method with caution!
• If commercialised, could the product bring employment to a geographical area?

Industrial significance:

What impact could it have on the industry? For instance if you’re revealing an issue with something, such as unintended negative consequences of a drug , what does that mean for the industry and the public? This could be:

• Reduced overhead costs
• Better safety
• Faster production methods
• Improved scaleability

How to describe the commercial and industrial significance of a study, with examples

Commercial significance.

If your technology could be commercially viable, and you’ve got an interest in commercialising it yourself, it is likely that you and your university may not want to immediately publish the study in a journal.

You’ll probably want to consider routes to exploiting the technology and your university may have a “technology transfer” team to help researchers navigate the various options.

However, if instead of publishing a paper you’re submitting a thesis or dissertation then it can be useful to highlight the commercial significance of your work. In this instance you could include statements of commercial significance such as:

The measurement technology described in this study provides state of the art performance and could enable the development of low cost devices for aerospace applications. An example of commercial significance I invented for this post

Industrial significance

First, think about the industrial sectors who could benefit from the developments described in your study.

For example if you’re working to improve battery efficiency it is easy to think of how it could lead to performance gains for certain industries, like personal electronics or electric vehicles. In these instances you can describe the industrial significance relatively easily, based off your findings.

For example:

By utilising abundant materials in the described battery fabrication process we provide a framework for battery manufacturers to reduce dependence on rare earth components. Again, an invented example

For other technologies there may well be industrial applications but they are less immediately obvious and applicable. In these scenarios the best you can do is to simply reframe your research significance statement in terms of potential commercial applications in a broad way.

As a reminder: not all studies should address industrial significance, so don’t try to invent applications just for the sake of it!

Societal Significance

What is the societal significance of a study.

The most broad category of significance is the societal impact which could stem from it.

If you’re working in an applied field it may be quite easy to see a route for your research to impact society. For others, the route to societal significance may be less immediate or clear.

Studies can help with big issues facing society such as:

• Medical applications : vaccines, surgical implants, drugs, improving patient safety. For instance this medical device and drug combination I worked on which has a very direct route to societal significance.
• Political significance : Your research may provide insights which could contribute towards potential changes in policy or better understanding of issues facing society.
• Public health : for instance COVID-19 transmission and related decisions.
• Climate change : mitigation such as more efficient solar panels and lower cost battery solutions, and studying required adaptation efforts and technologies. Also, better understanding around related societal issues, for instance this study on the effects of temperature on hate speech.

How is societal significance measured?

Societal significance at a high level can be quantified by the size of its potential societal effect. Just like a lab risk assessment, you can think of it in terms of probability (or how many people it could help) and impact magnitude.

Societal impact = How many people it could help x the magnitude of the impact

Think about how widely applicable the findings are: for instance does it affect only certain people? Then think about the potential size of the impact: what kind of difference could it make to those people?

Between these two metrics you can get a pretty good overview of the potential societal significance of your research study.

How to describe the societal significance of a study, with examples

Quite often the broad societal significance of your study is what you’re setting the scene for in your Introduction. In addition to describing the existing literature, it is common to for the study’s motivation to touch on its wider impact for society.

For those of us working in healthcare research it is usually pretty easy to see a path towards societal significance.

Our CLOUT model has state-of-the-art performance in mortality prediction, surpassing other competitive NN models and a logistic regression model … Our results show that the risk factors identified by the CLOUT model agree with physicians’ assessment, suggesting that CLOUT could be used in real-world clinicalsettings. Our results strongly support that CLOUT may be a useful tool to generate clinical prediction models, especially among hospitalized and critically ill patient populations. Learning Latent Space Representations to Predict Patient Outcomes: Model Development and Validation

In other domains the societal significance may either take longer or be more indirect, meaning that it can be more difficult to describe the societal impact.

