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... IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Table of Contents Abstract..4 Introduction5 Background5 Problem Statement/Project Purpose......6 Review of the Literature7 Summary of Literature Review10 Theoretical Framework....16 Methods17 Goals/Outcomes17 Project Participants....18 Protection of Human Subjects/Ethical Considerations..19 Perceived Barriers..19 Data Collection..20 Instrument/Tools/Evaluation.20 Data Analysis.....21 Results22 Discussion..30 Conclusion.31 References..32 Appendix36 Appendix A36 Appendix B37 2 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Appendix C.38 Appendix D.39 Appendix E.40 3 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 4 Abstract Throughout the country, Student Registered Nurse Anesthetists (SRNAs) are experiencing stress at an alarming rate. While stress is unavoidable, it tends to upset academic and clinical performance and overall health. This project was the implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness. The implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness will subsequently enhance the ability to learn. Literature supports the effects and importance of mindfulness interventions to reduce stress, anxiety, improve self-efficacy, resiliency and general health. Mindfulness interventions are not routinely incorporated into graduate nursing curricula; therefore, students are not learning these types of stress reduction techniques needed on a day-to-day basis. This study selected a convenience sample of nurse anesthesia students enrolled in the only two programs in Indiana. A pre/postsurvey via the Perceived Stress Scale-14 along with instructions to download the Mindfulness app to a mobile device and utilize it for 10 minutes a day for 14 days. Upon completion of the mindfulness meditation implementation, a reassessment of the perceived stress level of each participant was administered post-final exams of the spring semester. Findings suggest that the implementation of the Mindfulness app for meditation can be fundamentally related to decreased perceived stress and improve self-awareness among nurse anesthesia students. Keywords: mindfulness, stress, anxiety, awareness, resilience, graduate students, nursing, medical IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 5 Implementing mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness Introduction Anesthesia, as an advanced practice nursing specialty, is one that requires, not only critical thinking and technical skills, but also adaptability and resilience. This ability is challenging and not achieved easily. The path one takes to accomplish this, can be daunting, but it is a rewarding endeavor that requires a high level of emotional intelligence and self-efficacy. Within this world of emotional intelligence and self-efficacy, it is well received that nurse anesthesia education is high stress, high stakes mission, neither of which seem to support the development of adaptability and resilience (Connor, 2015). A student registered nurse anesthetist (SRNA) must meet the rigors and requirements of the educational curricula, that ultimately place demands on their personal and professional lives (Griffin, Yancey, & Dudley, 2017). Studies that have been conducted thus far on SRNAs experiences describe the nature and types of stressors that are encountered by students and expand the understanding of the pathogenesis of stress and how it can lead to undesirable outcomes (Griffin et al., 2017). Without the ability to recognize and appropriately handle stress, it can lead to untoward consequences. The utmost concern, as addressed in this project, is how to best manage stress for SRNAs to decrease stress and increase self-awareness. Background The matter of interest in safeguarding the health and mitigating the negative coping strategies that can ensue with stress at a manageable level seems to be an ongoing issue among graduate nursing students. One cannot predict performance by merely referencing the stressful stimuli, and that to predict outcomes in performance, it requires attention to the psychological IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 6 process that created individual differences in reaction (Lazarus & Folkman, 1984). Everyone reacts to stress differently. How one perceives stress is something innate within a person considering their psychological and neurochemical characteristics. While some degree of stress is necessary for motivation and higher performance (Griffin et al., 2017), the multifactorial nature that causes higher stress and coping strategies, diminish the opportunity to increase selfawareness and resilience (Slavin, Schindler, & Chibnall, 2014). In considering options to decrease the stress levels in SRNAs, mindfulness meditation can be implemented. Mindfulness has foundations in several indigenous cultures and is a spiritual practice and is an emerging concept within healthcare that has been proclaimed as a means of resiliency against stress, burnout and mental exhaustion (White, 2013). While mindfulness interventions may be ideal at the start of a nurse anesthesia program (NAP), implementation at any point in this journey can improve the SRNAs ability to cope with stress and learn new skills through cultivating present moment awareness and counteract stressors that lead to increased stress and anxiety. Problem Statement/Project Purpose Nurse anesthesia students experience a plethora of stress in an environment that is high stakes and complex. The demands that are placed on SRNAs may tend to negatively impact selfconfidence and performance levels, which can ultimately trigger unhealthy habits and coping mechanisms. Given the nature of nurse anesthesia education, three major types of stressors may be present: academic stressors, clinical stressors, and external stressors, all of which may vary in each student (Chipas et al., 2012). The American Association of Nurse Anesthetists (AANA) recognizes the impact of stress among SRNAs as a significant concern (American Association of Nurse Anesthetists, 2019). The purpose of this project is to use a mindfulness intervention for SRNAs to manage stress and anxiety to improve their overall sense of well-being. This project IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 7 titled Implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness addresses this notorious problem. While there are several stress reduction techniques used, mindfulness-based stress reduction (MBSR) techniques, is flexible, customizable and mindfulness is practiced in the manner that best suits the individual (Kabat-Zinn, 2003). Review of the Literature A literature review (Table 1) was conducted as a foundation for the project using the search terms stress, anxiety, graduate education, mindfulness, and interventions. A literature search was completed using Google Scholar, PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The scope of the articles was extensive when graduate education was utilized in the search (Thompson, 2018). Upon using mindfulness as a search term, the number of items narrowed, and therefore, the literature scope was acceptable for review. The sum of 26 articles was reviewed initially, and nine were chosen for this project on inclusion criteria. The articles included were published in the English language and within the last decade to disseminate the most current literature (Thompson, 2018). These articles were also from peer-reviewed journals from various disciplines within the specialty of health science and psychology. The exclusion criteria consisted of studies that were not in a university setting and not within levels of evidence I or II. Mindfulness well-defined refers to a meditation practice that cultivates present moment awareness, which encompasses attending to relevant aspects of experience in a non-judgmental manner (Ludwig & Kabat-Zinn, 2008). The study design was limited to randomized control trials (RCT) and meta-analysis to provide the highest level of evidence and reduce bias. The IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 8 studies that were reviewed were divided into three categories. First, does mindfulness reduce stress and anxiety? Secondly, does participation in the meditation aspect of mindfulness as an intervention increase self-efficacy and/or resiliency? Lastly, how does mindfulness specifically affect students level of stress in health science programs, and what is its relationship to improving self-awareness? Biofeedback utilized as a mindfulness technique was a study that focused on the myriad of stressors that plague nursing students (Ratanasiripong, Park, Ratanasiripong, & Kathalae, 2015). Biofeedback was found to reduce anxiety significantly (p = 0.001), but not stress (p > 0.05) and mindfulness meditation significantly decreased both stress and anxiety (p = 0.002). This study was conducted among 89 nursing students in Thailand who were randomly assigned to one of three groups (Ratanasiripong et al., 2015). There was an intervention biofeedback group, an intervention mindfulness meditation group, and a control group. The control group was the group exposed to the same stimulus; however, no intervention was utilized. In conclusion, while both interventions were effective, mindfulness meditation was effective in both anxiety and stress, and biofeedback was useful in anxiety only. A deficiency of this study is the concentration on the immediate rather than the long-term effects of mindfulness. The study was limited to one nursing school and to improve its reliability, a more diverse population is needed. Mindfulness, is an intervention to enhance self-efficacy, is a platform for future research from this study. In an RCT of 75 Malaysian medical students, a mindfulness-based stress management (MBSM) intervention called Mindful -Gym was introduced to decrease stress and anxiety. The effectiveness of this mindfulness-based stress management (MBSM/Mindful-Gym) to evaluate outcomes relative to perceived stress, mental distress and self-efficacy was the focus, and MBSM IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 9 was implemented to improve psychological distress and manage stress among medical students (Phang, Mukhtar, Ibrahim, King, & Sidik, 2015). This RCT included 75 medical students enrolled in their first through the third year of study from Universiti Putra Malaysia. The design of the study included measurable variables via pre/post surveys. This study utilized a modified (5-week) MBSM based on the principles of the standard 8-week MBSR programs (Kabat-Zinn, 2003) to have more emphasis on experimental training and daily practice tailored for medical students (Phang et al., 2015). There were significant improvements in perceived stress (p = 0.009), mental distress (p = 0.003), and self-efficacy (p < 0.001) at one-week post-intervention. Thus, six months post-intervention higher self-efficacy reported no difference regarding stress or psychological distress. The objective of the study was to establish an effective stress management program for medical students; this was achieved. Furthermore, indications from this research conclude that this program is critical to stress management and increased selfefficacy as a resolution for Malaysian medical students. Warnecke, Quinn, Ogden, Towle, & Nelson (2011), carried out a single-blinded RCT in three medical schools attached to the University of Tasmania to determine whether mindfulness reduces the level of stress in medical students in their senior year. The authors conducted this study among 66 medical students and concluded that mindfulness practice reduced stress and anxiety. The study design included two-self report surveys at baseline then at eight weeks concerning the intervention that included an audio cd of guided mindfulness meditation. The findings were that mindfulness reduced stress in senior medical students and the prevalence of stress can have adverse effects not only on the students but the patients as well (Warnecke et al., 2011). An important discussion point in this is that there was a wide range of baseline stress scores and stress, which was controlled by multivariable analysis. Thus, stress is the focal point IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 10 in this study. Multivariable analysis was used to control Despite the small sample size as a limitation, there was a sustained effect in utilizing mindfulness interventions. The study, despite the limitation, still impart support to the use of mindfulness to decrease stress and anxiety. The discussion of the various aspects of mindfulness and its relationship to stress and anxiety have been supported by the reviewed research. The authors maintain that stress for students is unlikely to decrease; therefore, it would be essential to provide an avenue for the students to increase their ability to cope with stress. The research, as listed in the matrix of the literature review is comprised of RCTs and meta-analysis (Table 1), all convenience samples to include large and small sample sizes. Summary from Literature Review Conclusions from this review propose that MBSR interventions are used in several ways to decrease stress and anxiety. While stress and anxiety share several of the same physical indicators, there are some key differences. In short, stress is the bodys reaction to an external trigger, which can be positive or negative and anxiety is a sustained mental health disorder that can be triggered by the negative effect of stress (Hurley, 2019). Therefore, despite variations in types of mindfulness interventions, the literature supports the suggestion that the incorporation of mindfulness in daily practice reduces perceived stress, increase self-awareness, and overall resiliency in health science students. Furthermore, the literature supports the fact that regardless of health science specialty, mindfulness interventions are effective in decreasing stress. The likelihood that the use of mindfulness can foster a link between promoting improved self-efficacy in students is essential to optimal outcomes. Many have concentrated on medical, dental, and nursing undergraduate and graduate-level students. A valid case has been made concerning the amount of stress and anxiety that encompasses health science majors at all levels. