The Influence of Emotions on Learning

by Jonathan Newbaker, PharmD, PGY1 Pharmacy Practice Resident, University of Mississippi Medical Center

In ‘The Righteous Mind’ by Jonathan Haidt, the author introduces the concept of the elephant and the rider.¹ In this analogy, the rider is our logical, reasoning self and the elephant is our reactive, emotional self. His point is that the rider, our reasoning, seems to guide our emotions and decision; however, the reality appears to be the opposite. Haidt argues that our intuition and emotions have a much larger subliminal impact on our decision-making than we are consciously aware. Emotion management, other than perhaps recommendations to seek counseling when needed, is not commonly discussed in the academic setting. Given the impact that emotions can have on logic and reason, it’s a topic worth exploring as recent studies are showing emotions are a driving force in information collection and strongly influences memory. In this essay, I will explore a definition of emotions, the correlation of emotions to learning, and some data on how the two intersect. In addition, the application of these findings will be discussed for health profession educators to consider when teaching.

Emotions can be considered a distinct form of cognition in that they are often the first process to occur in a situation before logical reasoning.² These feelings can be defined in terms of their valence and arousal.³ The valence of emotions, a term borrowed from the fields of physics and chemistry, describes them as positive or negative.³ The term arousal refers to how activating or deactivating the emotions are.³ Activating emotions energize us, whereas deactivating emotions lead to a loss of energy.³ These various combinations of valence and arousal are displayed in the table below. 

	Valence – Positive	Valence – Negative
Arousal – Activating	Excitement, joy	Anxiety, fear
Arousal - Deactivating	Contentment, calmness	Depression, shame

Activated and deactivated states as well as positive and negative emotions can predispose students to particular methods of processing and applying information.³  One study compared emotions (positive or negative) to the students’ information processing method (global processing or local processing).⁴ To induce the emotional state, the researchers had the students watch either a positive or negative emotionally evocative video or an emotionally neutral video (control). After viewing the video, students were asked to compare three geometric figures. The control figure was a triangular-shaped arrangement of three circles. This was to be contrasted to comparison item 1, a triangular assortment of three cubes, and to comparison item 2, a rectangular assortment of circles. When a student uses global processing, they will pick up on the triangular assortment of the differing shapes (i.e., triangular circles to triangular squares), whereas when a student uses local processing they will pick up on the presence of the same shapes in a different arrangement (i.e., triangular circles to rectangular circles).⁴ The results showed that students with positive emotional states were more likely to employ global processing than students who were shown the negative or neutral videos. The latter two groups had a stronger tendency to focus on specific details using local processing. Using two emotionally positive videos, one emotionally neutral video, and two emotionally negative videos, the researchers then tested for group differences in global bias scores using a 5 × 2 × 2 ANOVA (Video Group × Sex × Ethnicity). The video type was the only factor that had a significant effect (p = 0.042).⁴ The two positive emotion videos produced significantly greater global bias scores than the two negative emotion films (p = 0.035).⁴ In contrast, the global bias scores for the two negative clips did not differ from each other.⁴ The results suggest that various emotionally-charged delivery methods may change the way learners perceive and process information.

Unfortunately, the conclusion is not so straight forward and we cannot conclude that “positive emotions lead to improved processing and recall”. For example, some research shows that negative events are more likely to be spontaneously remembered than positive events.⁵ Researchers of one study analyzed involuntary memories in groups of traumatized subjects and contrasted these with involuntary memories among subjects who had an overwhelmingly happy experience. They found that the vividness of trauma-related memories was more significant than non-trauma memories (p < 0.005).⁵ Of note, the mean number of trauma flashbacks was lower than the mean number of non-traumatic flashbacks (p < 0.01), with happy memories being the most abundant.⁵ This data indicates that, although trauma is not a prerequisite for memory recall, it does play an important role in the amount of detail that one is able to recall. To tie this into learning, some negative experiences may have beneficial long-term effects and prompt behavior changes.  Therefore, mistakes which provoke negative emotions can be beneficial but students need to be taught how to view these events as opportunities for improvement rather than solely negative events.