Even so, here are some examples I’ve found from studies in non-healthcare domains:

We examined food waste as an initial investigation and test of this methodology, and there is clear potential for the examination of not only other policy texts related to food waste (e.g., liability protection, tax incentives, etc.; Broad Leib et al., 2020) but related to sustainable fishing (Worm et al., 2006) and energy use (Hawken, 2017). These other areas are of obvious relevance to climate change… AI-Based Text Analysis for Evaluating Food Waste Policies

The continued development of state-of-the art NLP tools tailored to climate policy will allow climate researchers and policy makers to extract meaningful information from this growing body of text, to monitor trends over time and administrative units, and to identify potential policy improvements. BERT Classification of Paris Agreement Climate Action Plans

Top Tips For Identifying & Writing About the Significance of Your Study

• Writing a thesis? Describe the significance of your study in the Introduction and the Conclusion .
• Submitting a paper? Read the journal’s guidelines. If you’re writing a statement of significance for a journal, make sure you read any guidance they give for what they’re expecting.
• Take a step back from your research and consider your study’s main contributions.
• Read previously published studies in your field . Use this for inspiration and ideas on how to describe the significance of your own study
• Discuss the study with your supervisor and potential co-authors or collaborators and brainstorm potential types of significance for it.

Now you’ve finished reading up on the significance of a study you may also like my how-to guide for all aspects of writing your first research paper .

Writing an academic journal paper

I hope that you’ve learned something useful from this article about the significance of a study. If you have any more research-related questions let me know, I’m here to help.

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Solar photovoltaic module end-of-life waste management regulations: international practices and implications for the kingdom of saudi arabia.

1. Introduction

1.1. literature survey, 1.2. research methodology, 1.2.1. research design, 1.2.2. data collection, 1.2.3. analytical framework, 1.2.4. criteria for analysis.

• Comprehensiveness: the scope and depth of regulations covering the life cycle of solar PV modules.
• Stakeholder Engagement: the involvement of manufacturers, consumers, and recyclers in the EOL process.
• Enforcement and Compliance: mechanisms in place to enforce regulations and ensure compliance.

1.2.5. Link to Objectives and Research Questions

• What are the best practices in solar PV EOL waste management among leading countries?
• How can these practices be adapted to fit the Saudi context under Vision 2030?
• What are the potential benefits of implementing these international practices in Saudi Arabia?

1.2.6. Inclusion and Exclusion Criteria

• The policy document must address solar photovoltaic (PV) end-of-life waste management, with a focus on recycling, reuse, and disposal of PV components.
• The policy document must be accessible to the public and written in English.
• The policy document must have been published by 2024.
• The policy document does not pertain to solar PV end-of-life waste management.
• The policy document is not publicly accessible or is written in a language other than English.
• Legal Framework : evaluation of the legal and regulatory structures governing solar PV end-of-life waste management in each country.
• Policy Goals : analysis of the objectives outlined in the policies concerning solar PV end-of-life waste management.
• Policy Tools : review of the instruments utilized to achieve the goals related to solar PV end-of-life waste management.
• Implementation : examination of the effectiveness of policy implementation regarding solar PV end-of-life waste management.
• Policy Effectiveness : assessment of how successful the policies have been in managing solar PV end-of-life waste.
• Stakeholder Engagement : Analysis of the involvement of key stakeholders, including industry and civil society, in the development and execution of solar PV end-of-life waste management policies.

2. Solar PV Module Waste Composition

Composition of solar pv waste, 3. countries generating higher solar pv end-of-life waste volumes, 4.1. national solid waste law.

