research methods for sports studies 2nd ed

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Research Methods in Sport

• Mark F. Smith - University of Lincoln, UK
• Description

Packed full of essential tools and tips, this second edition is your quick-start guide to undertaking research within real world of sport. Using clear, accessible language, Smith maps an easy-to-follow journey through the research process, drawing upon the most up-to-date evidence and resources to help you select the most appropriate research approach for your project. Throughout the book you will discover:

• Key points that highlight important definitions and theories;
• Reflection points to help you make connections between key concepts and your research;
• Learning activities to put your newfound knowledge into practice;
• Further reading to explore the wider context of sport research in the real world.

Featuring over thirty-five case studies of students’ and academics’ research in practice, this book is the perfect guide-by-your-side to have during your own sport research. 

See what’s new to this edition by selecting the Features tab on this page. Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email [email protected] . Please include your name, contact information, and the name of the title for which you would like more information. For information on the HEOA, please go to http://ed.gov/policy/highered/leg/hea08/index.html .

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Students of sport often doubt the value of research. This book works to change that mindset. It explains what research is, how sports research is done, and shows how research in sport advances the discipline. 

Needed something to bring Sports examples to my research methods class. some of the language is used differently than in the other textbook, which confused the students, but as a standalone it does not quite have enough detail. It is a very good introduction to use first.

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Research Methods for Sports Studies: Third Edition 3rd Edition, Kindle Edition

Research Methods for Sports Studies is a comprehensive, engaging and practical textbook that provides a complete grounding in both qualitative and quantitative research methods for the sports studies student. Leading the reader step-by-step through the entire research process, from identifying a research question and collecting and analyzing data to writing the research report, it is richly illustrated throughout with sport-related case-studies and examples from around the world.

Now in a fully revised, updated and expanded third edition, the book includes completely new chapters on using social media and conducting on-line research, as well as expanded coverage of key topics such as conducting a literature review, making the most of statistics, research ethics and presenting research.

Research Methods for Sports Studies is designed to be a complete and self-contained companion to any research methods course and contains a wealth of useful features, such as highlighted definitions of key terms, revision questions and practical research exercises. An expanded companion website offers additional material for students and instructors, including web links, multiple choice revision questions, an interactive glossary, PowerPoint slides and additional learning activities for use in and out of class. This is an essential read for any student undertaking a dissertation or research project as part of their studies in sport, exercise and related fields.

• ISBN-13 978-0415749336
• Edition 3rd
• Sticky notes On Kindle Scribe
• Publisher Routledge
• Publication date December 5, 2014
• Language English
• File size 2870 KB
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Editorial Reviews

'Understanding the research process and the value of sport research should be a responsibility for all those engaged in the sport enterprise; academicians and practitioners alike. Ian Jones has provided a text that creates a common link between the two, so that researchers and sport practitioners can communicate in the theoretical and practical.'

Dr Ronald W. Quinn, Associate Professor, Department of Sport Studies, Xavier University, Cincinnati, USA

' Research Methods for Sports Studies is structured in an easy to follow, clearly written format providing a step-by-step roadmap for research. This is an essential text for students in how to do sport studies research. The supplementary resources will assist lecturers who are teaching sport studies research, and provide students with value adding learning resources.'

Professor Tracy Taylor, Business School Deputy Dean, University of Technology, Sydney, Australia

'Ian Jones has written a highly accessible introductory text for undergraduate sports students from a range of sport disciplines, who are about to embark on a substantial piece of research for the first time. Likewise, the book provides a structure by which lecturers and tutors can shape the delivery of research methods modules. The case study and supplementary material brings to life what can sometimes be a rather mundane endeavour.'