The difficulty in providing standardized emotional experiences for students is that they are unique individuals and their emotional response to situations are different. It is possible that one student may feel positive emotions during an encounter with a professor and another student is offput by the same encounter. Therefore, feedback from both the educator and the learner should be incorporated at multiple points throughout a given semester to assess the students’ perspective and emotional state. In addition, this would afford the educator an opportunity to encourage the student to identify and manage any deactivating emotions.

It is clear that emotions play a significant role in how students perceive and remember information.  Thus, instruction techniques and methods for questioning students should consider the emotions they might evoke and the desired educational outcome. For example, playing a video that evokes excitement or joy might be great when global processing is preferred. However, when attention to detail is ideal, the educator could consider creating an environment that fosters a negative emotional state such as providing a grave clinical situation (or simulation) that drives the students towards local processing. Moreover, the educator should emphasize the importance of learning from mistakes which evoke negative, activating emotions. Negative events such getting a “bad grade” or making an ill-conceived recommendation during patient care rounds can leave a last impression on a student but, if managed by the teacher well, they can be “teachable moments” that motivate learning and behavior change. However, if handled poorly, these negative events can be demotivating, causing students to withdraw and avoid.

Lastly, it is important to gather feedback (either formally or informally) at regular intervals to assess the learners’ emotional states. Watch for non-verbal clues!  This should be considered along with formal assessments of student performance. Individuals will process the same experience in different ways, so it is critically important for health professions educators to pay attention to emotional clues and “check in” with students.

 

Resources:

1. Haidt J. The Righteous Mind. New York City, NY: Vintage; 2012.
2. Zajonc, R. B. Emotions. The handbook of social psychology. McGraw-Hill. 1998. P. 591–632.
3. McConnell MM, Eva KW. The Role of Emotion in the Learning and Transfer of Clinical Skills and Knowledge. Academic Medicine 2012; 87 (10): 1316–1322.
4. Fredrickson BL, Branigan C. Positive emotions broaden the scope of attention and thought-action repertoires. Cogn Emot 2005;19(3):313-332.
5. Berntsen D. Involuntary Memories of Emotional Events: Do Memories of Traumas and Extremely Happy Events Differ? Appl Cognit Psychol 2001;15(7): P. S135–S158.

Test Anxiety and Academic Performance

by Arlesha N. Armstrong, Pharm.D., PGY-1 Pharmacy Practice Resident, Magnolia Regional Health Center

American educator Booker T. Washington once said that “Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome”. One obstacle that many students at all levels of formal schooling find difficult to overcome is test anxiety. It is often silent and yet incredibly loud. The first and most important step is recognizing test anxiety and the effects it can have on a student and their future. Test anxiety encompasses more than just being “worried about the test” or “hoping to get a good grade”. For some students, the level of anxiety negatively impacts performance and can become unbearable. Test anxiety encompasses two broad domains: emotionality (physiological components such as perspiration and headaches) and worry (psychological components such as heightened sense of threat, increased distraction, and motivational disturbances)¹. Test anxiety is something that should be taken seriously and acted on. 

So how can educators notice the signs? The emotional symptoms in students might not be readily apparent, but the physical symptoms might be seen with close observation. Watching students and how they behave during “normal” classroom days compared to exam days may reveal subtle indications of their level of anxiety. Is the student quieter or more talkative than normal? Are they excessively sweating or noticeably breathing? Is the student shaking their leg, twitching, scratching and tapping, or pulling on clothes or hair? Although these can be normal behaviors, noticing differences in students’ behaviors surrounding exams can lead to conversations with them.

Text anxiety is surprisingly common.  Between 15 and 40% of students report experiencing some level of anxiety during examinations and other forms of assessment.³  Some students may have been told that they are overly dramatic or that they worry too much.  That they should learn to relax a little. After a while, the student may begin to think that this is just the way that they are and will have to just “live with it.” Although anxiety disorders are highly treatable, according to the Anxiety and Depression Association, only about one-third of people suffering from anxiety receive treatment. It is not a part of life. it is not a rite of passage.  It can be treated but far too often it’s not.