• The new Solid Waste Law stipulates that “solid waste” refers to items and substances that are in a solid, semi-solid, or gaseous state, contained in containers, and are generated from various activities such as production, daily life, and other activities. These items and substances have lost their original usefulness, are discarded or abandoned, despite potentially still having value.
• In the new Solid Waste Law, “solid waste” refers to objects and substances that are subject to management under laws and administrative regulations, except for waste that has undergone treatment to reduce its volume and hazardousness, meets national product quality standards, and does not pose a risk to public health or the environment. Additionally, any items that do not meet the standards and procedures for solid waste identification are not classified as solid waste.
• Producers’ Responsibility : the law requires producers of products to establish a sound EOL management system and to bear the primary responsibility for the collection, transportation, and disposal of EOL waste generated by their products.
• Collection and Disposal : Producers of products are required to set up collection points for EOL waste generated by their products and to ensure the proper disposal of such waste. In addition, producers are required to publish information about the EOL waste management system on their websites and in product manuals.
• Environmental Protection : Producers are responsible for ensuring that the disposal of EOL and it does not cause harm to the environment or human health. This includes proper handling and disposal of hazardous materials, such as lead, cadmium, and other toxic substances, which may be present in the panels.
• Reporting and Record-Keeping : producers of products are required to submit annual reports on the EOL waste management activities and to maintain records of the EOL waste collected and disposed of.
• Public Information : the law requires producers of products to provide information to the public about their EOL waste management activities and to promote public awareness of the importance of proper EOL waste management.
• Penalties : Companies that violate the provisions of the National Solid Waste Law, including those related to the management of EOL solid waste, may face fines and other penalties. The amount of the fine will depend on the severity of the violation and the extent of any environmental damage caused.

4.2. Specifications for Recycling and Reusing Thin-Film Solar Panels in Construction Applications (GB/T 38785-2020)

• Strategies for the collection, transit, and processing of discarded panels, extraction, and refinement of valuable components, alongside secure management and elimination of toxic substances;
• Establishes benchmarks for assessing the environmental repercussions of recycling and repurposing thin-film solar panels, alongside recommendations for the architectural and manufacturing phases to enhance recyclability and reusability;
• Seeks to advance the photovoltaic sector’s ecofriendly growth by advocating for the conscientious disposal of waste panels and effective resource utilization.

4.3. Regulations for the Control of Pollution from Storage and Landfill of Nonhazardous Industrial Solid Waste (GB 18599-2020)

• Comprehensive guidelines for the design, construction, operation, and closure of nonhazardous industrial solid waste storage and landfill sites;
• Criteria for site selection, groundwork, sludge management, gasses emission control, and overall site supervision to avoid pollution;
• Directions on acceptable waste categories for these sites, detailing procedures for waste reception, processing, and transportation;
• Requirements for continuous monitoring, documentation, and emergency response plans to efficiently identify and address environmental risks;
• Emphasizes community engagement in waste management processes and outlines methods for effective communication with local communities and stakeholders.

4.4. Technical Guidelines for the Recycling of Electrical and Electronic Equipment Waste (GB/T 23685-2009)

• Detailed procedures for the gathering, storing, transport, and dealing of WEEE, including the design and operational standards for collection facilities and safe handling practices for hazardous components;
• Guidelines for the extraction and purification of valued materials from WEEE, like metals and plastics. It contains techniques for material separation, reprocessing processes, and the potential reutilization of components;
• Standards for assessing the environmental effect of WEEE recycling activities, considering energy consumption and greenhouse gas emissions, to promote sustainability in recycling practices;
• The importance of community awareness and education regarding the proper management of WEEE, including recommendations for educational campaigns and community engagement efforts;
• Encouragement of the advancement of a healthy market for recycled materials to support a circular economy and decrease the waste generation.

4.5. Definitions Related to the Recuperation of Waste Products (GB/T 20861-2007)

• Offers a detailed compilation of definitions and terms relevant to the recovery of waste materials, encompassing aspects like sorting, collection, transportation, and processing of waste;
• Covers a wide range of terms related to the recovery and recycling operations for various waste materials, including plastics, metals, paper, and glass;
• Introduces vocabulary related to the environmental and economic advantages of waste recovery, emphasizing efficient resource use, principles for carbon footprint assessment, and circular economy;
• Objectives for standard harmonization to facilitate waste recovery global collaboration and communication;
• Highlights the reputation of exact and uniform terminology to enhance mutual cooperation and understanding between shareholders in waste recycling and recovery industries.

