Higher Education Research & Development

ISSN: 0729-4360 (Print) 1469-8366 (Online) Journal homepage: https://www.tandfonline.com/loi/cher20

Resilience in higher education students: a scoping

review

Margo. L. Brewer, Gisela van Kessel, Brooke Sanderson, Fiona Naumann,

Murray Lane, Alan Reubenson & Alice Carter

To cite this article: Margo. L. Brewer, Gisela van Kessel, Brooke Sanderson, Fiona
Naumann, Murray Lane, Alan Reubenson & Alice Carter (2019): Resilience in higher
education students: a scoping review, Higher Education Research & Development, DOI:
10.1080/07294360.2019.1626810

To link to this article: https://doi.org/10.1080/07294360.2019.1626810

Published online: 17 Jun 2019.

Submit your article to this journal

Article views: 197

View Crossmark data

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=cher20
HIGHER EDUCATION RESEARCH & DEVELOPMENT
https://doi.org/10.1080/07294360.2019.1626810

Resilience in higher education students: a scoping review

Margo. L. Brewer a, Gisela van Kessel b, Brooke Sanderson c
, Fiona Naumannd,
Murray Lane e, Alan Reubenson f and Alice Carter c
a
Faculty of Health Sciences, Curtin University, Perth, Australia; bSchool of Health Sciences, Division of Health
Sciences Department, University of South Australia, Adelaide, Australia; cSchool of Occupational Therapy,
Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia; dFaculty of
Health Executive Office, Faculty of Health, Queensland University of Technology, Brisbane, Australia; eStudent
Success Group, Learning and Teaching Unit, Queensland University of Technology, Brisbane, Australia; fSchool
of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia

ABSTRACT ARTICLE HISTORY

The health, wellbeing and employability of university students are Received 1 June 2018
key considerations within higher education. In response, interest Accepted 3 March 2019
in student resilience is on the rise. Reviews of contemporary
KEYWORDS
resilience literature highlight both conceptual and methodological Employability; mental health;
weaknesses, issues which hamper attempts to design effective resilience; retention; student
resilience interventions. To inform the design of a student experience
resilience program, to be piloted at three Australian universities, a
scoping review of resilience specific to the higher education
context was undertaken. Searches of three electronic databases
(PsychINFO, CINAHL and ProQuest) were conducted. Seventy-two
peer-reviewed articles published between 2007 and 2017 were
included in the review. While the review reaffirms the conceptual
and methodological issues found in previous resilience research, it
provides a useful critique of key issues in relation to university
student resilience and interventions to enhance students’
resilience. Recommendations for educators and researchers are
provided.

Introduction
The health and wellbeing of contemporary university students is cause for concern with
elevated levels of distress reported in 48% (Leahy et al., 2010) and 84% (Stallman, 2011)
of Australian students. More recently, Stallman (2016) found 60% of university students
reported clinical levels of stress. Baik, Naylor, and Arkoudis’s (2015) study revealed 19% of
first-year students contemplated deferring or dropping out of university with emotional
health issues the most frequently cited reason (72%). The National Centre of Excellence
in Youth Mental Health, Orygen (2017), cited multiple reasons for university students
struggling with mental health including lack of sleep, poor diet, living away from
family, academic pressure, uncertain graduate employment, and financial stress. Research-
ers have reported increased levels of suicidal ideation, anxiety, depression and burnout in
medical students (Puthran, Zhang, Tam, & Ho, 2016; Slavin, Schindler, & Chibnall, 2014)

CONTACT Margo L. Brewer m.brewer@curtin.edu.au Faculty of Health Sciences, Curtin University, GPO Box U1987,
Perth 6845, Australia
© 2019 HERDSA
2 M. L. BREWER ET AL.

with students suffering from burnout more likely to engage in cheating and dishonest
behaviour (Thompson, McBride, Hosford, & Halaas, 2016). Workplace learning (e.g.,
fieldwork placements) provides a particular challenge for students due to a lack of strat-
egies to deal with day-to-day challenges (Probst, Boylan, Nelson, & Martin, 2014) includ-
ing the heavy workload demands, the unwelcoming and negative attitudes of staff, coping
with the death of patients, and anxiety about making errors (Reyes, Andusyszyn, Iwasiw,
Forchuk, & Babenko-Mould, 2015).
Reviews of the higher education literature have highlighted the key role resilience plays
in assisting students to overcome challenges, manage their wellbeing and complete their
studies (Beltman, Mansfield, & Price, 2011; Howe, Smajdor, & Stockl, 2012; McAllister
& McKinnon, 2009; Reyes et al., 2015). Universities have responded to this growing inter-
est in resilience. For example, a recent review of the health professional education litera-
ture revealed a shift to the proactive promotion of resilience interventions (Sanderson &
Brewer, 2017). This review, however, also highlighted the lack of clarity over how resili-
ence was conceptualised and the limited research on how to enhance student resilience.
Beltman and colleagues’ (2011) review within the context of teacher education also
found resilience to be an emerging field which lacked conceptual clarity and methodologi-
cal rigour. Moving beyond a focus on health and teacher education, our review aimed to
gain an understanding of resilience within the broad higher education context. This
understanding would then inform the design of a program to enhance student resilience
across several Australian universities.

Method
A scoping review was employed as the lack of high-quality research (e.g., randomised
control trials) meant a systematic review was not feasible (Levac, Colquhoun, &
O’Brien, 2010). Scoping reviews provide a synthesis of the evidence of the research
(Rumrill, Fitzgerald, & Merchant, 2010). Arksey and O’Malley’s (2005) methodological
approach for scoping reviews provided the guiding framework for this review. The
review was undertaken by seven experienced researchers covering five disciplines to add
breadth and depth to the review. These researchers were supported by a research assistant.
Step 1. Identify the research question. Three key questions informed the literature
review: (1) how is resilience conceptualised within the higher education literature, (2)
how do researchers view the role of resilience within higher education and workplace
readiness, and (3) what is the extent and nature of interventions targeting student resili-
ence within higher education.
Step 2. Identify the relevant studies. Balancing our desire for breadth of the review with the
timeframe and resources of the research project three databases were utilised. PsycINFO was
selected because of the high level of interest in resilience within psychology, CINAHL (the
Cumulative Index to Nursing and Allied Health Literature) because it covers a wide range
of health disciplines, and ProQuest because it also includes multiple databases and fields of
study. Boolean connectors (AND, OR) were used to combine search terms such as higher
education, university, college, student*, resilien*, enhance* and program*.
Step 3. Study selection. Following agreement on the preliminary inclusion and exclusion
criteria (Table 1) the initial search yielded 856 records. A review of the title, abstract and
keywords by the research assistant indicated a large number of studies focused on study
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 3

Table 1. Preliminary study inclusion and exclusion criteria.

