This document summarizes a survey of Rutgers University students regarding barriers and supports for online education among students with psychiatric conditions. The survey found that while students with and without psychiatric conditions identified similar benefits of online classes, those with conditions reported greater challenges with time management, difficulty concentrating, and navigating course websites. The document recommends strategies faculty can use to support students with conditions, such as increasing personal contact, promoting time management skills, and improving site navigation and accessibility.

1. Rutgers, The State University of New Jersey
Identifying Barriers and Supports to Online
Education for Rutgers University Students with
Psychiatric Conditions: A Review of Survey
Results
Ann Murphy
Derek Malenczak
Department of Psychiatric Rehabilitation and
Counseling Professions

2. Rutgers School of Health Professions
STUDENTS WITH
PSYCHIATRIC CONDITIONS
2

3. Rutgers School of Health Professions
Psychiatric Conditions in College
• 7.1% of students
• Debate:
– Maybe more students with psych conditions
– Maybe more students seeking help
• Agreement:
– More students with severe conditions
– Steady increase in students exp. challenging emotions
(American College Health Association, 2012; 2015; Gallagher, 2014; Hunt & Eisenberg, 2010)

4. Rutgers School of Health Professions
Educational Outcomes
• Higher drop-out rates
• Lower course completion rates
• Less likely to complete and pass online courses
(Ginder & Kelly-Reid, 2013; Gruttadaro & Crudo, 2012; Kalsijannis, Zhang, Landmark, &
Reber, 2009; Richardson, 2014)

5. Rutgers School of Health Professions
What about online education?
• Potential Benefits
• Limited Transportation
• Flexibility of Schedule
Applies
Broadly
• Asynchronous Format
• Social Anxiety
• Peak Functioning Time
Specific to
People with
Psych
Conditions
(Banerjee & Brinckerhoff, 2002; Grabinger, 2010)

6. Rutgers School of Health Professions
What about online education?
• Response Inhibition
• Working Memory
• Procedural Memory
• Planning
Executive
Functioning
• Theory of Mind
• Social Perception
• Emotion Processing
Social
Cognition
• Challenges
(Altshuller et al., 2004; Bora et al., 2010; Crow, 2008; Grabinger, 2010; Green et al., 2004; LaGarde
et al., 2010; Snyder, 2013; Snyder et al., 2015; Tempesta et al., 2013)

7. Rutgers School of Health Professions
Cognitive Impairments on Online Education
• Challenges from heavily visual and written content
• Lose benefit of nonverbal communication cues
• Overwhelmed by asynchronous format
• Struggle following written directions & multi-step instructions
• Difficulty problem solving & persisting to resolve issues
• Losing place when navigating within site
(Banerjee & Brinckerhoff, 2002; Rowland, 2004)

8. Rutgers School of Health Professions
SURVEY OF CHOICE,
BENEFITS & CHALLENGES
8

9. Rutgers School of Health Professions
Student Survey
• First step in answering this question
• RedCAP survey
• All students registered for online courses
• Rutgers Spring 2015
• Complete data from 1,665

10. Rutgers School of Health Professions
Demographics
Variable Total Sample No Psych Cond Psych Cond
Mean (SD) Mean (SD) Mean (SD)
Age* 26.22 (9.0) 25.98 (9.0) 27.34 (9.1)
n (%) n (%) n (%)
Gender*
Female 1249 (75.0) 1008 (73.1) 241 (84.3)
Male 416 (25.0) 371 (26.9) 45 (15.7)
Year of Study*
Freshman 153 (9.2) 133 (9.6) 20 (7.0)
Sophomore 223 (13.4) 202 (14.6) 21 (7.3)
Junior 365 (21.9) 303 (22.0) 62 (21.7)
Senior 404 (24.3) 329 (23.9) 75 (26.2)
Grad Student 520 (31.2) 412 (29.9) 108 (37.8)

11. Rutgers School of Health Professions
Demographics (cont.)
Variable Total Sample No Psych Cond Psych Cond
n (%) n (%) n (%)
Level of Online Exp*
First Online Course 562 (33.8) 494 (35.8) 68 (23.8)
Some Exp w. Online
Courses
925 (55.6) 748 (54.2) 177 (61.9)
Almost All Courses
Online
178 (10.7) 137 (9.9) 41 (14.3)

12. Rutgers School of Health Professions
• Psychiatric Conditions (n = 257)
– Depression: 195 (68.2%) Anxiety Disorders: 165 (57.7%)
– Eating Disorder: 36 (12.6%) OCD: 27 (9.4%)
– Bipolar Disorder: 21 (7.3%) Psychotic Disorders: 4 (1.4%)
• Receiving services to manage/treat condition
– Yes (Currently or In Past): 85.6% No: 14.5%
• Registered with ODS
– Yes: 9%
• Have symptoms gotten in the way of receiving a passing
grade?
– In-person Class – 31.8% Online Class – 9.8%

