Student Resilience and COVID-19: A Review of the Literature

When students in the field of health sciences begin to matriculate in institutions of higher education in Fall 2020, they will be doing so in uncharted territory. If attending a brick and mortar university or college, students will come to realize that the institution has been utilizing online instruction predominantly for the prior spring and possibly all of summer semester. In other words, students have not sat in a desk in the classroom with others for many months. Depending on the university, some programs will remain online even in the Fall 2020 semester.

The question begs to be asked: How has the COVID-19 pandemic impacted students? More specifically, how do the aforementioned shifts in the higher education experience impact university-level students who are in a rigorous program of study such as health sciences? This impact can be addressed at several levels: emotional, mental, academic, and financial. This literature review will attempt to shed light on the current status of health sciences higher education in light of the COVID-19 pandemic. The author will take a top-down approach in reviewing the research. That is, first university systems will be discussed, then the author will move down to faculty and student impacts.

The literature reviewed is replete with papers and reports written from a systemic perspective, looking at how the pandemic has impacted larger university systems and their responses to the issue. There is a dearth of research on how health sciences fields of study have been specifically impacted. As such, effects at the university-level will be shared. While not as abundant, this author will also share what the research reveals about the impact on students, including what the literature has provided in terms of tips for students amid the pandemic [1-4].

According to the United States Centers for Disease Control and Prevention (CDC), as of May 4, the number of diagnosed cases of COVID-19 in the United States is 1,152,372 and the number of deaths is 67,456 (U.S. Centers for Disease Control and Prevention, 2020). The World Health Organization (World Health Organization [WHO], 2020) published just slightly higher incidence statistics for the United States with diagnosed cases numbered at 1,322,054 and the number of deaths at 79,634 a little over a week later. These ever-changing, startling statistics served as a catalyst for universities to act quickly.

Brown [4] reported that when it became clear COVID-19 was spreading rapidly on a global scale, governments suddenly took action and began shutting down businesses, schools, and universities [4-21]. Within a few weeks, about 20,000 higher education institutions had ceased normal operation and sent 200 million students home, with many switching to online instruction after only a few days of preparation. This falls in line with a survey sent to university presidents in which Lederman [12] reported the most-taken actions that presidents said they had completed by mid-April included steps most colleges took immediately: moving to remote instruction for students, remote work for employees, and closing administrative offices. Other actions included moving admissions processes and campus tours online in preparation for the Fall 2020 semester.

Additionally, it is acknowledged that while addressing these immediate concerns, it is also imperative that we look ahead from the macro- and micro-level to design the new normal of campus regarding contingency planning for physical assets, risk management, development activities, and online instruction The issues previously mentioned require top-down planning. Cowen [8] refers to this as taking the balcony view. This requires higher education administration to think beyond the crisis. It’s all about gaining perspective and taking the long view. He continues by recommending that administrators in higher education ask questions such as where do we want to be, and how can we come out stronger, when this is all behind us?

Other authors such as Hogan & Ramamurthy [11] feel that the crisis caused by the coronavirus should be used to transform graduate education to address long-standing issues such as equity, equality and access. University administrations should seize opportunities now to move toward greater equity. Failure to do so will amplify inequality even further. Choosing the path of equity will require making university governance more accessible to all. If this fails to happen, Hogan & Ramamurthy [11] believe that graduate education will survive but only at the expense of graduate students. The equity (or lack thereof) about which these authors speak can be felt to possibly an even greater degree in colleges and universities that serve historically minority populations. According to Quiett Smith [15], most historically Black colleges and universities do not exist in resource-rich environments. As such, this negatively impacts their ability to build resilient systems that are capable to responding innovatively to a crisis such as COVID-19.

This section will discuss those effects that have been documented in the literature as a result of COVID-19. One of the major impacts of the pandemic has been on the way information is presented to students. Pedagogically speaking, academe was and still is in a time of ‘pedagogical triage,’ as Bessette et al. [3] wrote in March in an analysis of higher education’s shift to remote teaching. But triage was never the mission or purpose of online teaching. It needs to be more than that (para. 8).

The shift to remote learning has impacted students as well as those instructors and professors who have quickly made drastic changes in the delivery of information. For example, this author switched one course to a completely project-based learning environment once stay-at-home measures were put in place. Changes in the way that curriculum is taught include adjusting assignments, expectations, and grading. Bessette et al. [3] hold that this is simply good teaching, however. Not all students have access to technology or high-speed Wi-Fi or may have limited access only. This provides professors the impetus for asking questions such as: Is it possible for students to work from a phone? What learning activities can be changed to asynchronous schedules? Is this learning activity absolutely essential to address the course objectives? Is video really necessary for this dialogue? How can I share course material without placing heavy demands on data download?

Given the shift to remote learning, Fotuhi [9] cautions against making assumptions that every student feels comfortable using technology as a sole means for learning or has technological literacy for online learning. For example, some students may need time to learn and navigate a new platform that is now their main method for learning content delivery. Some may prefer learning on paper, which allows for processing time and the ability to physically touch the material (e.g., taking notes, writing cue cards, skipping back to previous sections). As mentioned earlier, unanticipated difficulties with basic requirements for online learning, like a stable Internet connection or a computer capable of streaming lectures can pose additional problems for students. Fotuhi [9] adds, We can’t avoid using these new and emerging technological solutions if we want to continue teaching. But we need to be attuned to students’ difficulties, so we can speak to their anxieties (para. 5).