Inclusion Exclusion
• English publication in a peer-reviewed journal • Full paper • Non-English publication • Grey literature • Only abstract
accessible • Published between 1 January 2007 and 5 July accessible • Study population focused on school-aged
2017 • Study population of higher education students students

participants who had experienced significant trauma or a critical life event or were military
and first responders (e.g., police, ambulance). As this review focused on the general popu-
lation of higher education students the exclusion criteria were altered to state ‘study popu-
lation focused on trauma/critical life event, military, first responders, school-aged students’.
Following a review of the 856 abstracts for relevance to the research questions and
removal of duplicate records, 98 journal papers were read in full by the research assistant
to further assess their relevance. A further 34 papers were removed. A review of the refer-
ence list for the remaining 64 papers identified an additional eight papers for inclusion.
Two researchers then independently read these 72 papers for final inclusion (Figure 1).
Step 4. Charting the data. Meetings were held at the beginning, midpoint and end of the
review to refine the review process. A template (excel spreadsheet) for recording the data
was developed by the research team based on lessons learned from two previous scoping
reviews involving team members (Brewer, Flavell, Trede, & Smith, 2016; Sanderson &
Brewer, 2017). This template captured key data including biographic information, ration-
ale for inclusion, paper type, conceptualisation of resilience, key issues raised in relation to
resilience, resilience models/frameworks/processes or interventions, and study limitations.

Results
Study characteristics
The review identified a total of 72 papers that discussed the role of resilience within higher
education and/or described interventions targeting tertiary student resilience. Interest in
resilience increased over the past decade, with two-thirds of the papers published
between January 2013 and July 2017. Half of the studies related to the US context, one-
third to Australasia (Australia, Taiwan, India, China, Philippines and Hong Kong), and
the remaining the UK (8), Turkey (3), Brazil (1), Iran (1) and South Africa (1). While a
range of courses within health, business, behavioural sciences, sports science, agriculture
and music were included, medicine and nursing were the most frequently cited professions.
Psychology and business were the only other professions represented in more than one
paper. Half of the papers either combined multiple professions or did not specify the pro-
fessions involved. Almost two-thirds were empirical papers with papers describing an inter-
vention with no outcome data the next most common category. The remaining manuscripts
were spread equally among conceptual, summary/review and opinion papers. An overview
of the 72 papers follows.

Key issues identified

The higher education environment in the twenty-first century was described as fast-paced,
ever-changing, challenging and linked to increasingly high levels of stress for students
4 M. L. BREWER ET AL.

Figure 1. PRISMA flow diagram of study selection process.

(Ahmed & Julis, 2015). This environment impacted on student well-being, persistence,
academic performance and ongoing success or failure in university life (Baxter, 2012;
Reyes et al., 2015). Archana and Singh (2014) and Sood (2013) described resilience as
one of the most important factors for student well-being, satisfaction and successful tran-
sition into higher education. The association between resilience and academic success
(Ahmed & Julis, 2015; Beauvais, Stewart, DeNisco, & Beauvais, 2014; Crombie, Brindlet,
Harris, Marks-Maran, & Morris Thompson, 2013; Sheard, 2009; Yokus, 2015) and
between resilience and wellbeing (Archana & Singh, 2014; Kajbafnezhad & Keshi, 2015;
Priesak & Alcock, 2015; Sharma, 2012) were strong themes throughout.
Higher education was seen to play an important role in preparing graduates to face
today’s chaotic workplace (Goertzen & Whitaker, 2015) where stress, conflict, challenging
individuals and situations are inevitable (Shin & Kelly, 2015; Zhang, 2011). Concern was
raised that traditional university teaching practices are not preparing students sufficiently
for the workplace (Goertzen & Whitaker, 2015; Cuadra & Famadico, 2013) but by building
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 5

resilience and embedding opportunities to develop strategies to overcome workplace

issues, students will feel empowered to deal with ongoing challenges. Several papers
focused on the relationship between resilience and career, with resilience described as con-
tributing to students’ capacity to manage their own well-being which impacts on career
decision making (Shin & Kelly, 2015) and on career success, satisfaction and commitment,
adaptability and ongoing positive mental health (Buyukgoze-Kavas, 2016; Cilliers &
Flotman, 2016; Eley, Leung, Hong, Cloninger, & Cloninger, 2016).
While the development of resilience was identified as important to a wide range of
careers it was seen as particularly pertinent to specific industries and cohorts. First-year
students, medical students and those participating in fieldwork placements (Bahadir-
Yilmaz & Oz, 2015; Bamford, Djebbour, & Pollard, 2015; Reyes et al., 2015; Slavin
et al., 2014) are particularly vulnerable.