4.6. Observations

5. the united states of america (usa), 5.1. national legislation: resource conservation and recovery act (rcra).

• Solid Waste Definition Clarification: A new guideline was established to delineate when discarded PV panels are considered as solid waste, exempting them from RCRA mandates under certain conditions. This clarification aids the solar sector in navigating EOL waste management with reduced regulatory ambiguity;
• Hazardous Waste Regulation Adjustments: a conclusive regulation now omits specific PV panel types from being treated under hazardous waste guidelines, alleviating the solar industry’s regulatory obligations and fostering the recycling and repurposing of PV panels;
• PV Panels Conditional Exclusion: a conditional exclusion has been formulated for PV panels managed under specific criteria, enabling their recycling in a manner that is both environmentally responsible and exempt from the RCRA’s stringent regulations;
• Recycling Standards for PV Panels: the EPA has set forth standards for the recycling processes of PV panels, ensuring their environmentally sound management and recycling practices;
• National Recycling Capacity Assessment for PV Panels: An analysis to gauge the United States’ recycling industry’s capacity to handle PV panel waste was conducted. This assessment is instrumental in shaping future policy directions for PV panel waste management.

5.2. Overview of State-Level Regulations for Managing End-of-Life Waste from Solar PV Systems in the U.S.

5.3. observation, 6.1. waste management and public cleansing law (1970), 6.2. the resource recycling act (2013), 6.3. promotion of recycling of small waste electrical and electronic equipment (small appliance recycling act) (2013), 6.4. japan photovoltaic energy association (jpea) recycling guidelines (2014).

• Some of the key recommendations in the guidelines include the following:
• Manufacturers and importers of PV panels should establish a system for the collection and disposal of their products at the end of their useful life;
• Recycling companies should be certified by the government and follow appropriate safety and environmental regulations;
• PV panels should be dismantled and recycled to the extent possible, with materials such as glass, aluminum, and copper separated and sent for recycling;
• Hazardous materials contained within PV panels, such as lead and cadmium, should be managed and disposed of properly.

6.5. Ministry of the Environment’s Guidelines for the Sound Material-Cycle Society (2018)

6.6. observations, 7.1. the national programme on solar pv waste management provides a framework for managing eol solar pv waste (2020).

• Developing a comprehensive regulatory framework for the managing of PV EOL;
• Establishing a mechanism for the collection, transportation, and storage of PV EOL waste;
• Creating a system for the environmentally sound disposal of EOL solar PV waste;
• Promoting research and development in the area of solar PV waste management;
• Building capacity for the management of EOL solar PV waste;
• Creating awareness among stakeholders about the importance of sustainable solar PV waste management.

7.2. The E-Waste (Management) Rules (2016)

7.3. cpcb guidelines on the environmentally sustainable management of eol solar pv waste (2018), 7.4. observations, 8.1. the electrical and electronic equipment act (elektrog) (2005), 8.2. the waste electrical and electronic equipment directive (weee) (2012), 8.3. the german solar association (bsw), 8.4. observations, 9. global concern about solar pv end-of-life waste recycling and management, 9.1. challenges in recycling solar pv waste, 9.1.1. technological and economic barriers, 9.1.2. regulatory and logistical issues, 9.2. potential environmental impacts, 10. the kingdom of saudi arabia, 10.1. saudi arabia waste management law, 10.2. observations, 11. lesson learned for the ksa.