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE The literature supports the implementation of mindfulness intervention during education for nursing, medical and dental students to increase self-efficacy, decrease stress and anxiety, and overall well-being. The link between mindfulness, reduced stress, reduced anxiety, and increased selfefficacy has remained identified in the literature as an effective way to reduce perceived stress and anxiety. While the literature provides a plethora of examples of how useful mindfulness interventions are, there are some limitations. Additional research is warranted to recognize broader, diverse RCTs regarding the acknowledged barriers via the utilization of MBSR programs. Throughout the literature, mindfulness interventions at various lengths have been described, with no gold standard as a guide. 11 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 12 Table 1. Literature Matrix Author/Year Study Design Sample Mindfulness Intervention Primary Outcomes Results Conclusion Warnecke et al. RCT N=66 Meditation Stress Significant reduction in for stress (p<.050) and anxiety (p=.050) Mindfulness practices reduce stress and anxiety among medical students. Koru Perceived stress, sleep problems Significant correlations were observed among changes in perceived stress (p=.037) and sleep problems (p=.033) The use of Koru is effective for emerging adults in a university setting. Biofeedback and meditation Stress and Anxiety Biofeedback significantly decreased anxiety and maintained stress levels in nursing students. Mindfulness meditation similarly reduced anxiety levels (p=.002) while also lowering stress levels (p= .001) The use of biofeedback and mindfulness meditation supported Mindfulnessbased stress Stress Significant progress in perceived stress, Effective stress management 2011 Medical students Greeson et al. RCT N=90 2015 College students and emerging adults Ratanasiripong, RCT et al. 2015 Phang et al N=89 Nursing Students RCT N=75 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Author/Year Study Design Sample 2015 Medical students Falsafi, N RCT N=90 2016 Mindfulness Intervention RCT N=183 2016 Medical or Dental students Primary Outcomes management (Mindful Gym) Meditation and yoga College students Kuhlmann et al. 13 Conclusion mental distress, and self-efficacy. program for medical students p>.020 Depression Stress Anxiety MediMind Results Stress Depression, anxiety, and stress symptoms decreased significantly (p< .010) Mindfulness meditation and yoga were helpful with symptoms of depression, stress, and anxiety. Some preferred one over the other due to minor limitations. A selective drop-out for students who suffered more often from psychological symptoms was detected (p=.020). On the BSI, a significant overall interaction effect became apparent (p=.002) post hoc analyses were not significant. The use of MediMind contributes to a decrease in psychological morbidity. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Author/Year Study Design Sample Lynch et al. Randomized WaitList Control Study Meta-Analysis 2018 Bamber et al. 2018 Primary Outcomes Results Conclusion N=38 Meditation Graduate and undergraduate students. Academics, anxiety, depression and perceived stress Significant decrease in anxiety p=.01), perceived stress (p=.01) and depression (p=.05) Mindfulnessbased coping for university life is an acceptable and useful program, however further investigation with larger sample size needed N=1492 Meditation Graduate and undergraduate students. Anxiety Mindfulness-based interventions are significantly effective in decreasing anxiety in college students (p<.001). Mindfulnessbased interventions should be flexible to encourage participation and eliminate inconsistency. It is important to explore further utilizing mindfulnessbased interventions in this specific population considering anxiety is rapidly increasing. 22 journal studies 3 dissertations Mindfulness Intervention 14 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 15 Author/Year Study Design Sample Mindfulness Intervention Primary Outcomes Results Conclusion Yusufov et al. Meta-Analysis N=4400 Graduate and undergraduate students. CBT, coping skills training, relaxation training, Anxiety and Stress Cognitive-behavioral therapy, coping skills, and social support interventions were more effective in reducing perceived stress, whereas relaxation training, MBSR, and psychoeducation were more effective in reducing anxiety. p<.001 All techniques were effective in reducing stressrelated outcomes 2018 RCT: Randomized Control Trial; MBSR: Mindfulness-Based Stress Reduction; CBT: Cognitive-Based Therapy; BSI; Brief Symptom Inventory IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 16 Theoretical Framework Based on results from the review of the literature, Lazarus and Folkmans Psychological Stress and Coping Theory (1986), also known as Transactional Model for Stress and Coping (Appendix A) was chosen as the theoretical framework for this project. This theory highlights the transactional approach of stress which refers to a relationship with the environment that the person appraises as significant for his or her well-being and in which the demands tax or exceed available coping resources (Lazarus & Folkman, 1986). This theory can be applied to SRNAs as the focus of the theory and the resultant self-awareness of how unmanaged stress and anxiety can lead to adverse consequences, which can ultimately impede their ability to become a certified registered nurse anesthetist (CRNA). The theory predicts that mindfulness interventions will provide a gateway to decreased stress and anxiety in SRNAs that may subsequently improve self-awareness. Grounded on Lazarus and Folkmans theory, which analyzes the role of personal control in stress and coping from the perspective of cognitive appraisal and coping (Folkman, 1984). This theory posits that cognitive appraisal and coping, as mediators of stress related outcomes according to Folkman (1984), along with control as a generalized belief of an individual concerning the extent to which outcomes can be controlled. Therefore, interventions must allow the SRNA to practice stress reduction and improved self-efficacy in a way that appraisals of personal control are likely to change throughout a stressful situation. The use of mindfulness meditation as a technique to cope with stress helps alter thoughts and actions an individual applies to manage the external and/or internal demands of a specific environmental transaction that is appraised as stressful (Lazarus & Folkman, 1984). Mindfulness can be viewed as a type of self-control strategy (Marlatt & Marques, 1977) to counteract stimuli that may aggravate IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 17 stress. An appraisal is an assessment that categorizes the stressor according to the level of importance and outcome. An appraisal is a subjective process that is based on context, perceived threat, and past experiences. Cognitive appraisal is subdivided into primary and secondary appraisals. Primary appraisal is the evaluation of a stressor perceived as a threat or challenge. Secondary appraisal encompasses how one handles the stressor and the available resources to manage the situation. Individual differences and vulnerabilities effect the appraisal process and the quality of emotions experienced (Lazarus & Folkman, 1984). The utilization of mindfulness meditation, grounded in the theoretical principles of Lazarus and Folkmans theory of stress and coping, may ultimately decrease stress and anxiety, thus increasing self-awareness. Methods The student participants were from both nurse anesthesia programs in Indiana slated to graduate in year 2020 and 2021 and were recruited via email invitation sent by the administrative assistant of Marian University Leighton School of Nursing Doctor of Nursing Practice program and the program director of University of St. Francis Doctor of Nursing Practice program during the 12th week of the spring semester. The interested students gave their consent by accessing the link to the survey (Appendix E). All of the students were enrolled in at least 12 credit hours. The student participants were provided instructions within the email to download the Mindfulness App (Appendix B) and were asked to commit 10 minutes per day for 14 days. This activity was solely their decision as to how much time they invested in practicing mindfulness. Confidentiality was maintained during the pre- and post-survey, as there were no identifiers disclosed regarding the participants except to identify their age group, which nurse anesthesia program they were enrolled in, and graduation year. The administrative assistant re-administered IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 18 the PSS-14 to the student participants at the prescheduled time at the end of the semester following final exams. Goals/Outcomes The objective of this project was to learn how a mindfulness intervention affected stress levels in SRNAs, to utilize a mindfulness technique to decrease perceived stress and anxiety and improve self-awareness through mindfulness meditation. It is expected that a decrease in stress and anxiety level will ultimately improve self-awareness, learning ability, and resiliency. The stakeholders included in this project are registered nurses who are pursuing graduate-level education specializing in anesthesia. According to the literature, students pursuing this educational track, are at risk for increased stress and anxiety, which can ultimately have adverse outcomes. This intervention will objectively measure the result of mindfulness on the perceived stress and anxiety levels. Project Participants The participants were recruited as a convenience sample and consisted of students who are actively enrolled in the Universitys DNP program anesthesia track. SRNAs in Indiana from the only two programs in the state in their first and second year of the program. Both universities are comprised of a total of 59 SRNAs. The first year SRNAs (n=33) are currently in the didactic portion of the program and have not started clinical rotations. The second year SRNAs (n=26) have begun clinical rotations as well as didactic courses. The only restriction was that participants were actively enrolled in one of the DNP nurse anesthesia programs in Indiana. Both programs are similar in many ways. They offer the DNP as the terminal, 36-month degree. Clinical rotations begin in the second year, and both programs have virtually the same IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 19 academic plan and credit requirements for degree completion. Both programs are private and faith-based, and neither are on medical campuses. Also, both programs accepted their inaugural class the same year. Based on the curriculum in both programs, the 2020 cohorts was expected to juggle didactic classes in addition to clinical rotations, while the 2021 cohorts were in didactic classes without clinical rotations. With the similarities, there are some slight differences in admission criteria, Marian University requires a prerequisite online course in statistics/epidemiology offered by the university and the University of St. Francis requires two courses in chemistry. Despite the differences, both programs have similarities that are rigorous, intense and time-consuming. This amount of rigor tends to awaken the stress response. Lazarus and Folkmans Theory of Stress and Coping provides a model that allows for recognizing the stress, appraising it, and then utilizing a coping process to manage internal and external demands. Lazarus & Folkman (1986), explain that stress is a condition or feeling experienced when one perceives that the demands exceed the personal and social resources of the individuals ability to can handle. Protection of Human Subjects/Ethical Considerations The intervention project was reviewed by the Institutional Review Board of Marian University and deemed to be exempt from the need for human subjects protection (Appendix C). This DNP project does not pose a conflict of interest in either university. The subjects were