Question:
Discuss about the Pharmacological Academic Performance Enhancement.
The essay deals with the case scenario of Wasim, who is in a dilemma regarding the use of stimulants for academic performance as advised by his friends. In response to the case study management, the essay aims to address the PICO question developed by Wasim, which is “Do stimulants increase academic performance in university students?” Finding evidence to this question will help Wasim to make clinical decision. The use of the latest research studies about the problem area conscientiously, is referred as evidence-based practice. The essay aims to evaluate the two pieces of evidence pertaining to the clinical area and discuss barriers to implement the evidence.
PICO model involves the formulation of well-built clinical foreground question. The four components of the PICO question are – “P (population/problem), I (Intervention), C (comparison or placebo), and O (Outcome)”. In PICO question developed by Wasim university students are population, the stimulants use is intervention, and the academic performance enhancement is the outcome measured. These components help to identify specific literature evidence about the effect of the stimulants (Ahadi & Habicht, 2017).
Three authors from different professional backgrounds collaborated in the first qualitative research paper titled “Life context of pharmacological academic performance enhancement among university students”. The first Author, Elisabeth Hildt, is professor of philosophy and director of the Centre for the Study of Ethics in the Professions at Illinois Institute of Technology”, where her research focuses on philosophical and ethical issues in neuroscience, most significantly the field of cognitive enhancement. The second Author, known as Professor Klaus Lieb, is the Director of the Department for Psychiatry and Psychotherapy at Mainz University. The third author Andreas Günter Franke, works as a trainee in Department for Psychiatry and Psychotherapy at Mainz University (Hildt et al., 2014). Their qualification gives the confidence that the results are reliable. Moreover, the researchers obtained ethics approval for the study from local committee. It can be interpreted that the ethical issues were considered. It is evident that the research is well conducted.
The study aimed at reducing the gap concerning the empirical data management related to the enhancement of the academic performance. As there is insufficient literature about contextual factors of the stimulants use and the associated real world effects on the academic outcomes, the aims and objectives of the study seems justified. As per the literature review conducted by the author, it is unclear if the stimulants are used for cognitive and academic performance enhancement. It is unclear if it can also serve any other purpose. In this context, the author has well supported the background and rational for the study supporting with relevant literature.
The author has selected qualitative research methodology. For the data collection, face-to-face interview is used as instrument that contains open-ended questions. The interviews are based on semi-structured interview guidelines. A sample size of 18 people was included. As per inclusion criteria, only participants involved in non-medical use of stimulants for academic performance improvement were involved. To get better insights of the participants’ opinions, values and perception, open-ended questions in qualitative interview is justified. It will help understand the cause underlying the behaviour. The qualitative study will help generate ideas for improvement by studying the impact of stimulants in broad context (Mertens, 2014).
As per the study results, the main reason for administering the stimulants is to increase the memorising power and cope up with the academic pressure. The results can be interpreted that the improvement in academic performance due to stimulants is not an isolated performance. The sole target of these smart drugs is not the improvement in cognitive functioning. It is also integrated into the multifaceted context of life, which signifies its crucial relevance. In addition to improvement in the studies, the students can better cope with the academic curriculum and balance it with time off. Thus, it appears to be advantageous for them. It can be concluded that the study aims are achieved.
The credibility of the research is realised from their details given in the paper that includes work experience. Authorship determines the strength of the paper as it ensures that the authors have expertise to conduct research in this domain (LoBiondo-Wood & Haber, 2017). Thus, there may be no conflicts of interest about the findings considering the expertise, qualifications, and affiliations. This adds to the merits of the paper. The need of the study is justified as stimulants use (illicit or prescription) among university students is less explored and the study wants to explore the same in broader context (O’Brien et al., 2014).