• Extended Producer Responsibility (EPR) : mandating that manufacturers take responsibility for the entire life cycle of their products, including the design, take-back programs, and covering recycling costs.
• Public Awareness and Education Campaigns : launching initiatives to educate the public about the importance of recycling and proper waste management practices.
• Public–Private Partnerships (PPPs) : fostering collaborations between the government and private sector to develop and operate recycling facilities and waste management programs.
• Extended Producer Responsibility (EPR) : implement policies that require manufacturers to manage the life cycle of their products, ensuring they are recyclable and facilitating take-back programs.
• Public Awareness and Education Campaigns : develop and execute campaigns to raise public awareness about EOL waste and encourage community participation in recycling efforts.
• Public–Private Partnerships (PPPs) : encourage partnerships to invest in and manage recycling infrastructure and waste management programs effectively.
• Development of Recycling Infrastructure : invest in specialized facilities and technologies to handle the anticipated increase in solar PV waste.

12. Conclusions and Policy Implications

• Detailed policy analysis to support the development of robust EOL waste management regulations.
• Exploration of advanced technological solutions for recycling and disposal.
• Strategies for effective stakeholder engagement and public awareness.
• Economic assessment of EOL waste management practices to ensure sustainability.

Author Contributions

Data availability statement, acknowledgments, conflicts of interest.

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Ali, A.; Islam, M.T.; Rehman, S.; Qadir, S.A.; Shahid, M.; Khan, M.W.; Zahir, M.H.; Islam, A.; Khalid, M. Solar Photovoltaic Module End-of-Life Waste Management Regulations: International Practices and Implications for the Kingdom of Saudi Arabia. Sustainability 2024 , 16 , 7215. https://doi.org/10.3390/su16167215

Ali A, Islam MT, Rehman S, Qadir SA, Shahid M, Khan MW, Zahir MH, Islam A, Khalid M. Solar Photovoltaic Module End-of-Life Waste Management Regulations: International Practices and Implications for the Kingdom of Saudi Arabia. Sustainability . 2024; 16(16):7215. https://doi.org/10.3390/su16167215

Ali, Amjad, Md Tasbirul Islam, Shafiqur Rehman, Sikandar Abdul Qadir, Muhammad Shahid, Muhammad Waseem Khan, Md. Hasan Zahir, Asif Islam, and Muhammad Khalid. 2024. "Solar Photovoltaic Module End-of-Life Waste Management Regulations: International Practices and Implications for the Kingdom of Saudi Arabia" Sustainability 16, no. 16: 7215. https://doi.org/10.3390/su16167215

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What Is Cognitive Psychology and Why Is It So Important?

By Monique M. Chouraeshkenazi, Ph.D., PsyD, MSCP   |  08/15/2024

Cognitive psychology studies our brain functions and mental processes specifically focusing on how people think and learn. It is a psychological science that aims to better understand how individuals acquire, perceive, process, and store information.

Cognitive psychologists examine the reasoning processes that induce:

• Problem-solving skills

Understanding how people think is critical for understanding their actions, behaviors, and emotions. In cognitive psychology, we assess how individuals comprehend and respond to the world around them. Additionally, cognitive psychologists analyze how people change their mental processes over time.

The History of Cognitive Psychology

Knowledge of mental processes purportedly emerged as a philosophical concept in ancient times. Plato “discovered” cognitive science when exploring the association between the brain and mental processes. As more philosophical concepts emerged throughout history, the cognitive sciences began to take form.

For example, mind-body dualism is a concept that recognizes the mind and body as separate entities. Empiricism, another philosophical concept, suggests that we can only know what we perceive through our five senses. Lastly, nativism argues that the mind has innate capabilities and does not depend exclusively on experience to learn.

Together, mind-body dualism, empiricism, and nativism attempted to define the relationship between cognition and philosophy more closely.

By the 20th century, the study of human behavior continued to evolve. Advancements in computer science and information theories in the 1950s had a lasting influence on the psychology discipline. Experts examined the human brain through experimentation and various modalities, including computational modeling , neuroimaging, and quantitative analysis.

The cognitive psychology field arose as a result and became vital in understanding aspects of:

• Artificial intelligence
• Behaviorism
• Psychotherapy
• Neurological and neuropsychological conditions

By the 1960s, researchers embedded cognitive psychology into applied psychology, cybernetics, and linguistics. The psychology field revolves around examining mental processing models and human behavior. Continued research led to cognitive psychology becoming a staple in economics, linguistics, neuroscience, and other cognitive sciences.