Definitions/conceptualisations of resilience
Almost one-third of the articles offered no clear definition of resilience. Whilst definitions
varied considerably, resilience was generally conceptualised as an effective adaptation to
stress, adversity or change (Flinchbaugh, Luth, & Li, 2015; Hartley, 2013). Resilience
enabled people to withstand stress or adversity (Campa, 2010; Huang, 2014; Li & Yang,
2016), maintain well-being (Cuadra & Famadico, 2013; Sharma & Bali, 2013) and
return to their pre-existing state (Gerson & Fernandez, 2013; Steinhardt & Dolbier,
2008). Resilient individuals rebound from difficult life events (Li & Yang, 2016; McAllister
& McKinnon, 2009; Mak, Ng, & Wong, 2011). Several definitions went beyond the notion
of resilience as ‘surviving’ to ‘thriving’. Cuadra and Famadico (2013), Delany and col-
leagues (2015), and Maddi, Harvey, Khoshaba, Fazel, and Resureccion (2009) described
resilience as occurring when individuals are positively transformed through an encounter
with adversity, ultimately resulting in growth or learning. The environment, and one’s
interactions with and within, was also seen to influence resilience (Mak et al., 2011; Stein-
hardt & Dolbier, 2208; Tempski et al., 2015). Resilience could be strengthened throughout
an individual’s life (Eley & Stallman, 2014; Huang, 2014; Reyes et al., 2015).

Enhancing resilience
Seventeen of the studies reviewed described interventions which had been evaluated while
Galante and colleagues (2016) described a proposed intervention (Table 2). Many papers
lacked information on the target population. The intervention time frames varied from
one week (e.g., Gerson & Fernandez, 2013) to holistic approaches that integrated multiple
interventions including Waddell and colleagues’ (2015a, 2015b) longitudinal approach to
building career resilience in nursing students and Slavin and colleagues’ (2014) curricular
changes in medical education. All interventions, bar one, were delivered in the university
setting; Goertzen and Whitaker (2015) outlined an intervention in the workplace using a
service learning project. The mode of delivery was predominately face-to-face with only
three studies reporting online delivery.
A range of intervention approaches were described across these 18 papers. The most
common approaches were mindfulness-based stress reduction strategies (e.g., Galante
et al., 2016; Kamath, 2015; Slavin et al., 2014; van der Riet, Rossiter, Kirby, Dluzewska,
 6
Table 2. Resilience enhancement interventions.
Reference Profession Program Mode of delivery Frequency Strategies

M. L. BREWER ET AL.
Bamford et al. (2015) Not specified Learning module including Online Not specified Facebook groups were embedded as part of two
the use of social media modules in Years 1 and 3. Peer support and
mentoring were provided by postgraduate
students.
Daniels, Billingsley, Nursing, public health, Service learning training N/A Two years extracurricular Students delivered a health project as part of a
Billingsley, Long, food and nutrition, program service learning model
and Young (2015) psychology
Delany et al. (2015) Physiotherapy Positive psychology Face to face 4 × 90 minute evening sessions Cognitive behaviour therapy program (delivered
program by clinical psychologist) to manage stress
associated with clinical placement
Dolbier et al. (2009) Not specified ‘Transforming Lives Through Face to face 4 × weekly 2 hour sessions The same program as Steinhardt and Dolbier
Resilience Education’ (2008)
Galante et al. (2016) Not specified Mindfulness skills for Face to face 8 × weekly 1-1.5 hour sessions Proposed randomised control trial for mindfulness
students training
Gerson and Not specified ‘Program for Accelerated Face to face 3 × 1–1.5 hour sessions Psychoeducation to learn adaptive explanatory
Fernandez (2013) Thriving and Health’ styles based on personality and control concepts
(PATH)
Goertzen and Not specified beyond Leadership program Three modes – Three modules. Frequency not Psychoeducation within a leadership program
Whitaker (2015) undergraduate (includes a service- face to face, specified focused on the development of psychological
learning project) online or capital
blended
Kamath (2015) Not specified Mindfulness-based training Face to face Seven sessions over six months Mindfulness training modules which include
program counselling, meditation, mindfulness, yoga
Maddi et al. (2009) Not specified ‘The Hardiness Approach to Face to face Two classes per week over 11 weeks Lectures supplemented by weekly discussion
Stress Management’ groups
Pines et al. (2014) Psychiatric-Mental Didactic and simulated Face to face Four modules over two semesters Psychoeducation and simulated training using
Health Nursing learning scenarios related to resilience, empowerment
and conflict management
Shek, Sun, Tsien- Not specified ‘Tomorrow’s Leaders’ Face to face 14 × 1 hour lecture Psychoeducation including self-understanding,
Wong, Cheng, and leadership and resilience, competence, integrity, spirituality,
Yan (2013) interpersonal and identity
development course
Slavin et al. (2014) Medicine Multiple interventions Face to face Six hours over one semester Mindfulness program and curricular changes (e.g.,
pass/fail grades, reduced contact hours, staff-
student learning communities)
Smith and Khawaja International students ‘Strengths, Transitions, Face to face 4 × 2 hourly weekly sessions plus Psychoeducation program including settling in
(2014) Adjustments, and homework Australia, making friends, being proactive,
Resilience’ (STAR) program cognitive restructuring
Steinhardt and Not specified Transforming lives through Face to face 4 × 2 hour sessions Psychoeducation program includes modules on
Dolbier (2008) resilience education cognitive restructuring and meaningful
connections
Stephens and Nursing Social media social support Online 4× tweets per week for six weeks Deliver educational messages and/or questions
Gunther (2016) using Twitter (tweets) focused on enhancing protective
factors (e.g., social support)

HIGHER EDUCATION RESEARCH & DEVELOPMENT

van der Riet et al. Nursing & midwifery Stress management and Face to face 7 × 1 hour sessions Mindfulness skills to build resilience, reduce stress
(2015) mindfulness program and improve concentration
Waddell et al. (2015a, Nursing Career resilience: career Face to face 6 × 3 hour workshops over two Program includes career-visioning, identification
2015b) planning and years of values and strengths and areas for
development program development
Wald et al. (2015) Medicine Professional identity Face to face (i) 2 × 1 hour over six weeks; (ii) 7 × Three innovations to enrich professional identity.
formation 90 minute sessions over one year; Included reflective writing, mindful practice and
(iii) over three year residency use of e-portfolios

7
8 M. L. BREWER ET AL.