13. Rutgers School of Health Professions
Results – Reasons to Enroll
ITEM NO PSYCH PSYCH Χ2 p
Convenience 70.7% 74.7% 1.77 .18
Flexibility of Schedule 64.1% 69.6% 3.71 .05
Better Fit Around Work 57.1% 58.0% .40 .53
Class Only Online 33.8% 33.1% .02 .90
Avoid Commuting 30.3% 35.0% 5.12 .02
Ability to Learn Own Pace 29.0% 32.3% 1.34 .25
Better Manage Family Resp. 19.7% 27.6% 10.48 .001*
More Comfort Learning at
Home
19.4% 27.6% 9.82 .002*
Enjoy Online Learning Format 19.2% 23.7% 2.22 .14
Lack of Transportation 7.8% 7.4% .01 .91

14. Rutgers School of Health Professions
Top Reasons to Enroll
No Psych
Condition
Psych
Condition
Flexibility of Schedule 23.5% 20.7%
Convenience 20% 19.1%
Better Fit Around Work 19.1% 18%
Class Only Online 18% 21.1%
14

15. Rutgers School of Health Professions
Results – Benefits
ITEM NO PSYCH PSYCH Χ2 p
More Flexibility 80.0% 79.4% .07 .80
Longer Time to Form
Responses
41.6% 45.9% .79 .37
Increased Study Time 29.4% 27.6% .32 .57
No Need for
Textbook/Cheaper
19.7% 19.8% .04 .85
More Comfort Interacting
Online
18.6% 23.3% 3.47 .06
Limited Distractions 16.2% 18.7% 2.02 .16
Money Saved 11.4% 12.5% 1.97 .16
More Detailed
Instruction/Learn
11.1% 6.6% 3.33 .07
Increased Contact/Support
from Peers
5.1% 4.3% .18 .67

16. Rutgers School of Health Professions
Top Benefits
No Psych
Condition
Psych
Condition
More Flexibility 69.5% 63.5%
16

17. Rutgers School of Health Professions
Results – Challenges
ITEM NO PSYCH PSYCH Χ2 p
Lack of In-Person Contact w/ Prof 51.2% 54.9% 1.25 .26
Time Management 31.8% 42.4% 9.30 .002*
No Hands-On (live) Learning 30.2% 34.6% 2.78 .09
Decrease Possibility of Social Int. 28.9% 24.5% 1.25 .26
Lack of Self-Motivation 25.7% 31.1% 1.97 .16
Inability to Comm. Effect. Online 20.0% 22.6% 1.36 .24
Difficulty
Concentrating/Focusing
19.7% 26.8% 9.11 .003*
Diff. Navigating Course Website 17.1% 26.1% 11.09 .001*
Diff. Understand Online
Speech/Cues
8.1% 7.8% .01 .93
Lack of Technical Skills 4.9% 5.1% .01 .94

18. Rutgers School of Health Professions
Top Challenges
18
No Psych
Condition
Psych
Condition
Lack of 1:1 w/ Professor 30.7% 24.8%
Time Management 17.1% 22.9%
Lack of Self-Motivation 11.9% 14.7%
No Hands on Learning 8.9% 5%

19. Rutgers School of Health Professions
STRATEGIES:
WHAT CAN FACULTY DO?
19

20. Rutgers School of Health Professions
Top Barriers Reported
1. In-Person 1:1 contact with Professor
2. Time Management
3. Self-Motivation
20

21. Rutgers School of Health Professions
Barrier 1: In-Person 1:1 Contact
Let them see your face
21

22. Rutgers School of Health Professions
Barrier 1: In-Person 1:1 Contact
Add
Picture
to your
LMS
Profile
22

23. Rutgers School of Health Professions
Post online frequently
• Assignment Reminders
• Deadline Reminders
• Newly posted content
Barrier 1: In-Person 1:1 Contact
23

24. Rutgers School of Health Professions
Respond to student queries quickly
• Within 24 hours
• Offer multiple contact methods
–In-person
–Email
–Phone/text
Barrier 1: In-Person 1:1 Contact
24

25. Rutgers School of Health Professions
Make use of student feedback
• Care about your course
• End-of-semester evals: not enough
Barrier 1: In-Person 1:1 Contact
Personal
connection
with
instructor
Greater student
engagement
and motivation
25

26. Rutgers School of Health Professions
• Provide strategies and resources
–Recommend regular student routines
–Support task-focused planning
–Link to term paper plan calculator
Barrier 2: Time Management
26

27. Rutgers School of Health Professions
• Assist with the reduction of the
tendency to procrastinate
–Provide multiple deadlines leading
up to completion of larger projects
–Outlining instructions for all
assignments in concrete terms
Barrier 2: Time Management
27