Dr Jimmy O'Gorman, Senior Lecturer in Sports Development, Edge Hill University, UK

About the Author

Ian Jones is the Associate Dean for Sport at Bournemouth University. His teaching and research interests focus upon the areas of sport behaviour, and research methodology for sport. He is the author of several research methods texts, and has published his research in a variety of journals

Product details

• ASIN ‏ : ‎ B00QMIEEP6
• Publisher ‏ : ‎ Routledge; 3rd edition (December 5, 2014)
• Publication date ‏ : ‎ December 5, 2014
• Language ‏ : ‎ English
• File size ‏ : ‎ 2870 KB
• Simultaneous device usage ‏ : ‎ Up to 4 simultaneous devices, per publisher limits
• Text-to-Speech ‏ : ‎ Enabled
• Screen Reader ‏ : ‎ Supported
• Enhanced typesetting ‏ : ‎ Enabled
• X-Ray ‏ : ‎ Not Enabled
• Word Wise ‏ : ‎ Enabled
• Sticky notes ‏ : ‎ On Kindle Scribe
• Print length ‏ : ‎ 365 pages
• #99 in Physical Education
• #145 in Sociology of Sports (Kindle Store)
• #219 in Sports & Entertainment Industry (Kindle Store)

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Healthy Living with Diabetes

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How can I plan what to eat or drink when I have diabetes?

How can physical activity help manage my diabetes, what can i do to reach or maintain a healthy weight, should i quit smoking, how can i take care of my mental health, clinical trials for healthy living with diabetes.

Healthy living is a way to manage diabetes . To have a healthy lifestyle, take steps now to plan healthy meals and snacks, do physical activities, get enough sleep, and quit smoking or using tobacco products.

Healthy living may help keep your body’s blood pressure , cholesterol , and blood glucose level, also called blood sugar level, in the range your primary health care professional recommends. Your primary health care professional may be a doctor, a physician assistant, or a nurse practitioner. Healthy living may also help prevent or delay health problems  from diabetes that can affect your heart, kidneys, eyes, brain, and other parts of your body.

Making lifestyle changes can be hard, but starting with small changes and building from there may benefit your health. You may want to get help from family, loved ones, friends, and other trusted people in your community. You can also get information from your health care professionals.

What you choose to eat, how much you eat, and when you eat are parts of a meal plan. Having healthy foods and drinks can help keep your blood glucose, blood pressure, and cholesterol levels in the ranges your health care professional recommends. If you have overweight or obesity, a healthy meal plan—along with regular physical activity, getting enough sleep, and other healthy behaviors—may help you reach and maintain a healthy weight. In some cases, health care professionals may also recommend diabetes medicines that may help you lose weight, or weight-loss surgery, also called metabolic and bariatric surgery.

Choose healthy foods and drinks

There is no right or wrong way to choose healthy foods and drinks that may help manage your diabetes. Healthy meal plans for people who have diabetes may include

• dairy or plant-based dairy products
• nonstarchy vegetables
• protein foods
• whole grains

Try to choose foods that include nutrients such as vitamins, calcium , fiber , and healthy fats . Also try to choose drinks with little or no added sugar , such as tap or bottled water, low-fat or non-fat milk, and unsweetened tea, coffee, or sparkling water.

Try to plan meals and snacks that have fewer

• foods high in saturated fat
• foods high in sodium, a mineral found in salt
• sugary foods , such as cookies and cakes, and sweet drinks, such as soda, juice, flavored coffee, and sports drinks

Your body turns carbohydrates , or carbs, from food into glucose, which can raise your blood glucose level. Some fruits, beans, and starchy vegetables—such as potatoes and corn—have more carbs than other foods. Keep carbs in mind when planning your meals.

You should also limit how much alcohol you drink. If you take insulin  or certain diabetes medicines , drinking alcohol can make your blood glucose level drop too low, which is called hypoglycemia . If you do drink alcohol, be sure to eat food when you drink and remember to check your blood glucose level after drinking. Talk with your health care team about your alcohol-drinking habits.

Find the best times to eat or drink

Talk with your health care professional or health care team about when you should eat or drink. The best time to have meals and snacks may depend on

• what medicines you take for diabetes
• what your level of physical activity or your work schedule is
• whether you have other health conditions or diseases

Ask your health care team if you should eat before, during, or after physical activity. Some diabetes medicines, such as sulfonylureas  or insulin, may make your blood glucose level drop too low during exercise or if you skip or delay a meal.