self-selected and were not considered to be a vulnerable population, as no faculty were involved in the project. The literature supports this intervention and has found it to be effective. Therefore, limited harm or risk to the participants is anticipated. All data have been password protected by the principal investigator. Oversight of this project was done by the principal investigator in collaboration with the faculty and project mentor(s). IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 20 Perceived Barriers There are several possible barriers during the implementation that can be encountered. The study did not include any control group or randomization as the participants were selfselected. The lack of this could create bias related to sampling and decreases the generalizability of findings. The sample size will most likely prove to be a limitation of the project. Initially, the project began with 14 participants; the goal throughout the 2-week project was that all participants were able to complete all elements of the project. Thus, only 10 participants completed the post survey. Other barriers are the inability to verify that the same participant(s) who completed the pre-survey also completed the post-survey; therefore, the ability to control compliance is limited. Future studies may benefit from a design that includes randomization and a control group, increased number of participants, and instruction on the benefits of mindfulness interventions. Providing the participants with a mobile phone application to download, proved to be a limitation as technology, skepticism, and distractions could be overpowering elements with the intervention. Additionally, the aspects of the Mindfulness App demonstrated complexity as it had various features within the app. The daily requirement of practicing mindfulness for two weeks posed another limitation as setting aside time every day was challenging. Failure to understand the philosophy and functionality of mindfulness meditation could also lessen the benefits of the intervention. Data Collection The survey was administered electronically using school email accounts and data were collected using Qualtrics so that the calculations of the PSS-14 were available to the principal investigator. The surveys were completed online, and participants were provided a link before IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 21 implementation and after implementation was complete. The participants entered the data into the survey via the link provided. The pre-survey scores provided a baseline analysis of perceived stress and anxiety and was utilized to determine the effect of the intervention. After participating in the intervention, a post-survey was sent to the participants via email following final exams. Participants had approximately 14 days to complete the post-survey for definitive data collection. Instrument/Tool/Evaluation The Perceived Stress Scale (PSS-14) (see Appendix D) was utilized to measure the level of perceived stress of the participants. The PSS-14 was established by Sheldon Cohen and is broadly regarded as a psychological instrument for evaluating stress perception (Cohen & Williamson, 1988). This tool was developed to measure the degree to which a situation is perceived as stressful (Cohen, Kamarck, & Mermelstein, 1983). This tool tends to exhibit acceptable reliability across the literature. Specifically, items are designed to measure the extent to which ones life is perceived as unpredictable, uncontrollable, and overloading (Cohen et al., 1983). The principal investigator asked the participants to complete the survey and indicate on a 5-point Likert-type scale (0 = never to 4 = very often) as a reply to each question. The preand post-survey took approximately 10 minutes each to complete and was distributed via an online link with complete instructions (Appendix E). The outcomes in this pre/post assessment are the aggregate scores of the PSS-14 post-intervention application and demonstration of a change in perceived stress, anxiety, and self-awareness. Data Analysis Measurement approaches aim to encompass a quantitative analysis of PSS-14 scores to compare stress and anxiety pre and post-intervention. Differences between the pre/post survey item means for the 2020 cohort are reported in Table 2. Differences between the pre/post survey IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 22 item means for the 2021 cohort are reported in Table 3. Mean differences between the two cohorts are reported in Table 4. This aimed to determine if the difference in the mean between the pre/post surveys would be zero. To confirm that all the data were free of errors, Qualtrics was used so that all questions had a predetermined response. The distribution of scores for each test was determined and found to be standard by separating each cohorts responses. Results The outcome measures for the project were assessed and based on the changes in the scores from the PSS-14. Descriptive statistics were used to evaluate patterns of perceived stress as a result of participating in mindfulness medication via the Mindfulness app. A total of 16 students were initially recruited and completed the pretest survey. Six participants were excluded from analysis because of failure to complete the post-survey. As a result, ten participants (n=10) completed both pre and post surveys. Of the 10 participants, 60% (n=6) of them were enrolled in didactic courses in addition to clinical rotations, and the other 40% (n=4) were enrolled in didactic courses without clinical rotations. There was not a noteworthy difference in perceived stress between those who were in clinical rotations and those who were not. The results of the project for the 2020 cohort (Table 2) and the 2021 cohort (Table 3) showed that self-reported perceived stress decreased stress overall. Thus, there were substantial decreases post intervention in how often stress was felt, increases in being control of situations, staying on top of thing and accomplishing tasks. Participants also reported a decrease in how often they felt upset due to something that happened unexpectedly and an increase in how confident they were in their ability to handle their personal problems. The mean difference is thought-provoking to note that utilizing mindfulness meditation for 10 minutes per day for two IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 23 weeks had a positive effect on all participants, despite where they were within the nurse anesthesia program. Subsequently, the 2021 cohort showed a remarkable difference (Table 4) as it related to things going their way, coping with things that had to get done, and controlling the irritations of life. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Table 2. Cohort 2020 pre- and post-intervention means (n=8) Item Pre-intervention Post-intervention 1. In the last month, how often have you been upset because of something that happened unexpectedly? 2. In the last month, how often have you felt that you were unable to control the important things in your life? 3. In the last month, how often have you felt nervous and stressed? 4. *In the last month, how often have you felt confident about your ability to handle your personal problems? 5. *In the last month, how often have you felt that things were going your way? 6. In the last month, how often have you found that you could not cope with all the things that you had to do? 7. *In the last month, how often have you how often have you been able to control irritations in your life? 8. *In the last month, how often have you felt that you were on top of things? 24 3.0 (8) 2.5 (6) Pre- to postdifference - 0.5 2.8 (8) 2.6 (6) - 0.2 3.9 (8) 3.3 (6) - 0.6 3.6 (8) 4.0 (6) 0.4 3.3 (8) 3.8 (6) 0.5 2.6 (8) 2.5 (6) - 0.1 3.6 (8) 3.7 (6) 0.1 3.6 (8) 4.1 (6) 0.5 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Item Pre-intervention Post-intervention 25 Pre- to postdifference - 0.1 9. In the last month, 2.8 (8) 2.7 (6) how often have you been able to control the irritations in your life? 10. In the last month, 2.3 (8) 2.2 (6) - 0.1 how often have you felt difficulties were piling up so high that you could not overcome them? 11. In the last month, 2.8 (8) 2.7 (6) - 0.1 how often have you been angered because of things that happened that were outside of your control? 12. In the last month, 4.8 (8) 4.3 (6) - 0.5 how often have you found yourself thinking about things that you have to accomplish? 13. *In the last month, 3.3 (8) 3.4 (6) 0.1 how often have you been able to control the way you spend your time? 14. In the past month, 2.4 (8) 2.4 (6) 0 how often have you felt difficulties were piling up so high that you could not overcome them? NOTE: Responses of two participants were excluded from reporting and analysis, because they were the only respondents from the second institution and did not complete the post-test survey. The responses consisted of a cohort (2020) who were in clinical rotations along with didactic courses. *Numbers 4, 5, 7, 8, and 13 are scored in reverse direction. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Table 3: Cohort 2020 pre- and post-intervention means (n=6) Post-intervention Item Pre-intervention 1. In the last month, how often have you been upset because of something that happen unexpectedly? 2. In the last month, how often have you felt that you were unable to control the important things in your life? 3. In the last month, how often have you felt nervous and stressed? 4. *In the last month, how often have you felt confident about your ability to handle your personal problems? 5. *In the last month, how often have you felt that things were going your way? 6. In the last month, how often have you found that you could not cope with all the thing that you had to do? 7. *In the last month, how often have you how often have you been able to control irritations in your life? 8. *In the last month, how often have you felt that you were on top of things? 9. In the last month, how often have you been able to control the irritations in your life? 26 3.1 (6) 2.4 (4) Pre- to postdifference - 0.7 3 (6) 2.6 (4) - 0.4 4 (6) 3.3 (4) - 0.7 3.5 (6) 3.9 (4) 0.4 3.2 (6) 4.0 (4) 0.8 2.8 (6) 2.4 (4) - 0.4 3.5 (6) 3.9 (4) 0.4 3.6 (6) 4.1 (4) 0.5 2.9 (6) 2.7 (4) - 0.2 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Item Pre-intervention Post-intervention 27 Pre- to postdifference - 0.2 10. In the last month, how 2.4 (6) 2.2 (4) often have you felt difficulties were piling up so high that you could not overcome them? 11. In the last month, how 2.8 (6) 2.6 (4) - 0.2 often have you been angered because of things that happened that were outside of your control? 12. In the last month, how 4.7 (6) 4.1 (4) - 0.6 often have you found yourself thinking about things that you have to accomplish? 13. *In the last month, 3.3 (6) 3.6 (4) 0.3 how often have you been able to control the way you spend your time? 14. In the past month, how 2.5 (6) 2.4 (4) - 0.1 often have you felt difficulties were piling up so high that you could not overcome them? NOTE: Responses of two participants were excluded from reporting and analysis, because they were the only respondents from the second institution and did not complete the post-test survey. The responses consisted of a cohort (2021) who were taking didactic courses without clinical rotations. *Numbers 4, 5, 7, 8, and 13 are scored in reverse direction. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 28 Table 4: Mean differences comparison between Cohort 2020 and 2021 by item Item 1. In the last month, how often have you been upset because of something that happen unexpectedly? 2. In the last month, how often have you felt that you were unable to control the important things in your life? 3. In the last month, how often have you felt nervous and stressed? 4. *In the last month, how often have you felt confident about your ability to handle your personal problems? 5. *In the last month, how often have you felt that things were going your way? 6. In the last month, how often have you found that you could not cope with all the thing that you had to do? 7. *In the last month, how often have you how often have you been able to control irritations in your life? 8. *In the last month, how often have you felt that you were on top of things? 9. In the last month, how often have you been able to control the irritations in your life? 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? 2020 difference 2021 difference -0.5 -0.7 -0.2 -0.4 -0.6 -0.7 0.4 0.4 0.5 0.8 -0.1 -0.4 0.1 0.4 0.5 0.5 -0.1 -0.2 -0.1 -0.2 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Item 2020 difference 11. In the last month, how often -0.1 have you been angered because of things that happened that were outside of your control? 12. In the last month, how often -0.5 have you found yourself thinking about things that you have to accomplish? 13. *In the last month, how 0.1 often have you been able to control the way you spend your time? 14. In the past month, how 0 often have you felt difficulties were piling up so high that you could not overcome them? NOTE: *Numbers 4, 5, 7, 8, and 13 are scored in reverse direction. 