28. Rutgers School of Health Professions
• Promote process-focused mindset
–In contrast to outcome-focused
–Emphasize learning from experience
Barrier 2: Time Management
28

29. Rutgers School of Health Professions
• Link content to a bigger picture
• Start with small assignments
–Make them do-able
–Build self-efficacy, competence
• Reach out personally
Barrier 3: Self-Motivation
29

30. Rutgers School of Health Professions
Unique Challenges
1. Site Navigation
2. Difficulty Concentrating
30

31. Rutgers School of Health Professions
Site Navigation
• Course Clear & Uncluttered
• Enable Accessibility
• Remove Extra Items
• Department Standardization
• Follow UDL
31

32. Rutgers School of Health Professions
Difficulty Concentrating
• Task Chunking
• Pomodoro Technique
• Separate Browser
32

33. Rutgers School of Health Professions
Summary
• Students w/ Psych Conditions in your classes
• Choose for different reasons
• Same benefits
• Experience different challenges
• You can help!
33

34. Rutgers School of Health Professions
Questions???
34

35. Rutgers School of Health Professions
References
• Ariely, D., & Wertenbroch, K. (2002). Procrastination, deadlines, and performance: Self-control by
precommitment. Psychological Science, 13, 219–224.
• Banerjee, M., & Brinckerhoff, L. C. (2002). Assessing student performance in distance education
courses: Implications for testing accommodations for students with learning disabilities.
Assessment for Effective Intervention, 27, 25-35.
• Gallagher, R. P. (2014). National survey of college counseling centers. The International
Association of Counseling Services, Inc. Monograph Series Number 9V.
• Ginder, S. A., & Kelly-Reid, J. E. (2013). Enrollment in Postsecondary Institution, Fall 2012;
Financial Statistics, Fiscal Year 2012; Graduation Rates, Selected Cohorts, 2004-2009; and
Employees in Postsecondary Institution, Fall 2012. First Look (Provisional Data) (NCES 2013-
183).US Department of Education. Washington, DC: National Center for Education Statistics.
• Grabinger, S., (2010). A framework for supporting postsecondary learners with psychiatric
disabilities in online environments. Electronic Journal of e-Learning, 8, 1010-110.
• Green, M. F., Kern, R. S., & Heaton, R. K. (2004). Longitudinal studies of cognition and functional
outcome in schizophrenia: Implications for MATRICS. Schizophrenia Research, 72, 41-51.
• Gruttadaro, D., & Crudo, D. (2012). College students speak: A survey report on mental health.
National Alliance on Mental Illness.
35

36. Rutgers School of Health Professions
References
• Hunt, J., & Eisenberg, D. (2010). Mental health problems and help-seeking behavior among
college students. Journal of Adolescent Health, 46, 3-10.
• Jaggars, S.S., & Xu, D. (2013). Predicting online student outcomes from a measure of course
quality (Working Paper 57). New York, NY: Community College Research Center, Teachers
College, Columbia University.
• Katsiyannis, A., Zhang, D., Landmark, L., & Reber, A. (2009). Postsecondary education for
individuals with disabilities: Legal and practical considerations. Journal of Disability Policy Studies,
20, 35-45.
• Krause, K., & Freund, A. (2016). It’s in the means: Process focus helps against procrastination in
the academic context. Motivation and Emotion, 40, 422–437.
• LaGarde, G. V., Doyon, J., & Brunet, A. (2010). Memory and executive dysfunctions associated
with acute posttraumatic stress disorder. Psychiatry Research, 177, 144-149.
• McCrea, S. M., Liberman, N., Trope, Y., & Sherman, S. J. (2008). Construal level and
procrastination. Psychological Science, 19, 1308-1314.
• Rowland, C. (2004). Cognitive disorders part 2: Conceptualizing design considerations.
www.webaim.org/techniques/articles/conceptualize/?templatetype=3
• Synder, H. R. (2013). Major depressive disorder in association with broad impairments on
neurological measures of executive function: A meta-analysis and review. Psychological Bulletin,
139, 81-132.
36

37. Rutgers School of Health Professions
References
• Snyder, H. R., Kaiser, R. H., Warren, S. L., & Heller, W. (2015). Obsessive-compulsive disorder is
associated with broad impairments in executive function: A meta-analysis. Clinical Psychological
Science, 3, 301-330.
• Tempesta, D., Mazza, M., Serroni, N., Moschetta, F. S., DiGiannantonio, M., Ferrara, M., &
DeBerardis, D. (2013). Neurological functioning in young subjects with generalized anxiety
disorder with an without pharmacotherapy. Progress in NeuroPsychopharmacology and Biological
Psychiatry, 45, 236-241.
37