Plan how much to eat or drink

You may worry that having diabetes means giving up foods and drinks you enjoy. The good news is you can still have your favorite foods and drinks, but you might need to have them in smaller portions  or enjoy them less often.

For people who have diabetes, carb counting and the plate method are two common ways to plan how much to eat or drink. Talk with your health care professional or health care team to find a method that works for you.

Carb counting

Carbohydrate counting , or carb counting, means planning and keeping track of the amount of carbs you eat and drink in each meal or snack. Not all people with diabetes need to count carbs. However, if you take insulin, counting carbs can help you know how much insulin to take.

Plate method

The plate method helps you control portion sizes  without counting and measuring. This method divides a 9-inch plate into the following three sections to help you choose the types and amounts of foods to eat for each meal.

• Nonstarchy vegetables—such as leafy greens, peppers, carrots, or green beans—should make up half of your plate.
• Carb foods that are high in fiber—such as brown rice, whole grains, beans, or fruits—should make up one-quarter of your plate.
• Protein foods—such as lean meats, fish, dairy, or tofu or other soy products—should make up one quarter of your plate.

If you are not taking insulin, you may not need to count carbs when using the plate method.

Work with your health care team to create a meal plan that works for you. You may want to have a diabetes educator  or a registered dietitian  on your team. A registered dietitian can provide medical nutrition therapy , which includes counseling to help you create and follow a meal plan. Your health care team may be able to recommend other resources, such as a healthy lifestyle coach, to help you with making changes. Ask your health care team or your insurance company if your benefits include medical nutrition therapy or other diabetes care resources.

Talk with your health care professional before taking dietary supplements

There is no clear proof that specific foods, herbs, spices, or dietary supplements —such as vitamins or minerals—can help manage diabetes. Your health care professional may ask you to take vitamins or minerals if you can’t get enough from foods. Talk with your health care professional before you take any supplements, because some may cause side effects or affect how well your diabetes medicines work.

Research shows that regular physical activity helps people manage their diabetes and stay healthy. Benefits of physical activity may include

• lower blood glucose, blood pressure, and cholesterol levels
• better heart health
• healthier weight
• better mood and sleep
• better balance and memory

Talk with your health care professional before starting a new physical activity or changing how much physical activity you do. They may suggest types of activities based on your ability, schedule, meal plan, interests, and diabetes medicines. Your health care professional may also tell you the best times of day to be active or what to do if your blood glucose level goes out of the range recommended for you.

Do different types of physical activity

People with diabetes can be active, even if they take insulin or use technology such as insulin pumps .

Try to do different kinds of activities . While being more active may have more health benefits, any physical activity is better than none. Start slowly with activities you enjoy. You may be able to change your level of effort and try other activities over time. Having a friend or family member join you may help you stick to your routine.

The physical activities you do may need to be different if you are age 65 or older , are pregnant , or have a disability or health condition . Physical activities may also need to be different for children and teens . Ask your health care professional or health care team about activities that are safe for you.

Aerobic activities

Aerobic activities make you breathe harder and make your heart beat faster. You can try walking, dancing, wheelchair rolling, or swimming. Most adults should try to get at least 150 minutes of moderate-intensity physical activity each week. Aim to do 30 minutes a day on most days of the week. You don’t have to do all 30 minutes at one time. You can break up physical activity into small amounts during your day and still get the benefit. 1

Strength training or resistance training

Strength training or resistance training may make your muscles and bones stronger. You can try lifting weights or doing other exercises such as wall pushups or arm raises. Try to do this kind of training two times a week. 1

Balance and stretching activities

Balance and stretching activities may help you move better and have stronger muscles and bones. You may want to try standing on one leg or stretching your legs when sitting on the floor. Try to do these kinds of activities two or three times a week. 1

Some activities that need balance may be unsafe for people with nerve damage or vision problems caused by diabetes. Ask your health care professional or health care team about activities that are safe for you.