& Harmon, 2015). Cognitive behavioural strategies focused on identifying and changing
maladaptive thinking and psychoeducation strategies to increase personal knowledge
about the causes of, and contributors to, stress were combined in at least two studies
(Delany et al., 2015; Steinhardt & Dolbier, 2008).
In addition to the studies reporting interventions designed to enhance resilience, the
review uncovered 12 studies that either reviewed the literature or provided an opinion
or commentary on possible models or strategies to enhance resilience. The conceptual
papers included Dunn, Iglewicz, and Moutier’s (2008) proposed ‘reservoir’ model of
student wellbeing which incorporated resilience. Flinchbaugh and colleagues (2015) pro-
posed a model consisting of two types of stressors (hindrance and challenge) which result
in reduced or improved sense of wellbeing respectively with levels of thriving and resili-
ence mediating these effects.
Whether empirical or proposed, the various approaches to enhancing resilience could
be categorised into three interrelated domains: intrapsychic resources or protective factors,
interpersonal resources and strategies, and contextual resources. Intrapsychic relates to the
individual managing their thoughts and feelings while interpersonal relates to the individ-
ual obtaining resources, rewards, reactions or outcomes from others (Leary, Raim,
Jongman-Sereno, & Diebels, 2015). Approaches focused on intrapsychic resources
included those targeting coping (Hartley, 2010), empowerment (Pines et al., 2014), self-
efficacy (Cilliers & Flotman, 2016; Delany et al., 2015; Gerson & Fernandez, 2013; Li &
Yang, 2016; Priesak & Alcock, 2015; Tempski et al., 2015), self-concept (Willis &
Burnett, 2016), self-esteem (Sharma & Bali, 2013), personality (Eley et al., 2016; Kilbert
et al., 2014; Zhang, 2011), persistence or conscientiousness (Delany et al., 2015; Eley &
Stallman, 2014; Tempski et al., 2015), hardiness (Gerson & Fernandez, 2013; Huang,
2014; Maddi et al., 2009), optimism (Cuadra & Famadico, 2013; Mak et al., 2011),
emotional intelligence (Jayalakshmi & Magdain, 2015) and happiness (Sood, 2013).
Self-care activities such as mindfulness and meditation (Rogers, 2013), yoga (Dunn
et al., 2008), engaging in recreational activities (Wood, 2016) and help-seeking behaviour
(Hartley, 2010; Wood, 2016) also featured as intrapsychic resources that support resili-
ence, along with guided reflection (Wald et al., 2015; Wood, 2016). Approaches focused
on interpersonal resources included the development of conflict management and team-
work skills (Eley & Stallman, 2014; Gerson & Fernandez, 2013; Pines et al., 2014). The
third category of interventions focused on changes at the contextual level with a strong
emphasis on increasing social support (Paul, Sriram, Subalukshmi, & Mala, 2015; Wilks
& Spivey, 2010). Changes in faculty behaviour included positive role modelling and facil-
itating social connections (Howe et al., 2012) and positive professional relationships
(McAllister & McKinnon, 2009). Monitoring students’ emotional health and wellbeing
(Howe et al., 2012) was also proposed. Pedagogical and curricula changes included ensur-
ing students feel valued and supported to try and fail (Eley & Stallman, 2014), increasing
collaborative learning environments (Crombie et al., 2013; Wald et al., 2015), decreasing
online communication with students and developing staff-student learning communities
(Eley & Stallman, 2014), providing mentoring and peer support programs (Dyrbye et al.,
2010; Hartley, 2010; Wood, 2016), allowing time for personal and health activities within
schedules (Dyrbye & Shanafelt, 2011), establishing clear rules and expectations to
reinforce students’ responsibilities such as rarely granting assessment extensions to high-
light the need to meet obligations, manage stress and be proactive in their prioritisation
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 9

and decision making (Eley & Stallman, 2014). Others suggested changes to assessment
practices including pass/fail assessments to reduce competition and the preparation of stu-
dents for exposure to human suffering and ethical challenges (Dyrbye & Shanafelt, 2011).
Finally, in relation to the quality of the research, the studies utilised a diverse range of
tools to measure resilience, limiting our capacity to compare and contrast research
findings. Most studies employed cross-sectional designs lacking the ability to determine
cause and effect relationships (e.g., Ahern & Norris, 2011; Bacchi & Licinio, 2017;
Priesak & Alcock, 2015). Sample sizes tended to be small and lack statistical power to
make meaningful conclusions (e.g., Bacchi & Licinio, 2017; Campa, 2010; Dolbier,
Jaggars, & Steinhardt, 2009). Almost half of the studies relied exclusively on self-report
measures (e.g., Kamath, 2015; van der Riet et al., 2015). A high percentage of the
studies also employed convenience sampling so may be negatively impacted by selection
bias. The lack of suitable control groups (e.g., Waddell et al., 2015a, 2015b) further ham-
pered the quality of this research.

Discussion
Concern over the resilience and mental health of university students is a global issue.
While the findings of our review demonstrate increased interest in resilience within the
higher education literature over the past decade, several methodological issues have
impacted on our understanding of resilience. The lack of a universally accepted definition
of resilience is one such issue. Previous reviews of resilience within higher education
(Beltman et al., 2011; Sanderson & Brewer, 2017), and the broader literature have sup-
ported this finding. For example, Meredith and colleagues (2011) found 122 definitions
of resilience across 187 documents. Conceptualisations of resilience, though lacking in
many papers, also varied. In general, resilience was viewed as a dynamic, contextual
process focused on adaptation (to stress or change) which could be enhanced. This per-
spective is supported by other contemporary research (Stephens, 2013; van Kessel,
2013) and literature reviews (Aburn, Gott, & Hoare, 2016). Few authors focused on resi-
lience in relation to growth, a finding again supported by Meredith and colleagues’ (2011)
review which found only 18 of the 122 definitions discussed resilience in relation to
growth. Whilst differences in definitions or conceptualisation may be expected given
the diverse fields and professions involved in the research reviewed, this does raise chal-
lenges for educators and researchers. One such challenge is the array of tools used to
measure resilience, many of which were identified as lacking quality in Windle,
Bennett, and Noyes’s (2011) review of such resilience measures.
The vast majority of papers highlighted the important role resilience can play in mental
health and success both at university and in the workplace because of its association with
coping effectively with social, mental, emotional and educational challenges (e.g., Ahmed
& Julis, 2015: Archana & Singh, 2014), with many researchers calling for resilience to be
embedded at the curricular (e.g., Slavin et al., 2014) or co-curricular (e.g., Wood, 2016)
level. Particular emphasis was placed on the need for resilience enhancement during
transition into higher education and into the workplace (including fieldwork placements),
not surprising given research into the challenges many students face at these junctures
(Grant-Smith & Gillett-Swan, 2017; Kift, 2015; Postareff, Mattsson, Lindblom-Ylänne,
& Hailikari, 2017).
10 M. L. BREWER ET AL.