The research methodology is justified considering the aim of the strength of the paper. It will help solve the complex problem by breaking into manageable parts. The complexity refers to understanding the interaction of the participants with the stimulants to achieve the university academic goals. As this context is not clear, the qualitative study would be useful to explore the area and link with the mechanisms (Jensen et al., 2016). The findings meet the research aims.
The weakness of the study lies in discrepancies in the qualitative data management that was obtained from the interview. There are differences in the subjective experiences of the participants and the objective academic outcomes. Very less participants were used and is major drawback that may hamper the validity and reliability of the data. There is no sufficient details on triangulation process in data analysis. Due to self-selection of participants, there is a chance of potential bias (McCusker & Gunaydin, 2015).
In the quantitative study four authors from different professional backgrounds collaborated in the quantitative research paper titled, “The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes”. The first author, Bailey A. Munro, and second author, Lisa L. Weyandt, works at University of Rhode Island, United States. The former is a corresponding author associated with the Interdisciplinary Neuroscience Program. The second author works in the department of psychology as professor. The third author, Marisa E. Marraccini, works at “Alpert Medical School of Brown University, and is associated with “Bradley Hasbro Research Center, Rhode Island US”. The fourth author, Danielle R. Oster also works at “University of Rhode Island, United States” in the department of psychology as a professor (Munro et al., 2017). It can be interpreted that the research is well conducted. Therefore, there might not be any discrepancies concerning study findings as the National Centre for Research Resources of the National Institutes of Health supports the data.
The study has clear aim that is to determine the relationship between the “nonmedical use of prescription stimulants or NMUPS and Executive functioning among the college students”. The author justified the aims and objectives of the study by supporting with relevant studies in this area. Among the college students, the NMUPS has been found to be a burning problem as they are attracted by the improvement in executive functioning and academic performance enhancement (Maier & Schaub, 2015). Executive functions relate to goal-directed behaviour, planning skills, cognitive flexibility and self-regulation. When these functions are absent in a person, it leads to poor performance in academics as per literature review. It may cause risk behaviour among students. In this context, the hypothesis developed by the author seems to be justified. The hypothesis is – students may take NMUPS to overcome the executive functioning deficits for academic success. The other hypothesis also seems justified, which is NMUPS may moderate the relationship between executive functioning and academic performance.
Quantitative research methodology is selected for this research study, and the data is collected through survey questionnaire. For this study, 308 university students were selected. The study setting includes six public universities in US from different regions. For a psychology research, the methodology is justified. Data was analysed for statistical significance to ensure validity.
As per Munro et al. (2017), the rate of use of NMUPS, was higher among university students with executive function deficit than without deficit. The advantage of the stimulants as interpreted from the study is the improvement in the executive functioning skills. It acts as driving force for the student’s NMUPS. Therefore, the first research hypothesise is accepted. Further, students with the self-reported deficit in executive function also showed non-medical use of use of stimulants. However, the second hypothesis cannot be fully accepted as NMUPS did not moderate the relationship between “executive function and grade point average”. Significantly, poor grade point average was observed in the participants with deficit in the executive function skills.
These authors are highly qualified to research about human cognitive function. No conflict of interest seems to be present as per the authorship of the article and is the strength of the paper (LoBiondo-Wood & Haber, 2017). It would have been more convincing if author mentioned details on the ethics approval. Considering the work experience and academic qualifications the credibility of the research is evident. Further, the arguments and goals in the paper are well justified with the supporting literature. The need of the study to identify the university stud at risk of taking NMUPS is justified. In this context appropriate hypothesis was developed. Necessary interventions can be developed to prevent this issue.
Surveys are helpful to obtain the self-report data from the participants. Further, conducting the interview for large sample size would be impractical. Since the research has broad goals, the survey will help assess the feelings, thoughts and opinions to generate quick data (Mertens, 2014). This is the strength of the paper and the results were statistically significant making it reliable. Surveys are useful instrument and are right option for collecting the self-report data in psychology related research. It is justified when research has broad goals and constitutes strength of research (Anderson et al., 2015).