Physical Symptoms:	Emotional Symptoms:
·       Excessive sweating ·       Nausea, vomiting, or diarrhea ·       Stomach pain or “butterflies” ·       Rapid heartbeat ·       Shortness of breath ·       Headaches, Lightheaded or Faint ·       Restless or fidgety	·       Self-doubt ·       Fear ·       Stress ·       Hopelessness ·       Inadequacy ·       Anger ·       Nervousness

Test anxiety can have unfortunate detrimental effects on a student that leads to negative impacts on their performance. Anxiety can cause the student to procrastinate, reduce their ability to focus long enough to study, and lead to feelings of paralysis because they feel so overwhelmed. In some cases, the student might even become physically sick and cannot make it through the exam. These symptoms don’t just impact young children but can impact older students as well. Indeed, as a student advances in their education, the stressors can really add up.  Or it can be due to unresolved testing anxiety carried from childhood.

According to a study evaluating health professional students, there was a significantly positive correlation between test anxiety and procrastination on school-related work.² Not surprisingly, students with test anxiety tend to have lower scores on standardized tests and lower GPAs.³ Unfortunately, many decisions such as college admission, scholarships, and career opportunities are influenced by test scores.³ Thus, those with test anxiety are the ones who suffer the most because there is no way to adjust for test anxiety. Until we move past standardized testing, we need to help students address and overcome test anxiety so they can achieve their full potential.  It’s true that academic performance is influenced by many factors, but teachers should always strive to identify and address the obstacles that hinder their performance. Address text anxiety may not only lead to improvement in the students’ test performance but it may also to improvements in the student’s sense of wellbeing and life satisfaction.

So how can you help students who are struggling with test anxiety? Here are some things that students and educators can do:

Advice for Students:	Advice for Educators:
·  Preparation ·  Develop a routine ·  Adequate sleep and rest ·  Decrease caffeine ·  Eat balanced meals ·  Exercise ·  Talk to the instructor ·  Learn relaxation techniques ·  Get a tutor ·  Seek counseling and support ·  Ask for accommodations	·  Teach and provide opportunities to engage in breathing exercises ·  Provide practice exams ·  Offer comprehensive review ·  Set clear expectations ·  Stagger test schedules ·  Refrain from time limits (when possible) ·  Try different exam formats and styles ·  Provide accommodations if necessary ·  Offer encouragement

The first step in helping students with test anxiety is recognizing its validity and legitimacy. Helping them realize their triggers and what induces anxiety can help a student learn how to address anxious thoughts. One way this can be done is by having the counselors come to do a general presentation about anxiety (including test anxiety) — that way every student gets the information but no student is singled out. This opens the door for a student to come forward in private. Every teacher should destigmatize anxiety and encourage students to seek counseling, engage in some form of cognitive therapy, and (when needed) take medication. This is not to say that even when a student receives therapy that anxiety will never be there. But therapy can help students take positive action, rather than letting anxiety have a hold and control over them.

Helen Keller once said “Be of good cheer. Do not think of today’s failures, but of the success that may come tomorrow. You have set yourself a difficult task, but you will succeed if you persevere, and you will find a joy in overcoming obstacles.” Addressing and overcoming anxiety is difficult to do. No one wakes up each day and chooses to have anxiety. However, addressing test anxiety can arm a student with new coping skills that can help in many other life situations.  It can really improve a student’s academic performance and quality of life.

 

References:

1. Pate AN, Neely S, Malcolm DR, et al. Multisite study assessing the effect of cognitive test anxiety on academic and standardized test performance. Am J Pharm Educ. 2021; 85(1): Article 8041.
2. Sarvenaz R, Seyyed MA, and Alireza K. Investigating the relationship of test anxiety and time management with academic procrastination in students of health professions. Education Research International 2021; Article 1378774
3. Myers S, Davis S, and Chan JCK. Does expressive writing or an instructional intervention reduce the impacts of test anxiety in a college classroom? Research 2021; 6:44.
4. Harris H and Coy D. Helping students cope with test anxiety. ERIC Digest 2003.