Stay safe during physical activity

Staying safe during physical activity is important. Here are some tips to keep in mind.

Drink liquids

Drinking liquids helps prevent dehydration , or the loss of too much water in your body. Drinking water is a way to stay hydrated. Sports drinks often have a lot of sugar and calories , and you don’t need them for most moderate physical activities.

Avoid low blood glucose

Check your blood glucose level before, during, and right after physical activity. Physical activity often lowers the level of glucose in your blood. Low blood glucose levels may last for hours or days after physical activity. You are most likely to have low blood glucose if you take insulin or some other diabetes medicines, such as sulfonylureas.

Ask your health care professional if you should take less insulin or eat carbs before, during, or after physical activity. Low blood glucose can be a serious medical emergency that must be treated right away. Take steps to protect yourself. You can learn how to treat low blood glucose , let other people know what to do if you need help, and use a medical alert bracelet.

Avoid high blood glucose and ketoacidosis

Taking less insulin before physical activity may help prevent low blood glucose, but it may also make you more likely to have high blood glucose. If your body does not have enough insulin, it can’t use glucose as a source of energy and will use fat instead. When your body uses fat for energy, your body makes chemicals called ketones .

High levels of ketones in your blood can lead to a condition called diabetic ketoacidosis (DKA) . DKA is a medical emergency that should be treated right away. DKA is most common in people with type 1 diabetes . Occasionally, DKA may affect people with type 2 diabetes  who have lost their ability to produce insulin. Ask your health care professional how much insulin you should take before physical activity, whether you need to test your urine for ketones, and what level of ketones is dangerous for you.

Take care of your feet

People with diabetes may have problems with their feet because high blood glucose levels can damage blood vessels and nerves. To help prevent foot problems, wear comfortable and supportive shoes and take care of your feet  before, during, and after physical activity.

If you have diabetes, managing your weight  may bring you several health benefits. Ask your health care professional or health care team if you are at a healthy weight  or if you should try to lose weight.

If you are an adult with overweight or obesity, work with your health care team to create a weight-loss plan. Losing 5% to 7% of your current weight may help you prevent or improve some health problems  and manage your blood glucose, cholesterol, and blood pressure levels. 2 If you are worried about your child’s weight  and they have diabetes, talk with their health care professional before your child starts a new weight-loss plan.

You may be able to reach and maintain a healthy weight by

• following a healthy meal plan
• consuming fewer calories
• being physically active
• getting 7 to 8 hours of sleep each night 3

If you have type 2 diabetes, your health care professional may recommend diabetes medicines that may help you lose weight.

Online tools such as the Body Weight Planner  may help you create eating and physical activity plans. You may want to talk with your health care professional about other options for managing your weight, including joining a weight-loss program  that can provide helpful information, support, and behavioral or lifestyle counseling. These options may have a cost, so make sure to check the details of the programs.

Your health care professional may recommend weight-loss surgery  if you aren’t able to reach a healthy weight with meal planning, physical activity, and taking diabetes medicines that help with weight loss.

If you are pregnant , trying to lose weight may not be healthy. However, you should ask your health care professional whether it makes sense to monitor or limit your weight gain during pregnancy.

Both diabetes and smoking —including using tobacco products and e-cigarettes—cause your blood vessels to narrow. Both diabetes and smoking increase your risk of having a heart attack or stroke , nerve damage , kidney disease , eye disease , or amputation . Secondhand smoke can also affect the health of your family or others who live with you.

If you smoke or use other tobacco products, stop. Ask for help . You don’t have to do it alone.

Feeling stressed, sad, or angry can be common for people with diabetes. Managing diabetes or learning to cope with new information about your health can be hard. People with chronic illnesses such as diabetes may develop anxiety or other mental health conditions .