The weakness of the study comes from use of convenience sampling method. Using the sample in proportionate number may have eliminated the limitations related to generalisability of the findings (Munro et al., 2017).
As per the PICO question developed by Wasim, the literature evidence showed that stimulants increase the academic performance by enhancing the executive functions in university students. However, there are various barriers to the implementation of the research evidence. In the case of Wasim, it may be harmful using this evidence for personal use. In healthy individuals, no stimulants or drugs may be safe for cognitive functioning (Maier & Schaub, 2015). Irregular use may cause adverse reactions. Misuse of prescription has been found to have unfavourable consequences. Pharmacological neuroenhancement is associated with ambiguous effects although it helps to cope up with stress and studies. The given PICO question does not measure the negative aspects such as consequences of the illicit use of smart drugs. The PICO question can be modified in future studies to compare the use of stimulants medically and non-medically. Thus, there is a need of further evidence without which it is difficult for Wasim to decide on using the stimulants for academic enhancement.
Lack of the evidenced-based clinical guidelines is added disadvantage for nurses, clinician and patients to advocate the use of stimulants for university students. Further, barriers may include lack of awareness among the patients about the misuse of drugs and adverse reactions. Size and complexity of research are the other barriers to evidence-based practice implementation. Qualitative studies do not give definite concluding evidence so Wasim may not be sure about using stimulants. These studies only give subjective evidence. Use of survey includes underreporting of data due to sensitive questionnaires. Quality of the evidence is hampered because of bias due to personal response. Social desirability cannot be ruled out in questionnaire (Stavor et al., 2017). It may be difficult for Wasim to rely on the results of the quantitative studies for use of stimulants.
Conclusion
In conclusion, PICO is the useful and effective method for inquiry into health care. The evidence obtained from the critique of both the articles is that the use of stimulants by university students increases the academic performance. It highly benefits people diagnosed with ADHD. Executive functions can be enhanced by the stimulants. Considering the case scenario of Wasim, it would not be effective for him to use non-medically. Wasim should share the evidence obtained by PICO question with his friends so that they prefer medical use of these stimulants and refrain from non-medical use. The rationale for choosing the PICO process is justified as it is the systematic process of searching the evidence to solve the clinical questions (Richardson et al., 2017). In conclusion the PICO method is the effective one to systematically search evidence for solving clinical problems (Richardson et al., 2017).
References
Ahadi, N. J., & Habicht, R. J. (2017). Incorporating Evidence-Based Medicine into Your Daily Life. In Hospital Medicine (pp. 85-94). Springer International Publishing.
Anderson, D. R., Sweeney, D. J., Williams, T. A., Camm, J. D., & Cochran, J. J. (2015). An introduction to management science: quantitative approaches to decision making. Cengage learning.
Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students–a qualitative approach. BMC medical ethics, 15(1), 23.
Jensen, C., Forlini, C., Partridge, B., & Hall, W. (2016). Australian university students’ coping strategies and use of pharmaceutical stimulants as cognitive enhancers. Frontiers in psychology, 7.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Maier, L. J., & Schaub, M. P. (2015). The use of prescription drugs and drugs of abuse for neuroenhancement in Europe. European Psychologist.
McCusker, K., & Gunaydin, S. (2015). Research using qualitative, quantitative or mixed methods and choice based on the research. Perfusion, 30(7), 537-542.
Mertens, D. M. (2014). Research and evaluation in education and psychology: Integrating diversity with quantitative, qualitative, and mixed methods. Sage publications.
Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive behaviors, 65, 250-257.
O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine, 89(9), 1245-1251.
Richardson, A., Yarwood, J., & Richardson, S. (2017). Expressions of cultural safety in public health nursing practice. Nursing inquiry, 24(1).
Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the use of evidence-based practice and research utilization through the identification of barriers to implementation in a critical access hospital. Journal of Nursing Administration, 47(1), 56-61.
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