Still, cognitive psychology only became a prominent scientific discipline at the end of the 20th century. The discovery of language production and comprehension processes played a key role in establishing cognitive psychology as a field of study.

The Importance of Cognitive Performance

To understand cognitive psychology, we must first understand the factors that influence and help researchers measure cognitive performance. Cognitive performance refers to the brain’s ability to process information and conduct everyday functions like reasoning, problem-solving, and speaking. How people exercise their mental abilities can have lasting effects on their cognitive performance.

Attention  

Attention is the ability to focus on a stimulus while ignoring other stimuli or distractions. We may direct our full attention towards a single stimulus. Alternatively, we may split our focus between multiple stimuli at once.

Cognitive psychologists use specific language to describe how the human mind may direct its attention:

• Selective attention – The ability to focus on one stimulus while ignoring distracting or irrelevant stimuli simultaneously
• Divided attention – Processing and responding to multiple information sources or performing more than one task simultaneously (also known as multitasking)

Cognitive Development

The American Psychological Association (APA) defines cognitive development as “the growth and maturation of thinking processes of all kinds.” The concept of cognitive development is a critical underlying principle of the psychology discipline. Still, this concept is inherently complex.

Consequently, numerous theories aim to explain the intricacies of cognitive development, including:

• Piaget’s Theory – In 1936, Swiss psychologist Jean Piaget theorized that children progress through four essential developmental stages. These stages of cognitive development span from birth through adulthood. They include the sensorimotor, preoperational, concrete operational, and formal operational stages.
• Theory of Mind (ToM) – Psychologists David Premack and Guy Woodruff popularized the phrase “theory of mind” in 1978. The two doctors used this term in a paper they published that explored the mental processes of chimpanzees. ToM is a social cognitive theory that focuses on individuals’ abilities to understand that their beliefs, actions, and purposes differ from those of others.

Cognitive Neuroscience

Understanding cognitive neuroscience is key to understanding cognitive functioning – and cognitive psychology. Per the APA , cognitive neuroscience “focuses on the neural mechanisms of cognition.”

Essentially, cognitive neuroscience studies how the physical components within the brain affect behavior. This discipline is also known as “neurocognition.”

Cognitive neuroscientists use multiple methods to examine the connection between neural mechanisms and human thought:

• Brain imaging studies – Using neuroimaging techniques to assess brain activity and its connection to cognitive tasks and methods
• Neuropsychopathological assessments – Evaluations that provide data on how neurodevelopmental, neurocognitive, or neuropsychiatric conditions impact brain activity and cognitive performance

Problem-Solving

Cognitive psychologists study how the mind approaches, handles, and solves problems. There are several factors researchers must consider:

• Heuristics and biases – How does the mind use heuristics, schemata, and other mental shortcuts for problem-solving? How can these shortcuts create bias (e.g., confirmation bias )?
• Problem-solving strategies – How do individuals apply algorithms and rules to solve problems?

Cognitive abilities directly correlate to language skills. Accordingly, cognitive psychology focuses in part on how individuals construct, process, and use linguistics:

• Language acquisition – Researching and learning language and completing language development stages
• Speech recognition – Researching and examining how spoken language is attained

Cognitive psychologists study how we acquire knowledge and new skills. Our brains can learn and process information through a myriad of methods:

• Classical conditioning – A learning method that examines how automatic, conditioned responses are paired with specific stimuli (i.e., Pavlovian conditioning )
• Operant conditioning – A learning method that uses rewards and punishment systems to modify non-automatic (or voluntary) behaviors (i.e., Skinner and Thorndike )
• Observational learning – A social learning theory postulates that learning is based on imitating and watching others’ attitudes, behaviors, or emotions (i.e., Bandura's social learning theory )

Memory involves encoding, storing, and retrieving information. It uses recollection and retention skills. Cognitive psychologists study different types of memory:

• Short-term and long-term memory – Researchers observe how specific encoding and rehearsal methods transfer information from short-term to long-term memory.
• Episodic memory – Psychologists explore the factors that can influence or interrupt memories of autobiographical events.