Learn healthy ways to lower your stress , and ask for help from your health care team or a mental health professional. While it may be uncomfortable to talk about your feelings, finding a health care professional whom you trust and want to talk with may help you

• lower your feelings of stress, depression, or anxiety
• manage problems sleeping or remembering things
• see how diabetes affects your family, school, work, or financial situation

Ask your health care team for mental health resources for people with diabetes.

Sleeping too much or too little may raise your blood glucose levels. Your sleep habits may also affect your mental health and vice versa. People with diabetes and overweight or obesity can also have other health conditions that affect sleep, such as sleep apnea , which can raise your blood pressure and risk of heart disease.

NIDDK conducts and supports clinical trials in many diseases and conditions, including diabetes. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.

What are clinical trials for healthy living with diabetes?

Clinical trials—and other types of clinical studies —are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help health care professionals and researchers learn more about disease and improve health care for people in the future.

Researchers are studying many aspects of healthy living for people with diabetes, such as

• how changing when you eat may affect body weight and metabolism
• how less access to healthy foods may affect diabetes management, other health problems, and risk of dying
• whether low-carbohydrate meal plans can help lower blood glucose levels
• which diabetes medicines are more likely to help people lose weight

Find out if clinical trials are right for you .

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical trials for healthy living with diabetes are looking for participants?

You can view a filtered list of clinical studies on healthy living with diabetes that are federally funded, open, and recruiting at www.ClinicalTrials.gov . You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your primary health care professional before you participate in a clinical study.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.

NIDDK would like to thank: Elizabeth M. Venditti, Ph.D., University of Pittsburgh School of Medicine.

Identification and Identity: Differentiating the Conceptual terms

• Iryna RAYEVSKA Odessa I. I. Mechnikov National University
• Prof. Olena Matuzkova Odesa I.I. Mechnikov University
• Prof. Olga Grynko Odesa I.I. Mechnikov University

The problem of identity and identification has been occupying a prominent place in research studies since the early 20th century and is one of the most relevant issues in the science of the late 20 th - early 21 st centuries. It is determined by the changes in socio-cultural reality in the post-modern societies of the second half of the 20th century, the crisis in the existential approach to the personality studies, enhanced integrative trends in the scientific thinking, its humanitarianization and anthropocentric nature.

This research paper looks at the actualization of the studies on identity and identification, describes the history and scope of the identification studies, substantiates the differentiation between the terms of individual/collective identity and identification.

The subject of the article is the phenomenological and conceptual essence of identity and identification. The goal of the article is to substantiate identity and identification as the phenomena and scientific concepts. The methodological basis of the research includes the complex of the general research methods, namely: observation, description, induction and deduction, analysis and synthesis, taxonomy and modelling.

The differentiation of the investigated terms reduces to the fact that identification serves as a foundation for constructing identity, so they correlate as a mechanism, process, and result of such mechanism’s operation in an individual self-conscious. Identification is seen as a cognitive-and-emotional mechanism of identity construction, due to which the subject constructs his or her own sameness. Identity is a result of recognition and emotional assessment of the individual-and-group and collective characteristics by an individual or group. Such characteristics have been endorsed by the relevant others as a result of constructing the world image, the image of the collective, of individual's or group's self and their place in there, basing on the specific identifying features.

Author Biographies

Iryna rayevska, odessa i. i. mechnikov national university.

(PhD in Philology) is Associate Professor of the Translation Department at Odesa I. I. Mechnikov University, Odesa, Ukraine. Her areas of interest include general linguistics, sociolinguistics, dialectology, translation studies. Rayevska is the author of 1 collective monograph, 4 teaching aids and nearly 20 scientific articles. Recent publications: “Italian Language of Mass Media: Trends and New Challenges”, “Rendering of Italian Dialectisms in Translation”, “Rendering of Author Occasionalisms in Translation into the Ukrainian Language”, “Dialects in Advertisement Discourse: Example of Italy”, “Subdialect of Perugia in the System of Umbrian Dialects: Comprehensive Study and Analysis”.