29 2021 difference -0.2 -0.6 0.3 -0.1 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 30 Discussion The principal objective of this project was to implement mindfulness meditation as an adjunct to decrease stress among nurse anesthesia students who encounter high stress in a rigorous and demanding program. The sequential purpose of the project is to improve selfawareness using mindfulness meditation to mitigate the effects that come from increased stress. A two-week, 10-min per day mindfulness meditation via an app was implemented with initially 16 students from two cohorts. However, only 14 completed the entire program. Overall, participants from both cohorts were able to engage in the project as intended. The literature supports that other approaches to decrease anxiety, for example, biofeedback unaccompanied, decreases anxiety, but not stress levels. Mindfulness interventions decreased anxiety, along with stress (Ratanasiripong et al., 2015). Numerous MBSR programs have lengthy time commitments, which is an identified barrier. The rigor of a nurse anesthesia program is vastly stressful, thus rendering time constraints on students. Students would benefit from understanding the relevance of this intervention and its valuable effects on stress reduction. Warnecke et al. (2011), further substantiate that there is a sustained effect of using mindfulness. Their research was impacted by a small sample size; however, the use of mindfulness is still substantially supported. Lazarus and Folkmans Theory of Stress and Coping focuses on the transactional approach to stress and coping, which identifies that a response to a stressor has two main components, an environmental relationship that is appraised as stressful, and an appraisal of how well the stressor can be managed (Lazarus & Folkman, 1984). In this project, the rigors of nurse anesthesia education is the stressor, and this can be managed by SRNAs utilizing mindfulness interventions. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 31 Conclusion SRNAs, at the doctoral level, are challenged with a demanding and stressful educational and clinical environment that reflects the current state of healthcare. Nurse anesthesia education is both high stakes and overwhelming concerning knowledge acquisition and the development of clinical skills to deliver safe care. To develop competent, capable, and resilient anesthesia providers to serve a challenging patient population is the challenge. The intervention implemented was a Mindfulness-Based Stress Reduction program and was presented to a sample of Doctor of Nursing Practice nurse anesthesia students. Implementation was through the MINDFULNESS app and was composed of 10-minute daily meditations for a period of two weeks. The techniques within the app focused on breathing and present moment awareness. Their level of perceived stress was assessed by way of pre- and post-survey answers. The association between the intervention and decreased perceived stress and increased self-awareness proved useful. It is apparent that the use of mindfulness meditation positively affected the perceived stress levels and self-awareness of the students. It would prove helpful to know if introduced at the beginning of the program in addition to utilizing a control group would pose a more significant effect. This would be a suggestion in future research. A program geared toward nurse anesthesia students specifically will be discussed and proposed as an adjunct to current Wellness Center offerings. This project will be presented upon request High stress in an environment where optimal performance is paramount that SRNAs are receiving education and the clinical setting is not conducive to knowledge acquisition or the development of empathy. Mindfulness interventions are necessary to promote what may be essential to deliver safe, anesthesia care. IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 32 References American Association of Nurse Anesthetists (AANA). (2019). https://www.aana.com/practice/health-and-wellness-peer-assistance/about-healthwellness Bamber, M. D., & Morpeth, E. (2018). Effects of mindfulness meditation on college student anxiety: A meta-analysis. Mindfulness, 2, 203-214. https://doi.org/10.1007/s12671-0180965-5 Beddoe, A., & Murphy, S. (2004). Does mindfulness decrease stress and foster empathy among nursing students? Journal of Nursing Education, 47, 305-312. Retrieved from https://login.forward.marian.edu/login?url=http://search.ebscohost.com/login.aspx?direct =true&db=rzh&AN=106774102&scope=site Biggs, A., & Drummond, S. (2017). Lazarus and Folkmans psychological stress and coping theory. https://doi.org/10.1002/9781118993811.ch21 Butler, M., Collins, R., Drennan, J., Halligan, P., OMathuna, D., Schultz, T., ... Vilis, E. (2011, July 6). Hospital nurse staffing models and patient and staff-related outcomes. Cochrane Database of Systematic Reviews, 7. https://doi.org/10.1002/14651858.CD007019.pub2 Chipas, A., Cordrey, D., Floyd, D., Grubbs, L., Miller, S., & Tyre, B. (2012). Stress: perceptions, manifestations, and coping mechanisms of student registered nurse anesthetists. AANA Journal, 80, S49-S55. Retrieved from https://login.forward.marian.edu/login?url=http://search.ebscohost.com/login.aspx?direct =true&db=aph&AN=78332491&scope=site Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396. Retrieved from IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 33 http://search.ebscohost.com.forward.marian.edu/login.aspx?direct=true&db=mnh&AN=6 668417&scope=site Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. S. Spacepam & S. Oskamp (Eds.). Retrieved from http://www.psy.cmu.edu/~scohen/Cohen%2C%20S.%20%26%20Williamson%2C%20G. %20(1988).pdf Connor, M. (2015). Self-efficacy, stress, and social supportin retention of student registered nurseanesthetists . AANA Journal, 83, 133-138. Retrieved from www.aana.com/aanajournalonline Falsafi, N. (2016). A randomised control trial of mindfulness versus yoga: Effects on depression and/or anxiety in college students. Journal of the American Psychiatric Nurses Association, 22, 483-497. https://doi.org/10.1177/1078390316663307 Folkman, S. (1984). Personal control and stress and coping processes: A theoretical analysis. Journal of Personality and Social Psychology, 46, 839-852. https://doi.org/10.1037/00223514.46.4.839 Greeson, J., Juberg, M., Maytan, M., James, K., & Rogers, H. (2014). A randomized control trial of koru: A mindfulness program for college students and other emerging adults. Journal of American College Health, 62, 222-233. https://doi.org/10.1080/07448481.2014.887571 Griffin, A., Yancey, V., & Dudley, M. (2017). Wellness and thriving in a student registered nurse anesthetist population. AANA Journal, 85, 325-330. Retrieved from https://login.forward.marian.edu/login?url=http://search.ebscohost.com/login.aspx?direct =true&db=rzh&AN=125553517&scope=site IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 34 Hurley, K. (2019, March 19). Stress vs anxiety: How to tell the difference. PSYCOM. Retrieved from psycom.net/stress-vs-anxiety-difference Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10, 144-156. https://doi.org/10.1093/clipsy.bpg016 Kuhlmann, S. M., Huss, M., Burger, A., & Hammerle, F. (2016). Coping with stress in medical students: Results of a randomized control trial using mindfulness-based prevention training (medi-mind) in Germany. BMC Medical Education, 16(1), 1-11. https://doi.org/10.1186/s12909-016-0833-8 Lazarus, R., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer. Lazarus, R. S., & Folkman, S. (1986). Cognitive theories of stress and the issue of circularity. M. H. Appley & R. Trumbull (Eds.). New York, NY: Plenum. Ludwig, D., & Kabat-Zinn, J. (2008). Mindfulness in medicine. JAMA, 300, 1350-1352. https://doi.org/10.1001/jama.300.11.1350 Lynch, S., Gander, M., Nahar, A., Kohls, N., & Walach, H. (2018). Mindfulness-based coping with university life: A randomized wait-list controlled study. Sage Journals, 8(1), 1-7. https://doi.org/10.1177/2158244018758379 Marlatt, G. A., & Marques, J. K. (1977). Meditation, self-control, and alcohol use. R. B. Stuart (Ed.). New York: Burner/Mazel. Phang, C., Mukhtar, F., Ibrahim, N., King, S., & Sidik, S. (2015). Effects of a brief mindfulnessbased intervention program for stress management among medical students: The mind-ful gym randomized control study. Advances in Health Sciences Education, 20, 1115-1134. https://doi.org/10.1007/s10459-015-9591-3 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 35 Ratanasiripong, P., Park, J., Ratanasiripong, N., & Kathalae, D. (2015). Stress and anxiety management in nursing students: Biofeedback and mindfulness meditation. The Journal of Nursing Education, 54, 520-524. https://doi.org/10.3928/01484834-20150814-07 Slavin, S., Schindler, D., & Chibnall, J. (2014). Medical student mental health 3.0: Improving student wellness through curricular changes. Academic Medicine, 89, 573-577. https://doi.org/10.1097/ACM.0000000000000166 Thompson, T. (2018). Literature Review. Unpublished manuscript, Leighton School of Nursing, Marian University, Indianapolis, IN. Warnecke, E., Quinn, S., Ogden, K., Towle, N., & Nelson, M. (2011). A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Medical Education, 45, 381-388. https://doi.org/10.1111/j.1365-2989.2010.03877 White, L. (2013). Mindfulness in nursing: An evolutionary concept analysis. Journal of Advanced Nursing, 70, 282-294. https://doi.org/10.1111/jan.12182 Yusufov, M., Nicoloro-SantaBarbara, J., Grey, N., Moyer, A., & Lobel, M. (2018). Metaanalytic evaluation of stress reduction interventions for undergraduate and graduate students. International Journal of Stress Management, 1-19. https://doi.org/10.1037/str0000099 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Appendix A Transactional Model for Stress and Coping 36 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Appendix B 37 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 38 Appendix C Institutional Review Board DATE: February 5, 2019 TO: Terineka Thompson FROM: Marian University IRB RE: IRB Protocol # S19.004 TITLE: Implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness SUBMISSION TYPE: New Project ACTION: Determination of Exempt Status DECISION DATE: February 1, 2019 The Institutional Review Board at Marian University has reviewed your protocol and has determined the procedures proposed are appropriate for exemption under the federal regulations. As such, there will be no further review of your protocol and you are cleared to proceed with your project. The protocol will remain on file with the Marian University IRB as a matter of record. It is the responsibility of the PI (and, if applicable, the faculty supervisor) to inform the IRB if the procedures presented in this protocol are to be modified or if problems related to human research participants arise in connection with this project. Any procedural modifications must be evaluated by the IRB before being implemented, as some modifications may change the review status of this project. Please contact Karen Spear at (317) 955-6115 or kspear@marian.edu if you are unsure whether your proposed modification requires review. Proposed modifications should be addressed in writing to the IRB. Please reference the above IRB protocol number in any communication to the IRB regarding this project. Although researchers for exempt studies are not required to complete online CITI training for research involving human subjects, the IRB recommends that they do so, particularly as a learning exercise in the case of student researchers. Information on CITI training can be found on the IRBs website: http://www.marian.edu/academics/institutional-review-board Karen L. Spear, Ph.D., Interim-Chair, Marian University Institutional Review Board IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE Appendix D The Perceived Stress Scale (14 items) - Cohen et al, 1983 Recommended by The NIH Centers for Population Health and Health Disparities (CPHHD)-Measures and Methods Work Group (MMWG) CPHHD Taxonomy- Health and Mental Health [Well-being]-stress & hypervigilance-Perceived Stress Also recommended by MacArthur Foundation (see http://www.macses.ucsf.edu/research/psychosocial/stress.php#perceived) 1. In the last month, how often have you been upset because of something that happened unexpectedly? 2. In the last month, how often have you felt that you were unable to control important things in your life? 3. In the last month, how often have you felt nervous and stressed? 4. In the last month, how often have you dealt successfully with irritating life hassles? 5. In the last month, how often have you felt that you were effectively coping with important changes that were occurring in your life? 6. In the last month, how often have you felt confident about your ability to handle your personal problems? 7. In the last month, how often have you felt that things were going your way? 8. In the last month, how often have you found that you could not cope with all the things that you had to do? 9. In the last month, how often have you been able to control irritations in your life? 10. In the last month, how often have you felt that you were on top of things? 11. In the last month, how often have you been angered because of things that happened that were outside of your control? 