Metacognition

Metacognition refers to individuals’ awareness of their cognitive processes. For example, many people identify as either visual or auditory learners. Understanding which types of learning strategies best support cognitive performance demonstrates metacognition.

Perception has a major impact on cognitive performance. Our brains interpret sensory information to analyze our environments and our surroundings.

There are two fundamental types of perception that cognitive psychologists study:

• Visual perception – How visual information is interpreted and processed (e.g., facial recognition or recognizing objects)
• Auditory perception – How sounds are interrupted and perceived (e.g., music)

Prominent Research in Cognitive Psychology and Cognitive Processes

Many prominent research studies and theories have significantly contributed to shaping the cognitive psychology field. For instance, the earliest research was based on Jean Piaget and the stages of cognitive development he identified in the 1930s.

By 1956, American psychologist George A. Miller advanced our understanding of short-term memory capacity. Miller identified that individuals could hold large amounts of data for up to approximately seven minutes by chunking . This research was vital in understanding cognitive capacity.

As the 1960s approached, social scientist Herbert Simon, along with computer scientist Allen Newell and other colleagues, helped fuel the “cognitive revolution.” This era was underscored by a pivotal convergence of behaviorism theories that led to cognitive psychology.

Simon, Newell, and their colleagues researched and formed monumental theories for problem-solving and information processing. Their work served as the modern framework of cognitive psychology.

Then, in 1964, English psychologist Anne Treisman hypothesized that unattended data is attenuated and partially blocked. Treisman’s most influential work in cognitive psychology was the Attenuation Model, based on attenuation theory, which indicated that our attention is a “filter” when selecting information to process (i.e., selective attention).

Nevertheless, fellow cognitive psychology pioneer Ulric Neisser published “Cognitive Psychology” three years later. This book bolstered internal mental processes and their relationship with examining cognition in real-world contexts.

By 1968, psychologists Richard C. Atkinson and Richard M. Shiffrin developed three memory models:

• Sensory memory
• Short-term memory
• Long-term memory

These models are vital in cognitive psychology, and they helped influence the creation of countless other memory models .

In 1972, Canadian psychologist Endel Tulving examined the relationship between episodic and semantic memory . Tulving focused mainly on cognitive approaches that affect long-term memory.

Two years later, psychologists Daniel Kahneman and Amos Tversky researched decision-making processes. Together, Kahneman and Tversky centralized their efforts on biases and heuristics .

That same year, British psychologist Alan Baddeley and his postdoctoral fellow Graham Hitch expounded on Atkinson and Shiffrin’s short-term memory research. The two psychologists established the conceptualization of working memory.

In fact, Baddeley and Hitch developed the phonological loop and the visuospatial sketchpad . Researchers use both components to model the working memory.

Also in 1974, psychologists Elizabeth F. Loftus and John C. Palmer conducted the now-famous “ car crash experiment .” This experiment explained how phrasing questions could significantly affect memory, thus relying upon unreliable eyewitness testimonies. Loftus and Palmer’s research had crucial implications within the legal system .

What Is the Job of a Cognitive Psychologist?

Cognitive psychologists work in various fields and have a broad spectrum of duties. For example, many cognitive psychologists design and conduct experiments to examine different facets of cognition and cognitive performance.

Cognitive scholars can also develop conceptual frameworks, models, and theories to hypothesize and explain cognitive processes. Their work is essential for predicting human behavior, which guides further research within the field.

In addition, cognitive psychologists can apply their knowledge and expertise to educational settings. Their research may shed light on opportunities for schools to support cognitive processes and behavior better. Similarly, cognitive psychology research has the potential to identify new ways to improve productivity in the workplace.