The dominance of the professions of medicine and nursing may have been influenced
by the databases utilised. However, the demands of the typical work environment for
health professionals (Howe et al., 2012; Reyes et al., 2015) is likely to have also contributed
to this. For health students, cultivating resilience was seen as not only important for their
studies and work-lives but also improving their ability to promote the health of their
patients (Eley et al., 2016). The absence of papers from teacher education and law
should be noted as a limitation of this review as concern over student resilience (Gibbs
& Miller, 2014; Mansfield, Beltman, Broadley, & Weatherby-Fell, 2016) and mental
health (Bergin & Pakenham, 2015; Field, Duffy, & Huggins, 2015) has been highlighted
in both of these fields.
Our review revealed a range of approaches to enhance student resilience within intrap-
sychic, interpersonal and contextual domains. Akin to Sanderson and Brewer’s (2017)
review, most empirical studies occurred within the classroom. Rogers’ (2016) review of
the effectiveness of resilience interventions supports the emphasis on face to face delivery
for resilience interventions but ignores the growth in technologically enhanced learning
needed for the scalability of resilience interventions within higher education.
Although a variety of study populations with differing cultural, social and educational
backgrounds were included in the small number of empirical papers, the lack of large scale,
high-quality studies limited the generalisability of interventions in different higher edu-
cation settings. Similar concern over the methodological weakness of this area of research
has been expressed in previous reviews (Beltman et al., 2011; Rogers, 2016; Sanderson &
Brewer, 2017).
Several key recommendations emerged from this review. A shared definition of resili-
ence specific to the higher education context is needed to inform the design of resilience
interventions and resilience research. This definition should focus on thriving and not just
surviving thereby encouraging students and educators to view university as a place of
growth. We propose the following definition of resilience: resilience is a dynamic
process of positive adaptation in the face of adversity or challenge. This process involves
the capacity to negotiate for, and draw upon, psychological, social, cultural and environ-
mental resources (see Brewer, 2018, p. 1 for a more detailed description of resilience).
Educators need to pay attention to the social and organisational contexts within which
the individual functions. Interventions which target individual students’ emotional intelli-
gence, mindfulness, coping strategies and thinking (e.g., growth mindset) show promise
but should be supplemented with environmental strategies such as fostering self-efficacy
by increasing students choice and control over aspects of their learning, facilitating
social connections (e.g., mentoring programs), scaffolding exposure to challenges, and
preparing students for the complexities of the twenty-first century workplace. The impor-
tance of self-care and help-seeking should also be made explicit to students. Eley and Stall-
man’s (2014) suggestion that educators provide clear expectations that reinforce student
responsibility (e.g., enforcing deadlines/rarely granting extensions) to assist students to
understand the importance of meeting obligations, managing stress, and being proactive
and responsible in their decision making is worthy of exploration in preparing students for
the realities of many workplaces.
Researchers need to provide a definition or conceptualisation of resilience and a
description of the study participants and context, key elements missing from many of
the papers reviewed. The use of valid and reliable measures of resilience (Windle et al.,
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 11

2011) which are relevant to the study context and go beyond self-reported outcomes is
critical to advancing resilience research. Turner, Holdsworth, and Scott-Young’s (2017)
resilience scale, designed specifically for the higher education context, may provide one
solution to the measurement challenge.
Research is needed on the most appropriate intervention for cohorts (e.g., international
students) and contexts (e.g., face to face, online), and on the impact of organisational/
environmental strategies. Kirkpatrick and Kirkpatrick’s (2006) training evaluation frame-
work, applied in several contemporary studies (e.g., Phuong, Cole, & Zarestky, 2018; This-
tlethwaite, Kumar, Moran, Saunders, & Carr, 2015), provides a useful model to inform
resilience intervention studies.

Conclusion
Resilience is a growing area of interest within the higher education literature. While it
remains a contested term, resilience was associated with the health, wellbeing and employ-
ability (workplace readiness) of students. Resilience was typically described as either a
process or an outcome in relation to positive adaptation. A range of interventions and sug-
gestions were described, however, methodological issues with the empirical studies made it
difficult to draw any conclusions on how to best enhance university students’ resilience. A
shared definition of resilience within the higher education context and quality research
into resilience interventions would add significantly to the higher education agenda.

Acknowledgement
We would like to acknowledge the contribution of Michelle Donaldson, Sonia Ferns, Helen Flavell,
Sharon Maresse, Millie Watson, Omar Abdelrahman, Sue Barnard, Bernie Cooper and Caroline
Rueckert.

Disclosure statement
No potential conflict of interest was reported by the authors.

Funding
This research was funded by the Australian Technology Network.

ORCID
Margo. L. Brewer http://orcid.org/0000-0001-9580-0390
Gisela van Kessel http://orcid.org/0000-0002-6955-0727
Brooke Sanderson http://orcid.org/0000-0002-1453-1860
Murray Lane http://orcid.org/0000-0002-1571-030X
Alan Reubenson http://orcid.org/0000-0002-0689-5090
Alice Carter http://orcid.org/0000-0002-3783-1372
12 M. L. BREWER ET AL.