COVID-19 has also affected student and employee mental health and student attrition. This is especially true for low-income and underrepresented students. Even in the best of times, these students are most vulnerable to disruptions in their educational careers and threats to their personal well-being. Brown & Kafka [4] (2020 report that student mental health concerns in higher education were already skyrocketing prior to the pandemic. The crisis seems to have exacerbated students’ feelings of sadness, isolation, and anxiety (Global Resilience Institute, 2020). In a survey of over two thousand university students conducted by Active Minds (2020), 80 percent of those students surveyed reported that the pandemic has negatively impacted their mental health. The ways that their mental health has been impacted include stress/anxiety, disappointment/ sadness, loneliness/isolation, and relocation.

Adding to students’ stress is the financial impact of COVID-19. As a result of businesses closing, working college students are experiencing financial setbacks. They now must file for unemployment to help support themselves. Some students have yet to see any funds as the system is overloaded [1]. After all, they are competing with more than 36 million people who, in March and April, 2020, have filed for unemployment due to job loss during the pandemic as reported by Cohen & Hsu [6].

This section has discussed negative impacts of COVID-19 as it relates to higher education not as much from a systemic frame of reference but from a more localized perspective. It is clear from the literature that the effects of the coronavirus have impacted both instructors and students in several ways. The next section will discuss what authors have published in terms of how university systems and students can and are responding to the pandemic.

In terms of responding to COVID-19, Cowen [8] states that institutions of higher education will not be able to return to the status quonor should they. To prepare for the future, Brown [5] indicates that colleges and universities need to prepare themselves for the substantial changes that will be made. These changes will impact the way higher education institutions operate currently and in the future.

Depending on the size and location of the institution, survival and recovery must be considered. Cowen [8] adds that rebuilding for the future with the intention of making institutions more resilient requires leaders in academia to see exactly what’s going on and discover patterns and opportunities for improvement and innovation. It is imperative that leaders in institutions of higher learning work with stakeholders to utilize federal and state funds wisely to improve and innovate during a time of re-building and restructuring.

In a survey of 187 two- and four-year college presidents conducted by Inside Higher Ed, the changes referenced in the aforementioned paragraphs are representative of long-term goals. The survey results showed the short-term, immediate focus to be on employees’ and the most vulnerable students’ mental and physical health, student attrition, and unbudgeted financial costs. Lederman [12] notes that the mental health of students remains colleges’ and universities’ very top concern currently. Forty-seven percent of presidents surveyed in April, 2020, said they are very concerned about student mental health.

Luthra & Mackenzie [13] suggest that given the instability of the current global environment, students need resilience and adaptability. These skills are necessary to navigate effectively through the pandemic. Looking into the future, some of the most important skills that employers will be looking for will be those that come out of a state of resilience and adaptability: creativity, communication and collaboration, empathy, emotional intelligence, and being able to work effectively as part of a team.

A number of universities have posted helpful tips for students on their websites in the wake of the pandemic. Northeastern University, for example, established a Global Resilience Institute in response to COVID-19. The institute offers specific ways that students can manage their emotional and physical well-being. For example, students are encouraged to share their feelings with trusted family members or friends and ask for help if they want support (Global Resilience Institute, 2020). The University of Michigan (2020) is another university that has offered ways to support students during the pandemic. Like the Global Resilience Institute (2020), they suggest that students find their new normal. They want their students to recognize that without their usual routines, they may miss the structure. Students are urged to take the time to find resources and create productive routines such as creating schedules, making checklists of things to be done just for today, as well as creating a productive work space. Universities such as the University of Oregon (2020), University of California- Los Angeles (2020), and Columbia University (2020), to name a few, have developed extensive website space to address the corona virus targeted toward students, faculty, parents and the community.

To manage physical wellness, the Global Resilience Institute (2020) also recommends that students think about the things they do to take care of themselves every day and attempt to continue those activities. Try to get at least six to eight hours of sleep and maintain a healthy diet. Students are urged to take a virtual exercise or yoga class and engage in activities outside that allow for physical distancing (e.g., hiking or running). Walks with family or friends while practicing physical distancing are deemed beneficial as are meditation and mindfulness activities.

Universities have also extended commitment deadlines for students to address the financial burden that graduate education can often create. They have deferred start dates for summer and fall semesters because of students’ and parents’ uneasiness about returning to the classroom too soon. With the unprecedented levels of uncertainty, disruptions, and stress students are facing as they try to make sense of new and constant demands and requirements, educators are in a unique position to support students. Therefore, they need to understand the potential obstacles that might get in the way of their learning [9].

This literature review has looked at how colleges and universities have addressed COVID-19 up to this point. The author used a top-down framework, first looking at the large-scale impact of the pandemic (i.e., university-level). This was followed by direct impacts that faculty and students are currently addressing. Finally, methods of tackling the pandemic were shared. In terms of implications for future research, universities with colleges of allied health or health sciences have a responsibility to review implementation plans that support students in terms of and data collected on their effectiveness. Implementation plans should be addressing emotional, mental, academic, and financial issues with which students in health sciences fields are dealing. It will behoove health sciences programs to review their strategic plans to ensure that in the next three to five years, academic departments and colleges are addressing these critical matters to ensure a culture of resilience exists for students.

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