Healthcare and medical environments can also benefit from research in this field. Cognitive psychology findings can help to assist and support the development of therapeutic interventions for a variety of patient concerns:

• Medical conditions
• Mental health and behavior modification
• Physical health
• Other physiological concerns that impact cognitive performance

Cognitive psychologists can work directly with patients to assess and treat cognitive problems resulting from developmental, neurological, or neuropsychiatric conditions. In this modality, psychologists might work in hospitals, laboratories, private practices, or rehabilitation centers.

Simply put, cognitive psychologists use their experience and insights to examine how people think and process information. Research in this field helps identify positive coping styles and new methods to help people live healthier lifestyles.

Career Paths in Cognitive Psychology

Cognitive psychologists can potentially work in clinical settings, research, and teaching. They can also work in the private sector or for government agencies. Corporations may hire cognitive psychologists to assist with human-computer interaction, software development, or industrial/organizational psychology.

Entry-level positions are not unheard of. Still, it is worth noting that most roles in the field require a master’s- or doctorate-level education.

Practical Applications for Cognitive Psychology

Cognitive psychology research continues to advance. Consequently, this field is now one of the most versatile psychology fields.

People interested in pursuing career paths in cognitive psychology do not need to be medical specialists, neurologists, or neurophysiologists. They can instead complete their studies in psychology.

The human brain is a powerful organ that allows us to utilize our five senses and understand and perceive language. Nevertheless, the brain can sometimes fail us. That is why cognitive psychologists exist: to study the brain and provide expertise on its inner workings.

Because cognitive psychology focuses on studying the human brain, the field has substantially benefited mental health research. Cognitive psychology practices surpass traditional behavioral, humanistic, and psychoanalytic methods to understand our minds.

In fact, the birth of this field was dubbed the “cognitive revolution.” This title was inspired by researchers’ dedication to exploring the connection between actions, cognition behaviors, and emotions. Cognitive psychology also aims to explain how psychological distress may lead to anxiety, depressive, and stress disorders.  

Understanding the need for new treatment developments, early researchers helped bring a cognitive approach to the mental health field. For example, cognitive psychologists helped to pioneer cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT).

CBT is a form of psychotherapy or “talk therapy” that identifies and modifies thought behaviors and patterns. It is predicated on the notion that a person’s actions, behaviors, emotions, and thoughts are interconnected. The purpose of CBT is to alter negative behaviors and thoughts to improve mental functioning and emotional well-being.

CBT is the most empirical and experiential research-based treatment. Clinical psychology practitioners consider CBT the “gold standard” for treating a plethora of conditions:

• Eating disorders
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Sleep disorders
• Substance use disorders

REBT is a form of CBT. It assists people with identifying and correcting their irrational thoughts and beliefs that can create behavioral and emotional problems.

REBT examines how behaviors, emotions, and thoughts are linked. It may help to bolster rational thinking and healthy emotional responses to adverse events.

The Role of Cognitive Psychologists in the Greater Psychology Field

Researchers publish an overwhelming amount of scientific data on cognitive psychology. Many influential studies provide additional information on the field and its relationship to behavioral psychology, neuropsychology, and neuroscience.

Cognitive psychology is a prominent faction in psychological science. It continues growing as experts expand their knowledge of human psychology.

New findings have provided invaluable guidance to help inform the way we study the brain. Additionally, cognitive psychology research continues to uncover insights about how the mind impacts human behavior.

Psychology Degrees at American Military University

For adult learners interested in studying human behavior and cognitive processes, American Military University (AMU) offers an online bachelor’s degree in psychology and an online master’s degree in psychology . AMU offers flexible programs led by faculty members who bring real-world experience to the virtual classroom.

Courses in these degree programs include personality theories, learning and cognition, scientific writing, multicultural issues in human behavior, deployment psychology, and disaster psychology. For more information, visit our program page.