References
Aburn, G., Gott, M., & Hoare, K. (2016). What is resilience? An integrative review of the empirical
literature. Journal of Advanced Nursing, 72(5), 980–1000.
Ahern, N., & Norris, A. E. (2011). Examining factors that increase and decrease stress on adolescent
community college students. Journal of Pediatric Nursing, 26(6), 530–540.
Ahmed, Z., & Julis, S. H. (2015). Academic performance, resilience, depression, anxiety, and stress
among women college students. Indian Journal of Positive Psychology, 6(4), 367–370.
Archana, U., & Singh, R. (2014). Resilience and spirituality as predictors of psychological well-being
among university students. Journal of Psychosocial Research, 9(2), 227–235.
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework.
International Journal of Social Research Methodology, 8(1), 19–32.
Bacchi, S., & Licinio, J. (2017). Resilience and psychological distress in psychology and medical stu-
dents. Academic Psychiatry, 41(2), 185–188.
Bahadir-Yilmaz, E., & Oz, F. (2015). The resilience levels of first-year medical, dentistry, pharmacy,
and health sciences students. International Journal of Caring Sciences, 8(2), 385–392.
Baik, C., Naylor, R., & Arkoudis, S. (2015). The first year experience in Australian universities:
Findings from two decades, 1994-2014. Melbourne, Australia: Melbourne Centre for the Study
of Education.
Bamford, J., Djebbour, Y., & Pollard, L. (2015). “I’ll do this no matter if I have to fight the world!”
Resilience as a learning outcome in urban universities. Journal for Multicultural Education, 9(3),
140–158.
Baxter, J. (2012). Who am I and what keeps me going? Profiling the distance learning student in
higher education. The International Review of Research in Open and Distance Learning, 13(4),
107–129.
Beauvais, A., Stewart, J., DeNisco, S., & Beauvais, J. (2014). Factors related to academic success
among nursing students: A descriptive correlational research study. Nurse Education Today,
34(6), 918–923.
Beltman, S., Mansfield, C., & Price, A. (2011). Thriving not just surviving: A review of research on
teacher resilience. Education Research Review, 6(3), 185–207.
Bergin, A., & Pakenham, K. (2015). Law student stress: Relationships between academic demands,
social isolation, career pressure, study/life imbalance and adjustment outcomes in law students.
Psychiatry, Psychology and Law, 22(3), 388–406.
Brewer, M. (2018). Building resilience for the 21st century: Facilitator guide. Canberra, ACT:
Australian Technology Network. Retrieved from www.enhancingresilience.com/
Brewer, M. L., Flavell, H. L., Trede, F., & Smith, M. (2016). A scoping review to understand ‘leader-
ship’ in interprofessional education and practice. Journal of Interprofessional Care, 30(4),
408–415.
Buyukgoze-Kavas, A. (2016). Predicting career adaptability from positive psychological traits. The
Career Development Quarterly, 64(2), 114–125.
Campa, B. (2010). Critical resilience, schooling processes, and the academic success of Mexican
Americans in a community college. Hispanic Journal of Behavioural Sciences, 32(3), 429–455.
Cilliers, F., & Flotman, A. (2016). The psychological well-being manifesting among master’s stu-
dents in industrial and organisational psychology. SA Journal of Industrial Psychology, 42(1),
1–11.
Crombie, A., Brindlet, J., Harris, D., Marks-Maran, D., & Morris Thompson, T. (2013). Factors
that enhance rates of completion: What makes students stay? Nurse Education Today, 33(11),
1282–1287.
Cuadra, D., & Famadico, L. (2013). Male nursing students’ emotional intelligence, caring behavior,
and resilience. International Journal of Arts & Sciences, 6(3), 243–260.
Daniels, K., Billingsley, K., Billingsley, J., Long, Y., & Young, D. (2015). Impacting resilience and
persistence in underrepresented populations through service learning. Journal for
Multicultural Education, 9(3), 174–192.
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 13

Delany, C., Miller, K., El-Ansary, D., Remedios, L., Hosseini, A., & McLeod, S. (2015). Replacing
stressful challenges with positive coping strategies: A resilience program for clinical placement
learning. Advances in Health Sciences Education, 20(5), 1303–1324.
Dolbier, C., Jaggars, S., & Steinhardt, M. (2010). Stress-related growth: Pre-intervention correlates
and change following a resilience intervention. Stress & Health, 26(2), 135–147.
Dunn, L., Iglewicz, A., & Moutier, C. (2008). A conceptual model of medical student well-being:
Promoting resilience and preventing burnout. Academic Psychiatry, 32(1), 44–53.
Dyrbye, L. N., & Shanafelt, T. D. (2011). Commentary: Medical student distress: A call to action.
Academic Medicine, 86(7), 801–803.
Dyrbye, L., Power, D., Massie, F., Eacker, A., Harper, W., Thomas, M., … Shanafelt, T. (2010).
Factors associated with resilience to and recovery from burnout: A prospective, multi-insti-
tutional study of US medical students. Medical Education, 44(10), 1016–1026.
Eley, D., Leung, J., Hong, B., Cloninger, K., & Cloninger, C. (2016). Identifying the dominant per-
sonality profiles in medical students: Implications for their well-being and resilience. PLoS one,
11(8), e0160028.
Eley, D. S., & Stallman, H. (2014). Where does medical education stand in nurturing the 3Rs in
medical students: Responsibility, resilience, and resolve? Medical Teacher, 36(10), 835–837.
Field, R., Duffy, J., & Huggins, A. (2015). Teaching independent learning skills in the first year: A
positive psychology strategy for promoting law student well-being. Journal of Learning Design, 8
(2), 1–10.
Flinchbaugh, C., Luth, M., & Li, P. (2015). A challenge or a hindrance? Understanding the effects of
stressors and thriving on life satisfaction. International Journal of Stress Management, 22(4),
323–345.
Galante, J., Dufour, G., Benton, A., Howarth, E., Vainre, M., Croudance, T., … Jones, P. (2016).
Protocol for the mindful student study: A randomised controlled trial of the provision of a mind-
fulness intervention to support students’ well-being and resilience to stress. BMJ Open, 6(11),
e012300.
Gerson, M., & Fernandez, N. (2013). PATH: A program to build resilience and thriving in under-
graduates. Journal of Applied Social Psychology, 43(11), 2169–2184.
Gibbs, S., & Miller, A. (2014). Teachers’ resilience and well-being: A role for educational psychol-
ogy. Teachers and Teaching, 20(5), 609–621.
Goertzen, B., & Whitaker, B. (2015). Development of psychological capital in an academic-based
leadership education program. Journal of Management Development, 34(7), 773–786.
Grant-Smith, D., & Gillett-Swan, J. (2017). WIL wellbeing: Exploring impacts of unpaid practicum
on student wellbeing. Perth, WA: National Centre for Student Equity in Higher Education, Curtin
University.
Hartley, M. (2010). Increasing resilience: Strategies for reducing dropout rates for college students
with psychiatric disabilities. American Journal of Psychiatric Rehabilitation, 13(4), 295–315.
Hartley, M. (2013). Investigating the relationship of resilience to academic persistence in college
students with mental health issues. Rehabilitation Counselling Bulletin, 56(4), 240–250.
Howe, A., Smajdor, A., & Stockl, A. (2012). Towards an understanding of resilience and its
relevance to medical training. Medical Education, 46(4), 349–356.
Huang, J. (2015). Hardiness, perceived employability, and career decision self-efficacy among
Taiwanese college students. Journal of Career Development, 42(4), 311–324.
Jayalakshmi, V., & Magdain, S. (2015). Emotional intelligence, resilience, and mental health of
women college students. Journal of Psychosocial Research, 10(2), 401–408.
Kajbafnezhad, H., & Keshi, A. (2015). Predicting personality resiliency by psychological well-being
and its components in girl students of Islamic Azad University. I-Managers Journal on
Educational Psychology, 8(4), 11–15.
Kamath, S. (2015). Role of mindfulness in building resilience and emotional intelligence and
improving academic adjustment among adolescents. Indian Journal of Health and Wellbeing,
6(4), 414–417.
Kift, S. (2015). A decade of transition pedagogy: A quantum leap in conceptualising the first year
experience. HERDSA Review of Higher Education, 2, 51–86.
14 M. L. BREWER ET AL.