12. In the last month, how often have you found yourself thinking about things that you have to accomplish? 13. In the last month, how often have you been able to control the way you spend your time? 14. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? [0=never; 1=almost never; 2=sometimes; 3=fairly often; 4=very often] Note: Items 4, 5, 6, 7, 9, 10, and 13 are scored in reverse direction. 39 IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 40 Appendix E Dear fellow SRNAs, You are invited to participate in a research study titled Implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness. This study is being conducted by Terineka Thompson, principal investigator and student registered nurse anesthetist at Marian University. The purpose of this survey is to examine the prevalence of mindfulness meditation in nurse anesthesia programs and to determine student stress levels and perceived selfawareness. You are being asked to take part in this study because you are a student in a Nurse Anesthesia program in Indiana. The survey consists of 17 multiple choice questions with the last three questions relating to demographics for group comparison. Once the survey has been completed, please download the MINDFULNESS APP to your mobile device, available for iPhone and Android users. This phase of the project consists of utilizing the app DAILY for 14 days via timed sessions for 10 minutes each day. There will be a follow up survey sent via email after final exams. Pre and post surveys will take approximately 10 minutes each to complete. Participation in this study is entirely voluntary. You can choose not to participate at all, decline to answer any of the questions, or discontinue participation and not submit the online survey. Regardless of your decision, there will be no effect on your relationship with the researcher, Marian University or University of St. Francis. If you agree to participate, you are asked to fill out an online survey the link to the survey is provided below. All the responses to this survey will remain anonymous. Once you submit your completed survey, there will be no way to withdraw your responses from the study. Results of the survey will be provided to the Principal Investigator. If you have any questions regarding the survey, the mindfulness app, or this research project in general, please contact the principal investigator, Terineka Thompson via email at tthompson607@marian.edu or her advisors Memory Mdlongwa at memorym@umaryland.edu or Stacie Hitt at sfhitt@marian.edu. By completing and submitting this survey, you are indicating your consent to participate in this study. Note: This invitation does not imply any endorsement of the survey, research and/or its findings by Marian University, University of St. Francis, INANA or AANA. The survey contents and findings are the sole responsibility of the individual conducting the study. Sincerely, Terineka Thompson, SRNA, Doctoral Candidate, Marian University IMPLEMENTING MINDFULNESS MEDITATION AMONG NURSE 41 Your feedback is humbly requested by April 24, 2019. To start the survey, please follow the link below. https://marian.co1.qualtrics.com/jfe/form/SV_eJbtuxFgHOeqO5T  ...

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... Teaching Professional Networking: Students Building Contacts Outside the Classroom Dr. Jeffery Kaufman, Primary Author Assistant Professor Marian University Oldenburg Hall Rm# 155 3200 Cold Spring Road Indianapolis, IN 46222 Ph: (317) 955-6348 jkaufman@marian.edu Dr. Malar Hirudayaraj, Second Author Assistant Professor Rochester Institute of Technology One Lomb Memorial Drive Lewis P. Ross Hall Rm# 1992 Rochester, NY 14623 Ph: (585) 475-7104 mvhdss@rit.edu Dr. Barbara Hagler, Third Author Associate Professor Southern Illinois University 475 Clocktower Drive Pulliam Hall Rm# 210 Carbondale, IL 62901-4605 Ph: (618) 453-1969 bhagler@siu.edu Teaching Professional Networking: Students Building Contacts Outside the Classroom Abstract This pilot study implemented a method for teaching professional networking to college business communication students. The method introduced students to data on new college graduate unemployment and underemployment, research on methods for filling open positions, and the concept of six degrees of separation. Where most examples of professional networking instruction in prior research took place exclusively in the classroom, this method required students to make and track contacts in their chosen professional fields. Student reactions were captured in reflection papers and an open response survey and analyzed qualitatively using coding and similarity comparison (Boeije, 2010). Responses were not overly surprising as students indicated learning about their career field, the importance of utilizing connections, challenges in networking, and the benefits that can come from networking. The hands-on nature of the instruction and need for networking as a skill among CTE students creates opportunities for future research. Teaching Professional Networking: Students Building Contacts Outside the Classroom Introduction Educators at all levels seek to instill in their students the skills requisite for success, which includes knowledge and skills related to employment and advancement in professional environments. There has been previous research on what educators and employers consider to be necessary job skills. Such skills range from appearance training (Freeburg & Arnett, 2010) to time management, critical thinking, and ethics (Hodge & Lear, 2011). Among these critical skills is the development of a professional network. This pilot study implemented an andragogical approach for teaching networking skills to students in an undergraduate business communication class, which included students from agriculture, automotive, and workforce education, as well as management, accounting, and marketing. The instructional method required students to actually make contact with professionals in their chosen field using personal and professional relationships they already had. While the population of this study was undergraduate students, the skill is relevant since all students will be pursuing employment or career advancement. The model is also scalable as it can be adjusted for varying class sizes and those in secondary, postsecondary, adult, and graduate career education programs. Theoretical Framework The study investigated the process of establishing contact with professionals in their preferred fields might influence the knowledge of undergraduate students about their preferred fields, their preparation to enter the field, and their attitudes towards the transition. Therefore, the study was based on Kolbs Experiential Learning Theory (ELT), which postulates that learning is a process whereby knowledge is created through the transformation of experience (1984, p. 38). The ELT particularly focuses on learning as a process founded on concrete experiences that are augmented by reflection, abstraction, and further experimentation. Following these four phases of the ELT, this project attempted to investigate the process of learning triggered by an authentic networking experience and the outcomes of the learning process. Even though Kolbs theory has been extensively used in different fields of education, this study provided an opportunity to apply it to authentic networking experiences in a college classroom setting. Purpose of the Study The primary research question guiding this study was how the experience of establishing contact with professionals in the students preferred field would impact the career attitudes and preparation of college students. Impetus for the study came from the troubling statistics for high school and young college graduate employment rates. According to Shierholz, Sabadish, and Finio (2013), 8.8 % of college graduates between the ages of 21-24 years of age face unemployment, and 18.3% face underemployment. High school graduates will encounter an even greater struggle. According to the Economic Policy Institute (Shierholz et al., 2013), high school graduates face unemployment rates of 29.9% and underemployment rates of 51.5%. These findings paint a troubling picture for high school and younger college graduates. The study was loosely built off Phase 3 of MacDermotts (1995) networking assignment, which required students to interview a role model in their career path. MacDermotts assignment included five phases, which included choosing a role model, conducting company research, interviewing the role model, writing a resume and cover letter, and engaging in a mock interview. While students in this study were not required to interview the individuals to whom they were referred, this is essentially what they were doing. Students were seeking the referred contacts perspectives and insights regarding the professional field the student was pursuing. At the college level, innovative programs offering a blend of networking instruction and real-world application, such as the Zeigler Institute for Professional Development (ZIPD) at Bloomsburg University in Bloomsburg, Pennsylvania, do exist; and college students in some departments might be encouraged to build a professional network. In fewer cases, career and guidance counselors at the high school level direct students to make professional contacts as part of their career development. Without direction, students are left to try to build connections by indiscriminately accepting invitations to connect on professional networking sites such as LinkedIn, attending alumni functions, or simply hoping it just happens. Effective networking has been shown to be a critical aspect of the job search process (Wanberg, Kanfer, & Banas, 2000), for gaining entry into a career (Forret & Dougherty, 2001), accelerating growth within the field (Thompson, 2005), and for achieving success within careers (Torres, 2005). Networking with professionals can provide access to information about job opportunities, influence career trajectories, and also create possibilities of mentoring within a chosen field (de Janasz & Forret, 2008). It can serve as a means of overcoming information asymmetrics (Urwin, Di Pietro, Sturgis, & Jack, 2008, p. 946) because the level one achieves within an organization correlates with the individuals engagement with professional activities (Forret & Dougherty, 2001). Likewise, networking has been shown to relate to concurrent salary, salary growth, and career satisfaction (Wolff & Moser, 2009). Davis and Warfield (2011) found networking to be a skill that can be taught and cultivated within academia; and de Janasz and Forret (2008) showed that by creating opportunities for undergraduate students to practice networking behaviors, faculty can enhance the networking ability of students. Segrist and Pawlow (2009) suggested that educating undergraduate students about networking was an essential step in preparing them for a career, and Kryder (2011) presented how business communication coursework could be used as an indirect means to help students create professional networks. The instructional methods of Davis and Warfield (2011), de Janasz and Forret (2008), Segrist and Pawlow (2009), and Kryder (2011) were all limited to practice in the classroom rather than requiring students to learn through the practice of actually making contacts and tracking their network. Instructional Methodology The study took place in an introductory business communication class consisting of 55 total students. The assignment was given to all students and the instructor explained that while everyone would be required to complete the assignment and summary paper, they were not required to participate in the study itself and have their responses included in the findings to be analyzed. Institutional Review Board approval was granted and a doctoral student, unrelated to but familiar with the study, presented the consent forms without the instructor present, explained participant rights and fielded questions, and collected the consent forms. The primary researcher, who was the instructor for the class, was not aware of who had agreed to participate. Of the 55 students, 20 agreed to have either their summary paper or a completed survey included as data to be analyzed. In the first step, the instructor began to lay the foundation of the importance of networking by presenting research on the employment situation for new graduates. The information that was presented was specific to new college graduates; but employment data for new high school graduates, such as those mentioned in the introduction, could be provided for appropriate groups. The research that was presented also served as the impetus for the study as it raised concerns as to the opportunities that would be available to these students upon graduation. According to the Economic Policy Institute (Shierholz et al., 2013), 8.8% of college graduates between the ages of 21-24 years of age face unemployment, and 18.3% of those same graduates face underemployment. Research by the John J. Heldrich Center for Workforce Development at Rutgers University (Godofsky, Zukin, & Van Horn, 2011) found in its survey of 22-29 year old college graduates that, among those who are employed, 51% were employed full time. Another 26% reported