The User Experience Service has collaborated with Student Experience Services on a three month qualitative research project exploring student experiences around health and wellbeing.

We wanted to learn how we might prevent the less severe problems students experience from escalating to more complex problems and associated support.

So, we focused on learning about the general experiences and challenges faced by the majority of students, rather than those with severe or complex support needs.

In addition we spoke to staff involved in activities to embed student health and wellbeing in the curriculum.

This project took place during the lockdown, so we also explored students’ related experiences and conducted all of the research over video call. Specific attention was given to how we could effectively conduct remote research, particularly when asking questions about adverse experiences, which could potentially be a sensitive topic.

How we prepared for a student one-to-one

Being interviewed about personal behaviour and experiences can be an intense experience even when physically co-located.

Interviewing people to learn about upsetting events would need to be sensitively designed even for a physically co-located session.

When working over video call it’s harder to assess whether someone is getting uncomfortable. People get tired more quickly.

In a physical space we might for example conduct the interview in a private space not a communal one, use a more informal space rather than an office. What would the parallel precautions be for a remote format?

We were conducting these interviews during the peak of a global pandemic and during the associated lockdown

We could not ignore that this would have an impact on the students’ health and wellbeing. We also could not dedicate the whole session time to talking about this one topic.

Good practice in remote session design

It is easier for people to get distracted by their environment. Including active participation for the attendees helps mitigate this.

There is a potential for an intense online session to have a ‘disembodied’ sense, so it is important for participants to maintain a connection with their body and environment.

It is harder to focus and recall information so it helps to provide information, especially instructions, and questions visually as well as verbally.

Shorter sessions help. Longer sessions need breaks.

Making design thinking activities work digitally

In human-centred design we use specially formulated activities to draw information out of people in a way which feels enjoyable and light-hearted. Sometimes these are referred to as design thinking activities or games. There are resources available, and a particularly good book and website is Gamestorming.

Gamestorming website

Our student research sessions were designed to incorporate aspects of design thinking games, good practice for remote workshopping, and an approach to deal with the potential sensitivity of the topic.

• The session was based on creating avatars and using metaphors to create distance from the personal nature of the topic.
• This allowed us to pose questions indirectly and very gradually lead into talking about the behaviour around adverse experiences which we wanted to learn about.
• The gradual lead-in created a natural progression to asking about personal experiences.
• This helped to mitigate potential distress from talking about negative personal experiences ‘head-on’ and reduced the intensity of a remote ‘Q&A’ format interview.
• Sketching on paper put the participant’s focus in their current environment and had them do something physical which is grounding.

The design of the student one-to-one

First the student was asked to create an ‘avatar’ – in the form of a squiggle bird

Squiggle birds exercise – Gamestorming

The avatar was given the identity of ‘A University of Edinburgh student’ and by drawing out the experiences and characteristics of a student we also learned something about the students’ own experiences, specifically:

• The characteristics of a student
• Challenges of being a student
• Benefits of being a student

We used this avatar in two further activities to explore the understanding of terminology and behaviour around adverse experiences. The students were asked to create two worlds: one with ‘poor health and wellbeing’ (a so-called ‘zombie’ world), and then one with optimal health and wellbeing.

The students were asked to position their ‘student squiggle bird’ avatar in the ‘zombie world’ and describe its experience.

Then they were asked if they could relate to any of those experiences personally.

After this they were asked to position the ‘student squiggle bird’ in the ‘optimal health world’ and describe its experience.

Our findings

There is a very high probability that students are not the primary audience for web-based information about support services.

• When in need of support, students look to speak to a person who can listen to their needs and guide them to the relevant support for their current circumstances. Before speaking to a member of staff students were very likely to have spoken to someone else first: family, friends or peers.
• Health and wellbeing and support information they had been given was not paid attention to or used when it was given in advance of need. Giving information about coping with pressure during a course can also be seen as irrelevant when it relates to future job pressures (for example, on medical courses).
• Students could mostly describe the characteristics of someone with poor health and wellbeing who might be struggling. Although students noticed changes in peers who were struggling, they were less likely to identify those changes in themselves when they were under pressure or stress.
• Students were reticent in coming forward to speak to staff, with peers helping them to make these arrangements after observing that they were in difficulty.
• When speaking to staff students did not state their support needs directly. They had often ‘bottled up’ a problem or several issues and so became distressed during support conversations.

A number of factors contribute to students ‘bottling up’ problems and not seeking support, including:

• impostor syndrome
• not knowing how to talk about needing support
• not considering themselves in need of support, even though they were

The most effective support facilities had staff who could build relationships with students and be proactive in supporting them. They also had dedicated resources which allowed them to provide a network of support for staff.

Information about support services is essential. The primary audience for this material is people providing student support. This includes staff who directly support students and anyone contacted by a student in need or distress. Students themselves might be looking for information to help a friend or peer.

Information on what to do if you are experiencing difficulties is necessary and needs to be balanced with proactive initiatives or it risks delivering a message that “struggling is expected”.

The most effective way to support students’ health and wellbeing is to equip them with the skills to manage their own wellbeing, in a positive, constructive way.

In particular, it is useful for a student to be able to:

• notice their internal state so that they are more able to tell when they need support
• identify helpful and unhelpful behaviours for dealing with challenges

These are skills that some students might already have developed, and that students might benefit from guidance in learning.

A very effective way to do this is to embed health and wellbeing activities in the curriculum because these are skills which are learned from practice rather than from reading information.

Care is needed when doing this so as not to add to student workload, for example with an additional module – students are already reporting workload related stress. Care must also be taken to avoid students seeing this information as not relevant to them, either because they don’t have or see a present need or because it is not course related.

A way to avoid this is to co-create the solutions with the students and replace items from the curriculum with these activities. As Dr Peter Felton said in his Learning & Teaching Conference 2019 keynote session: “the single largest factor in students’ sense of wellbeing… [is] what happens in the classroom.”

Keynote talks – Learning & Teaching Conference 2019

There are multiple initiatives happening in the organisation where staff are already embedding health and wellbeing in the curriculum. It might be useful for the staff involved in these initiatives to meet to share ideas and outcomes.

The existing initiatives share a common theme – the students themselves are active participants in identifying the challenges and solutions. In this project we used activities which did similar, and students reported benefitting from them.

Recommendations and next steps

This research concluded by making several recommendations:

• Support and train staff in supporting students – staff wellbeing affects students.
• Build relationships between students and staff – students look for a person’s help.
• Train students in skills to manage personal challenges – rather than providing information in advance of need.
• Embed health and wellbeing in the curriculum – engage students in identifying challenges and solutions.
• Focus on solutions rather than problems – make use of internal expertise on positive psychology.
• Work in partnership with students – learn from staff doing this already internally and from external co-design projects.
• Work holistically with parallel projects, for example the tutor support system and the sense of belonging projects to share overlapping insights and goals.

The next phase in this project is to perform a content audit to see who owns and produces material around health and wellbeing: how is it produced, who by and for what audience and purpose?

There is also an opportunity to experiment with the use of the 5 ways to wellbeing as a way to unify the message on overlapping service provision and make it easy to find information on what to do in an emergency.

5 ways to wellbeing

The most effective way would be to continue to involve both staff and students – explore different types of content and co-design opportunities.