Kilbert, J., Lamis, D., Collins, W., Smalley, K., Warren, J., Yancey, C., & Winterwood, C. (2014).
Resilience mediates the relations between perfectionism and college student distress. Journal
of Counselling and Development, 92(1), 75–82.
Kirkpatrick, D. L., & Kirkpatrick, J. D. (2006). Evaluating training programs: The four levels (3rd
ed). San Francisco: BK Publishers.
Leahy, C. M., Peterson, R. F., Wilson, I. G., Newbury, J. W., Tonkin, A. L., & Turnbull, D. (2010).
Distress levels and self-reported treatment rates for medicine, law, psychology and mechanical
engineering tertiary students: Cross-sectional study. Australasian and New Zealand Journal of
Psychiatry, 44(7), 608–615.
Leary, M. R., Raim, K. T., Jongman-Sereno, K. P., & Diebels, K. J. (2015). Distinguishing intrap-
sychic from interpersonal motives in psychological theory and research. Perspectives on
Psychological Science, 10(4), 497–517.
Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology.
Implementation Science, 5(1), 69.
Li, M., & Yang, Y. (2016). A cross-cultural study on a resilience-stress path model for college stu-
dents. Journal of Counselling and Development, 94(3), 319–332.
Maddi, S., Harvey, R., Khoshaba, D., Fazel, M., & Resureccion, N. (2009). Hardiness training facili-
tates performance in college. The Journal of Positive Psychology, 4(6), 566–577.
Mak, W., Ng, I., & Wong, C. (2011). Resilience: Enhancing well-being through the positive cogni-
tive triad. Journal of Counselling Psychology, 58(4), 610–617.
Mansfield, C. F., Beltman, S., Broadley, T., & Weatherby-Fell, N. (2016). Building resilience in
teacher education: An evidenced informed framework. Teaching and Teacher Education, 54,
77–87.
McAllister, M., & McKinnon, J. (2009). The importance of teaching and learning resilience in the
health disciplines: A critical review of the literature. Nurse Education Today, 29(4), 371–379.
Meredith, L. S., Sherbourne, C. D., Gaillot, S., Hansell, L., Ritschard, H. V., & Wrenn, G. (2011).
Promoting psychological resilience in the U.S. Military. Santa Monica, CA: RAND Corporation.
The National Centre of Excellence in Youth Mental Health, Orygen. (2017). Under the radar: The
mental health of Australian university students. Parkville, Victoria: The National Centre of
Excellence in Youth Mental Health, Orygen.
Paul, H., Sriram, S., Subalukshmi, S., & Mala, V. (2015). Resilience, academic motivation, and social
support among college students. Indian Journal of Positive Psychology, 6(1), 106–110.
Phuong, T. T., Cole, C., & Zarestky, J. (2018). A systematic literature review of faculty development
for teacher educators. Higher Education Research & Development, 37(2), 373–389.
Pines, E., Rauschhuber, M., Cook, J., Norgan, G., Canchola, L., Richardson, C., & Jones, M. (2014).
Enhancing resilience, empowerment, and conflict management among baccalaureate students:
Outcomes of a pilot study. Nurse Educator, 39(2), 85–90.
Postareff, L., Mattsson, M., Lindblom-Ylänne, S., & Hailikari, T. (2017). The complex relationship
between emotions, approaches to learning, study success and study progress during the tran-
sition to university. Higher Education, 73(3), 441–457.
Priesak, A., & Alcock, J. (2015). Well-being and self-efficacy in a sample of undergraduate nurse
students: A small survey study. Nurse Education Today, 35(5), e16–e20.
Probst, H., Boylan, M., Nelson, P., & Martin, R. (2014). Early career resilience: Interdisciplinary
insights to support professional education of Radiation Therapists. Journal of Medical Imaging
and Radiation Sciences, 45(4), 390–398.
Puthran, R., Zhang, M. W., Tam, W. W., & Ho, R. C. (2016). Prevalence of depression amongst
medical students: A meta-analysis. Medical Education, 50(4), 456–468.
Reyes, A., Andusyszyn, M., Iwasiw, C., Forchuk, C., & Babenko-Mould, Y. (2015). Resilience in
nursing education: An integrative review. Journal of Nursing Education, 54(8), 438–444.
Rogers, D. (2016). Which educational interventions improve healthcare professionals’ resilience?
Medical Teacher, 38(12), 1236–1241.
Rogers, H. (2013). Mindfulness meditation for increasing resilience in college students. Psychiatric
Annals, 43(12), 545–548.
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 15