working part-time; however, 40% reported taking a position that required a four-year degree and only 20% saw their present job as part of their career path. The findings of both of these studies paint a less than promising picture for younger college graduates as they face the very real prospect of unemployment or accepting positions that provide little to no return on the investment they made on their education. In addition to the employment information, student debt was also discussed. The Institute for College Access and Success (2012) found that two-thirds of college students carry some student loan debt, and the average loan balance carried by college graduates has risen to $26,600. The instructor explained that this debt is very difficult to get discharged even in instances of bankruptcy; and that in almost 20% of the cases, graduates took positions they could likely have accepted four years earlier directly out of high school without any debt. Presenting this research to the students was used to engage them in discussions about their job prospects and actions that could be taken to seek advantages when entering the job market. In step two, students were made aware of research regarding the job market and were then asked to identify ways they believed open positions are filled. Answers generally centered on good grades, extracurricular activities, using the alumni network, and knowing others in the field. The instructor provided findings from research conducted by CareerXRoads that revealed that while 42% of all positions are filled internally, the number one method for filling open positions with external candidates was through referrals (Crispin & Mehler, 2013). Referrals accounted for 24.5% of selection, so the instructor asked students to identify areas from which these referrals might originate. The most common network path mentioned was through university alumni. Students understood that such opportunities existed and even indicated a rudimentary understanding of how relationships could be effective tools for gaining employment. In step three, once the concept of professional networking was introduced as an integral aspect of employment attainment for external candidates, the instructor led a discussion on the concept of six degrees of separation. To do so, the instructor explained Frigyes Karinthys (1929) notion of human interconnectedness and how that evolved into the concept of six degrees of separation. This concept was eventually tested in Stanley Milgrims Small World Problem (1967) study where he found the average number of intermediate relationships connecting any two random individuals in the study to be only five. More recently a study of Facebook friend connections found that all friends on Facebook are connected by an average of 4.74 relationships (Backstrom, Boldi, Rosa, Ugander, & Vigna, 2011). The notion of degrees of separation was used to show the students how they were likely connected to people within their chosen field and how a network can grow exponentially. Ultimately all of the statistics were presented to establish the relevance of networking skills as a means to motivate students to engage in the process. Finding ways to make coursework relevant is an ongoing quest for content ranging from math (Stone, Alfeld, & Pearson, 2008) to science (Jenkins, 2011), and professional networking is no different. Students need to see the value of learning networking skills and how professional networking relates to them personally. The assignment was designed to assist in both the development of the networking skills and the creation of an initial set of contacts the students could use when their job search began. In step four students were allowed to choose one of two assignments to complete. This phase was the concrete experiment one where the students were required to directly establish contact with a professional in their field or identify individuals who could lead them to a professional in their field. The first option was to start contacting first degree relationships (defined as anyone who knew the student on a first name basis) and asking those first degree relationships who they knew in the students chosen career field. For example, if the student were a marketing major, he/she would ask his/her first degree relationships for names and contact information for anyone the contact knew who worked in the field of marketing. If the first degree contact did not know anyone in the students chosen field, the student would ask for someone the first degree contact knew who might know someone in the chosen field. The student would email or call the second degree relationships and map each of them, even if not in the students field, in an Excel spreadsheet. A truncated example of a contact map is provided in Figure 1. 3rd Degree Relationship Primary Student (1st degree) relationship 2nd Degree Relationship in Target Field 2nd Degree Relationship 3rd Degree Relationship In Target Field In Target Field Figure 1Example of a truncated contact map. The second assignment option required the students to choose someone highly influential in their major field or in any industry who may be beneficial in assisting them in their career pursuits. This individual may be a high-powered political figure or corporate executives such as Barack Obama or Bill Gates. The students were not restricted on who they chose, but the potential contact had to be someone relevant to their career and not a first degree relationship. Once the students had chosen the target contact, they were then required to begin contacting their first degree relationships, using those first degree relationships to gather contacts that might know the target person, and determining how many degrees separated them from the target person. As with the first assignment option, the students were required to contact and track all intermediate contacts that led them to their target contact. A visual example of the assignment is provided in Figure 2. Level 2+ Student Level 1 Relationship(s) Target Relationship Figure 2 Student to Target Contact Diagram. Regardless of the option they chose, the students were given approximately 10 weeks to complete the experience phase and; the product at the end of this phase was a written assignment. The assignment prompted the students to reflect on the process of the experience and respond to three simple questions: what went well with their networking process, what challenges did they encounter in establishing professional connections, and what might they change about the process of establishing networks within their fields In step five, all students were emailed the survey two weeks after the conclusion of the semester. Because the instructor was not privy to the students who had agreed to participate, the survey was sent to all students who were then asked to complete it if they agreed to participate in the study. The responses were analyzed to see what new knowledge and concepts were learned about their field and if any changes occurred in their perception about and attitudes towards preparing to transition into the world of work. Findings At the end of the semester, the data (in the form of responses to the survey and the student reflection papers) were analyzed qualitatively. At this stage, meaningful units of data were identified and descriptive labels added to them. Once the individual open coding of the data was completed, the codes were compared and similarities identified (Boeije, 2010). The open codes and units of data attached to them were compiled and connections among the initial codes were sought. When the initial codes were categorized based on similarities, they were moved from descriptive labels to interpretive labels, some of which were informed by the literature in the field and the social capital theory. Once this stage of axial or analytical coding was completed, patterns across the categories were sought. The responses of the students emphasized the learning that had taken place as part of the process of building a professional network. Four main themes emerged from the data. Students had learned about (a) career realities, (b) the process of building a network, (c) challenges in making connections with people, and (d) gains or benefits of establishing professional connections. The following sections elaborate on each of these themes and the first names used are not the actual names of the participants. Career Realities Students who took the survey and/or wrote a short piece about their experience in building a professional network for themselves seemed to have gained a better understanding of the reality of the job market, the process of job search, and the possible means of entry and growth within an industry of their choice. The students in the Business Communication class realized that achieving their career goals was going to take time and effort and it certainly was not going to be a one-step process after graduation. There isnt a direct ladder you can climb to get to the topIn agriculture and specifically in John Deere to get to the top, you have to be part of almost every department along the way for a long time (Ellen). Adam added, It may take little longer to reach my career goals than I wanted Hard hourslot of paper workbut possibilities of advancement. Students learned that the time frame they had in mind to reach their career goals was not very realistic, and that they needed to adjust their time frames based on the entry and growth process of the industry in which they were seeking employment. The conversations students had with actual employees about the process of entry and growth within their fields helped them internalize the reality of their field. Given the state of the economy, they felt that they had to compete with many more candidates than they had imagined. What seemed to have struck home was the reality that the participating students understood that they were not only competing with fresh graduates like themselves but also were competing for the same positions with individuals with work experience who were seeking to re-enter the job market or to switch careers, or who were seeking opportunities to advance in their careers. Its a very competitive job market. There is a lot of experienced, hard-working, competent people out there that are after the same thing as you are (Adam). The students felt that with the nature of competition they had to face, they could take no short-cuts to reach their career goals and establishing a professional network was a means to ensure that more doors opened for them. I have yet to receive a job that was not because of a recommendation and I believe that is most likely how I will be hired in the future (Helen). The networking assignment appeared to establish the importance of building connections within the industry, learning about the field and career opportunities, and also becoming visible to the people who could possibly provide them with a referral. More importantly, the assignment taught the students the importance of becoming a known or a familiar face among the pile of nameless candidates applying for positions in response to a job advertisement. Process of Building a Professional Network To some extent, the networking assignment compelled the students to contemplate their career goals. In order to establish a professional network, the students first had to identify a field they were interested in or in which they would want to work, as well as the organization where they would like to be employed. So they had to focus on their career, even while at college. Like Nancy, who felt that I really need to start thinking about what I want to do and about the people that can help me get there, many others also had spent or wanted to spend time considering their career goals. The process of establishing networks was not easy for many students, especially those who were generally shy or introverted. Most of the respondents stated that initially they had been apprehensive about approaching people they did not know or even talking to people they knew about their own career interests. Some had to overcome their pride to ask for help through emails, especially from people they did not really know very well, or who were beyond their circle of acquaintances. Many had not been sure of the responses they would get. However, like Nancy who said, I didnt expect for people to be so willing to help, most of them expressed a sense of surprise about the helpfulness of their contacts. The helpfulness of the individuals the students contacted allayed their anxiety about networking to an extent and gave some of them the confidence to reach out to more people. In the process of seeking referrals, students realized that establishing professional connections was more important than just winning referrals for the sake of the assignment. Donald stated, I would like to build a relationship instead of just trying to find the next referral. Therefore, students willingly sought opportunities to establish these professional connections in order to gain more information and advice on their career trajectories. Andy, said, I asked him who his supervisors are and if I could get in touch with them and see if they could give me some advice on how to reach my career goals. By doing so, students were achieving multiple goals like gathering inside information about their industry, making themselves familiar to people in hiring positions, and establishing contacts with people who could lead them to people or positions of interest. Most importantly, the networking assignment helped the students see everyone around them as a potential resource from whom to seek support with regard to their career. Challenges in Making Connections Students shared the challenges they faced in getting referrals or establishing professional connections within their industry. One of the major challenges was the lack of goal clarity. Many were in a four-year degree program and were going through their courses without much thought about their careers. In a way, the networking assignment forced them to think beyond college. I had to decide two things; the first was what my actual goal was. What did I want to ultimately end up with? What job was I seeking? (Nancy). Not having adequate insight about their preferred careers or knowledge about their field, they could not determine who would be able to help them in gaining access to their chosen field. Secondly, even though the students could establish social connections with ease, they were not use to building professional networks, and doing it consciously. Therefore, lack of experience with professional networking rendered the process formidable for most of them. The process was more daunting to students who did not have a large circle of contacts personally or who were from families who did not possess contacts in professional circles. I never had any prior experience with networking, and having to figure out who I could ask to give me references was difficult because my close personal connects (sic) are pretty much nonexistent (Nancy). Moreover, as many students stated, asking for help was not easy. Helen remarked, I was reluctant to start this e-mail referral request because I find it difficult to ask for helpI was uneasy about asking for referrals. The faceless mode of communication that the email allowed made it doubly difficult for the students to make that first contact. Some equated it to making cold calls to people or companies. The students became aware that in the process of establishing contacts and talking to professionals in the industry, they were making an impression on these individuals. Some people do not realize the impact that you can leave on someone if you impress them, that they could help you out somewhere along the way (Ellen). Some students were concerned about making a positive impression within the industry. They were anxious about being prepared for a conversation and asking the right questions, or simply not burning the bridges. The actuality of making an impression in the process of establishing contact was nerve-wracking to some students. Gains or Benefits of Establishing Professional Connections Even though the students expressed their challenges and their initial concerns about the networking assignment, their responses also indicated that each one of them gained something specific from the activity based on what they were looking for and where in the program they were. For some, like Andy, the assignment clarified their career goals and the process of the search. What I really found interesting with this project was seeing what could be my future laid out in front of me (Andy). The process of networking helped clear up some of the myths about the employment scenario and helped students learn the reality first hand. For some who had been reluctant to begin with and had been unsure of the responses, the process had given them confidence in approaching people. With the positive responses from their initial contacts, some ventured to gain additional referrals in their fields. All in all my results were very good and I branched out at least [two] degrees if not three in some areas (Ellen). Being able to make contacts within professional circles in even a small a way emphasized the possibility of making professional connections for students like Nancy, who felt the network available to them by virtue of their families was very limited. The networking activity taught them that they could start building their own professional network for the future and showed them some methods to do so. Some students who were not looking for jobs at the time of the assignment were in fact amazed that they found summer positions or internships in the process of completing the assignment. Nancy stated that, I might even have summer employment due to the connections I made by doing this assignment. For students with limited professional contacts, the activity was a great step forward towards not just thinking about their careers but actually getting themselves some actual work experience. The assignment presented them with the possibility of gaining experiential knowledge and also gaining entry into organizations they might want to work with after college. Most importantly, for some students the networking assignment seemed to have opened avenues they were not aware existed prior to starting the activity. The process of talking to people and making connections gave students interesting leads and made exploring career opportunities they had not considered before possible for them. I had some interesting third degree referrals, sending me all the way to the NASA education department. This caused me to contemplate different teaching career paths rather than just a typical school classroom (Helen). The fact that their contacts led them to previously unknown opportunities also doubled their faith in the power of networking. In addition to getting students to start thinking about careers, summer jobs, and interesting avenues, the networking assignment also led a few students towards actual positions. I now have two possible positions from just thinking about a job and asking my aunt if she knew of any employment opportunities (Nancy). The ease with which connections could create opportunities established the significance of networking to students. Even those who began the assignment with anxiety about the process and uncertainty about the outcomes were convinced that networking was clearly a means to finding a job, especially in the face of relentless competition and the supply of graduates exceeding the necessary demand. Summary The purpose of the study was to determine how the experience of establishing contact with professionals in their preferred field would impact the career attitudes and preparation of college students. The described activity created a learning opportunity for students to engage in professional networking and investigate their reactions to the process. The reactions centered on what the students learned regarding career realities; the process of building a network; challenges in making connections with people; and gains or benefits of establishing professional connections. Recommendations for Future Research and Practice While the overall student responses to the study were positive certain areas for future research were identified, and alterations to the methodology may prove beneficial regarding student takeaway. As this was a pilot study, the researcher had students write a paper on their experience; however, future research may consider using a systematized format to capture student reactions with a quantitative measure to gauge changes in levels of variables such as selfefficacy, locus of control, and confidence. A longitudinal study on how the contacts that the students developed through this activity were utilized over time or how these contacts translated into career opportunities may be merited and could also measure the growth of the network over time. In this instructional method, students were given significant latitude in investigating and mapping their network. This quasi-heutagogical approach (Hase & Kenyon, 2000) was intended to give students the freedom to dig into the process unfettered and self-directed. Such an approach may have created opportunities for self-determined learning, but it also may have hindered the students ability to begin the process with some degree of confidence. To help students avoid undue stress, future researchers may choose to include coursework and activities similar to those used by de Janasz and Forret (2008), Segrist and Pawlow (2009), and Kryder (2011) prior to sending students off on their own to make contact with potential network members to avoid undue nervousness or stress. This application-based method is extremely relevant for CTE due to the pragmatic perspective of educators in those fields. The emphasis on experiential learning and transfer of skills to the workplace extends to soft skills such as professional networking. Students in such programs may be more responsive to such a method because they are familiar and comfortable with learning through real-life application as emphasized in CTE related programs. Ultimately, educators want their students to succeed and doing so means providing students with both job specific knowledge and general skills to navigate their professional landscape. This study addressed professional networking as one such skill to help students gain entry into and advance their career. The experience seemed to benefit the participants based on their responses, but more systematic research is needed to hone the method for optimal learning and application. References Backstrom, L., Boldi, P., Rosa, M., Ugander, J., & Vigna, S. (2011). Four degrees of separation. Retrieved from http://arxiv.org/abs/1111.4570 Boeije, H. (2010). Analysis in qualitative research. Thousand Oaks, CA: Sage. Crispin, G., & Mehler, M. (2013). Sources of hire 2013: Perception is reality. Retrieved from http://www.careerxroads.com/news/SourcesOfHire2013.pdf Davis, D. J., & Warfield, M. (2011). The importance of networking in the academic and professional experiences of racial minority students in the USA. Educational Research and Evaluation, 17(2), 97113. de Janasz, S. C., & Forret, M. L. (2008). Learning the art of networking: A critical skill for enhancing social capital and career success. Journal of Management Education, 32(5), 629-650. Forret, M., & Dougherty, T. (2001). Correlates of networking behavior for managerial and professional employees. Group & Organization Management, 26(3), 283-311. Freeburg, B., & Arnett, S. E. (2010). The impact of appearance management training, work status, and plans after high school on opinions regarding appearance at work and school. Journal of Career And Technical Education, 25(2), 109-119. Godofsky, J., Zukin, C., & Van Horn, C. (2011, May). Unfulfilled expectations: Recent college graduates struggle in a troubled economy. Retrieved from: http://www.heldrich.rutgers.edu/sites/default/files/content/Work_Trends_May_2011.pdf Hase, S., & Kenyon, C. (2000, December). From andragogy to heutagogy. Ulti-BASE In-Site. Retrieved from http://pandora.nla.gov.au/nphwb/20010220130000/http://ultibase.rmit.edu.au/New/newdec00.html Hodge, K. A., & Lear, J. L. (2011). Employment skills for 21st century workplace: The gap between faculty and student perceptions. Journal of Career And Technical Education, 26(2), 28-41. The Institute for College Access and Success. (2012). Student debt and the class of 2011. Retrieved from http://projectonstudentdebt.org/files/pub/classof2011.pdf. Jenkins, L. (2011). Using citizen science beyond teaching science content: A strategy for making science relevant to students' lives. Cultural Studies of Science Education, 6(2), 501-508. Karinthy, F. (1929). Chain-links. 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Retrieved from: http://s4.epi.org/files/2013/Class-of-2013-graduates-job-prospects.pdf Stone, J. R., Alfeld, C., & Pearson, D. (2008). Rigor and relevance: Enhancing high school students' math skills through career and technical education. American Educational Research Journal, (3), 767. doi:10.2307/27667150 Thompson, J. A. (2005). Proactive personality and job performance: A social capital perspective. Journal of Applied Psychology, 90, 10111017. Torres, N. L. (2005). Its who you know. Entrepreneur, 33, 128132. Urwin, P., Di Pietro, G., Sturgis, P., & Jack, G. (2008). Measuring the returns to networking and the accumulation of social capital: Any evidence of bonding, bridging, or linking? American Journal of Economics & Sociology, 67(5), 941-968. Wanberg, C. R., Kanfer, R., & Banas, J. T. (2000). Predictors and outcomes of networking intensity among unemployed job seekers. Journal of Applied Psychology, 85(4), 491-503. doi:10.1037//0021-9010.85.4.401 Wolff, H., & Moser, K. (2009). 