Rumrill, P. D., Fitzgerald, S. M., & Merchant, W. R. (2010). Using scoping literature reviews as a
means of understanding and interpreting existing literature. Work, 35(3), 399–404.
Sanderson, B., & Brewer, M. (2017). What do we know about student resilience in health
professional education? A scoping review of the literature. Nurse Education Today, 58, 65–71.
Sharma, A. (2012). Impact of well-being on resiliency to stress. Indian Journal of Positive
Psychology, 3(4), 440–444.
Sharma, A., & Bali, D. (2013). Self-esteem and well-being as the major indicators of resilience to
stress. Indian Journal of Positive Psychology, 4(2), 262–269.
Sheard, M. (2009). Hardiness, commitment, gender, and age differentiate university academic
performance. British Journal of Educational Psychology, 79(1), 189–204.
Shek, D., Sun, R., Tsien-Wong, T., Cheng, C., & Yan, H. (2013). Objective outcome evaluation of a
leadership and intrapersonal development subject for university students. International Journal
on Disability and Human Development, 12(2), 221–227.
Shin, Y., & Kelly, K. (2015). Resilience and decision-making strategies as predictors of career
decision difficulties. The Career Development Quarterly, 63(4), 291–305.
Slavin, S., Schindler, D., & Chibnall, J. (2014). Medical student mental health 3.0: Improving student
wellness through curricular changes. Academic Medicine, 89(4), 573–577.
Smith, R. A., & Khawaja, N. G. (2014). A group psychological intervention to enhance the coping
and acculturation of international students. Advances in Mental Health, 12(2), 110–124.
Sood, S. (2013). Happiness as mediator between resiliency and mental health in university students.
Indian Journal of Health and Wellbeing, 4(2), 252–255.
Stallman, H. M. (2011). Embedding resilience within the tertiary curriculum: A feasibility study.
Higher Education Research & Development, 30(2), 121–133.
Stallman, H. M. (2016). The university stress scale: Measuring domains and extent of stress in uni-
versity students. Australian Psychologist, 51(2), 128–134.
Steinhardt, M., & Dolbier, C. (2008). Evaluation of a resilience intervention to enhance coping strat-
egies and protective factors and decrease symptomatology. Journal of American College Health,
56(4), 445–453.
Stephens, T., & Gunther, M. (2016). Twitter, millennials, and nursing education research. Nursing
Education Perspectives, 37(1), 23–27.
Stephens, T. M. (2013). Nursing student resilience: A concept clarification. Nursing Forum, 48(2),
125–133.
Tempski, P., Santos, I., Mayer, F., Enns, S., Perotta, B., Paro, H., … Martins, M. (2015). Relationship
among medical student resilience, educational environment and quality of life. PLoS ONE, 10(6),
e0131535–13.
Thistlethwaite, J., Kumar, K., Moran, M., Saunders, R., & Carr, S. (2015). An exploratory review of
pre-qualification interprofessional education evaluations. Journal of Interprofessional Care, 29
(4), 292–297.
Thompson, G., McBride, R. B., Hosford, C. C., & Halaas, G. (2016). Resilience among medical
students: The role of coping style and social support. Teaching and Learning in Medicine, 28
(2), 174–182.
Turner, M., Holdsworth, S., & Scott-Young, C. (2017). Resilience at university: The development
and testing of a new measure. Higher Education Research & Development, 36(2), 386–400.
van der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress
management and mindfulness program for undergraduate nursing students: Student feedback
and lessons learned. Nurse Education Today, 35(1), 44–49.
van Kessel, G. (2013). The ability of older people to overcome adversity: A review of the resilience
concept. Geriatric Nursing, 34(2), 122–127.
Waddell, J., Spalding, K., Canizares, G., Navarro, J., Connell, M., Jancar, S., … Victor, C. (2015a).
Integrating a career planning and development program into the baccalaureate nursing curricu-
lum: Part I. Impact on students’ career resilience. International Journal of Nursing Education, 12
(1), 163–173.
Waddell, J., Spalding, K., Navarro, J., Jancar, S., & Canizares, G. (2015b). Integrating a career plan-
ning and development program into the baccalaureate nursing curriculum. Part II. Outcomes for
16 M. L. BREWER ET AL.

new graduate nurses 12 months post-graduation. International Journal of Nursing Education, 12

(1), 175–182.
Wald, H., Anthony, D., Hutchinson, T., Liben, S., Smilovtich, M., & Donato, A. (2015). Professional
identity formation in medical education for humanistic, resilient physicians: Pedagogic strategies
for bridging theory to practice. Academic Medicine, 90(6), 753–760.
Wilks, S., & Spivey, C. (2010). Resilience in undergraduate social work students: Social support and
adjustment to academic stress. Social Work Education, 29(3), 276–288.
Willis, K., & Burnett, H. (2016). The power of stress: Perceived stress and its relationship with rumi-
nation, self-concept clarity, and resilience. North American Journal of Psychology, 18(3), 483–
498.
Windle, G., Bennett, K. M., & Noyes, J. (2011). A methodological review of resilience measurement
scales. Health and Quality of Life Outcomes, 9(1), 8.
Wood, D. F. (2016). Mens sana in corpore sano: Student well-being and the development of resi-
lience. Medical Education, 50(1), 20–23.
Yokus, T. (2015). The relation between pre-service music teachers’ psychological resilience and aca-
demic achievement levels. Educational Research and Reviews, 10(14), 1961–1969.
Zhang, L. (2011). Hardiness and the big five personality traits among Chinese university students.
Learning and Individual Differences, 21(1), 109–113.