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... Educational Technology in Top-Tier Science Education Research: A Literature Review Demetrice Smith-Mutegi Marian University, Indianapolis IN Abstract Overview of Review Process Findings Access, implementation, and teacher attitudes about technology in the classroom have increased in recent years. While numerous reports (Purcell, Heaps, Buchanan, & Friedrich, 2013; CompTIA, n.d.; Schacter, 1999) cite the impact of technology broadly, there are limited reports dedicated to exploring the impact of technology implementation in science courses. This review examines the technology tools implemented in formal and informal K-12 science settings published in top-tier science journals from 2010 to 2016. Findings include the most commonly studied technology tools in physical science, life science, and earth/space science disciplines, as well as their reported impacts on student achievement, dispositions, and student-teacher interactions. While challenges are evident, technology integration in the teaching and learning of science across disciplines has made many significant positive impacts. To select articles for this literature review, a search of the ERIC database was conducted via EBSCO Host for articles published from 2010 through the first quarter of 2016 in top tier science education journals, according to SCImago Journal Rankings. As a result, the search was narrowed to the following journals: Journal of Research in Science Teaching, Science Education, Journal of Science Teacher Education, International Journal of Science Education, Studies in Science Education, Research in Science Education, and Journal of Science Education and Technology. In an effort to identify articles related to educational technology in science education, several key terms and phrases were used (technology uses in education, educational technology and technology integration). The original search results returned 154 articles. Of the 154 articles, an initial review of the title, abstract, and keywords of each article was performed to eliminate studies that: (1) did not explicitly focus on any level of K-12 education, (2) were not empirical studies, and (3) focused primarily on teacher professional development or pre-service teaching. Technology tools researched are unique to the disciplines. Life Science Technology: Online Discussion Boards, Games, Simulations, Remote scanning microscopy Earth Space Science Technology: GIT Tools, Video Cases, VoiceThread, Online Research Physical Science Technology, Probeware, Simulations Students have benefited from the experience (achievement, attitudes, interests, perceptions). Teachers could use technology to save time for class discussions of data, leading to deeper learning. Implementation of technology does not lead to deeper learning. Technology integration in science may be difficult to implement with less experienced teachers and students. Teachers should expect growing pains with new tools. Students do not always have positive dispositions. Students have cited feelings of frustration, distraction, and confusion when it comes to using technology tools While most studies included detailed methodologies of the studies conducted, only some studies described the demographics of their participant pool. 97% of teachers reported having access to a computer in the classroom on a daily basis (2010) 40% of teachers indicated they used the computers often in classroom instruction Plan and share lessons Interact with parents Assign e-book readings to students Student collaboration on assignments Participate in online discussion boards Introduction Supporters of educational technology argue that technology plays a significant role in the teaching and learning of science (NSTA, 1999). The goal of science teaching and learning is to produce individuals capable of understanding and evaluating information that is, or purports to be, scientific in nature and of making decisions that incorporate that information appropriately, and, furthermore, to produce a sufficient number and diversity of skilled and motivated future scientists, engineers, and other science-based professionals (Committee on Science Learning, 2007, p. 34). According to science education scholars, the impact of digital technologies on science teacher education is more pervasive than any curricular or instructional innovation in the past (Flick & Bell, 2000). But, just how effective is this implementation? What evidence from empirical studies document the impact of educational technology in science instruction? In particular, what can we learn about educational technology from science education literature? The purpose of this paper is to review current literature on the implementation of educational technology in the science classroom in order to (1) identify the technologies utilized in K-12 (formal and informal) science classrooms among empirical studies published in top science education journals and to (2) describe how the aforementioned studies contribute to the field of knowledge of educational technology in science education with a particular focus on student achievement and learning of scientific concepts. Lastly, this paper addresses the implications of technology use in the classroom for urban students learning science and provides recommendations for further research. Table 1. Journal Distribution of Final Literature Review Pool . # of Articles Journal of Research in Science Teaching 5 Science Education 3 Conclusions Journal of Science Teacher Education 0 International Journal of Science Education 4 Studies in Science Education 0 Research in Science Education 1 Journal of Science Education and Technology 19 The representation of literature is found to be consistent with teacher use, at this point in time. While the research reviewed in this paper mirrors the frequency of practice, there were a number of top-tier journals with little to no representation. In the studies reviewed, technology integration has positively affected student behaviors, including perceptions about science, motivation, and engagement across several studies. However, the results were not as positive when considering student achievement, especially student achievement of low-achieving students (Chao et al., 2016; Kluge, 2014; Williams et al., 2012). Technology alone is insufficient to make positive change without effective pedagogical implementation. Students require proper instruction and pedagogical approach beyond the tool to engage in deeper learning. This approach has been longed argued by TPACK theorists (Koehler & Mishra, 2009) and has implications for future practice, including the need to professionally develop teachers to use technology in the most effective implementation. Chemistry/Physical Science Life Biological Science Earth/Environmental General Science/Various Content Areas General Science/Various Content Areas, 5, 16% Chemistry/Physical Science, 7, 22% Earth/Environmental , 10, 31% Life Biological Science, 10, 31% Figure 1. Representation of Science Content Area Contact Selected References Demetrice Smith-Mutegi Marian University Email: dmsmith@marian.edu Website: www.marian.edu/educatorscollege Phone: 317-955-6681 1. 2. 3. 4. Chao, J., Chiu, J. L., Dejaegher, C. J., & Pan, E. A. (2016). Sensor-Augmented Virtual Labs: Using Physical Interactions with Science Simulations to Promote Understanding of Gas Behavior. Journal of Science Education and Technology, 25(1), 16-33. Deniz, H., & Dulger, M. F. (2012). Supporting Fourth Graders' Ability to Interpret Graphs through Real-Time Graphing Technology: A Preliminary Study. Journal of Science Education and Technology, 21(6), 652-660. Evans, M. A., Lopez, M., Maddox, D., Drape, T., & Duke, R. (2014). Interest-Driven Learning among Middle School Youth in an Out-of-School STEM Studio. Journal of Science Education and Technology, 23(5), 624-640. Flick, L., & Bell, R. (2000). Preparing tomorrows science teachers to use technology: Guidelines for science educators. Contemporary Issues in Technology and Teacher Education, 1(1). Retrieved September 17, 2016, from http://www.citejournal.org/vol1/iss1/currentissues/science/article1.htm 5. Gray, L., Thomas, N., and Lewis, L. (2010). Teachers Use of Educational Technology in U.S. Public Schools: 2009 (NCES 2010-040). National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education. Washington, DC. 6. Klopp, T. J., Rule, A.C., Schneider, J. S., & Boody, R. M. (2014). Computer Technology Integrated Projects Should Not Supplant Craft Projects in Science Education. International Journal of Science Education, 36(5), 865-886 7. Kluge, A. (2014). Combining Laboratory Experiments with Digital Tools to Do Scientific Inquiry. International Journal of Science Education, 36(13), 2157-2179 8. Koehler, M. J., & Mishra, P. (2009). What is technological pedagogical content knowledge? Contemporary Issues in Technology and Teacher Education, 9(1), 60-70 9. Kulo, V., & Bodzin, A. (2013). The Impact of a Geospatial Technology-Supported Energy Curriculum on Middle School Students' Science Achievement. Journal of Science Education and Technology, 22(1), 25-36. 10. Park, J. C. (2008). Probeware tools for science investigations. Technology in the Secondary Classroom, pp. 33-41. NSTA Press. 11. Sadler, T. D., Romine, W. L., Stuart, P. E., & Merle-Johnson, D. (2013). Game-Based Curricula in Biology Classes: Differential Effects among Varying Academic Levels. Journal of Research in Science Teaching, 50(4), 479-499.  ...

... Growing the STEM Teacher Workforce: A Focus Group Study of the Career Considerations of High-Achieving, Underrepresented, High School Students Demetrice Smith-Mutegi, Marian University Jomo Mutegi, Indiana University Purdue University Crystal Morton, Indiana University Purdue University Introduction The low number of STEM teachers from underrepresented minority groups is a national concern that has major implications for the STEM performance of underrepresented minority students. In fact, the low number of underrepresented minority teachers across all disciplines and all grade levels is a well-documented problem facing the nation. For example, a report by the Center for American Progress shows that while 44% of the nations students are non-white, only 18% of the nations teachers are non-white (Boser, 2014). Methodology Preliminary Findings Qualitative Study 20 Focus Group Interviews Interview Length: 1.5 to 2 hours Research Participants High achieving minority students (N=50) Parents of participating students (N=38) 1. Students career decisions are most heavily supported by extracurricular experiences (e.g. internships, summer camps, mentors, career pathways & informal arrangements). Parents actively seek out informal experiences for their children. 2. Schools are the primary institution on which parents rely to provide career preparation information. Some schools fill this role well. Others do not. 3. Students and parents often (about 90%) report that they had never considered teaching careers, especially science and mathematics teaching. Discouragement from practicing teachers, lack of confidence in mathematics and science, and lack of patience necessary to manage a classroom were cited as the primary reasons. 4. While most students were not interested in a STEM teaching career, students found that their life goals aligned with life goals that could be realized with a teaching career. (Giving back to their communities, supporting youth, serving as a role model). Figure 1. Race/Ethnicity of Student Participants 10% 6% These disparities become even more pronounced when examining the STEM teaching workforce. According to a report produced by Horizon Research, Inc. (Banilower et al., 2013) only 8% of high school science teachers and 8% of high school mathematics teachers characterize themselves as non-white. Despite the pervasive shortage of STEM teachers from underrepresented minority groups, and educational detriment realized in the absence of underrepresented minority teachers, the recruitment of STEM teachers is a subject of study that receives very little attention from mathematics and science education researchers. Purpose The objective of this study is to generate an empirically grounded understanding of three aspects of the career considerations of high-achieving, underrepresented minority students. These are (a) their career interests and barriers, (b) the people and organizations that influence career decisions, and (c) the fit between STEM teaching and students life goals. Black Hispanic Mult iracial 84% Data Collection Registration survey Demographic information (Grade level, race, school, GPA, household income, etc.) Video and audio-recorded focus group interviews Note-taking Data Analysis Transcription of interviews Coding for patterns/themes Focus Group Discussion Topics What college majors are you considering? Where have you gotten information about the majors you are considering? Imagine your life 20 years from now. What do you want your life to look like? Have you considered a major in science or mathematics education? (Revised: What are the benefits and detriments of mathematics and science teaching?) References Banilower, E. R., Smith, S. P., Weiss, I. R., Malzahn, K. A., Campbell, K. M., & Weis, A. M. (2013). Report of the 2012 National Survey of Science and Mathematics Education. Retrieved from: http://www.horizonresearch.com/2012nssme/wpcontent/uploads/2013/02/2012-NSSMEFull-Report1.pdf Boser, U. (2014). Teacher diversity revisited: A new state-by-state analysis. Retrieved from https://cdn.americanprogress.org/wpcontent/uploads/2014/05/TeacherDiversity.p df Acknowledgements This study is supported by the IUPUI Office of the Vice Chancellor for Research. Its contents are solely the responsibility of the authors and do not reflect the official views of the OVCR.  ...