Prof. Olena Matuzkova, Odesa I.I. Mechnikov University

(Dr. of Science in Philology) is a Full Professor, Professor of the Translation Department at Odesa I. I. Mechnikov University, Odesa, Ukraine. Her areas of interest include linguo­cul­turology, cognitive discursology, identity linguistic studies, linguistics of translation. O. Matuzkova is the author of 1 monograph, 4 collective monographs, 17 teaching aids and nearly 130 scientific articles. Re­cent publications: “English Identity as Linguocultural Phenomenon: Cognitive-Discursive Aspect”, “On Content and Correlation of Concepts English Identity and British Identity ”, “Rendering of Odessa Realia in English Fiction and Non-Fiction Texts”, “Linguoculture as Synergy of Language, Culture and Mind”.

Prof. Olga Grynko, Odesa I.I. Mechnikov University

 (PhD in Philology) is Associate Professor of the Translation Department at Odesa I. I. Mechnikov University, Odesa, Ukraine. Her areas of interest include cognitive linguistics, archetypal concepts, and translation studies. Grynko is the author of 1 collective monograph, 2 teaching aids, and nearly 20 scientific articles. Recent publications: “Archetypal Concepts of the Elements in W. Golding’s Prose Fiction”, “Foreign Words: On the Issue of Their Functioning and Translation”, “Rendering the Predicate of State in Translation from the English Language”, “Artionyms: Structure Features and Translation into English”.

Abushenko, V. L. (1998). Identichnost’ (Identity, in Russian). In A. A. Gritsanov (Ed.), Modern Philosophy Dictionary (pp. 400-404). Minsk: Publ. V.M. Skakun.

Aslet, C. (1997). Anyone for England? London: Little Brown.

Bauman, Z. (2010). Identity. Conversations with Benedetto Vecchi. Cambridge: Polity Press.

Boiko, V. V. (2008). Identyfikatsiia (Identification, in Ukrainian). In V. G. Gorodianko (Ed.), Sociological Encyclopaedia (p. 147). Kyiv: Akademvydav.

Erikson, E. H. (1996). Identichnost’: yunost’ i krizis (Identity, Youth and Crisis, in Russian). ?oscow: Publishing group “Progress”.

Golenkova, Z. T. (2000). Identifikatsiya sotsial’naya (Social Identification, in Russian). In V. N. Ivanov & G. Yu. Semigin (Eds.), Political Encyclopedia (pp. 415-416). ?oscow: Mysl.

Grishayeva, L. I. (2007). Osobennosi ispolzovaniya yazyka i kul’turnaya identichnost’ kommunikantov (Peculiarities of the Language Use and Cultural Identity of Communicants, in Russian). Voronezh: VGU.

Katanova, E. N. (2007). Nominativnye strategii pri oboznachenii subjekta samoidentifikatsii v samoidentifitsyruyuschem vyskasyvanii (Nominative Strategies of Nominating a Subject of Self-Identification in a Self-Identifying Utterance, in Russian). Language, Communication, and Social Environment, 7, 251-260.

Kravchenko, A. I., & Anurin V. F. (2006). Sotsiologiya: Uchebnik dlya vuzov (Sociology: A Textbook for Higher Education, in Russian). Saint-Petersburg: Peter.

Krysko, V. G. (2001). Sotsialnaya psikhologiya: slovar’-spravochnik (Social Psychology: A Reference Dictionary, in Russian). Minsk: Harvest, Moscow: AST.

Malakhov, Yu. S. (2004). Identichnost’ (Identity, in Russian). In A. A. Ivin (Ed.) Philosophy: Encyclopaedical Dictionary (pp. 299-300). Moscow: Gardariki.

Malakhov, Yu. S. (2011). Identichnost’ (Identity, in Russian). In V. S. Stenin (Ed.), New Encyclopedia of Philosophy (pp. 78-79). Moscow: Mysl.

Matuzkova, E. P. (2014). Identichnost i lingvokul’tura: metodologiya izucheniya: monografiya (Identity and Linguoculture: Research Methodology: monograph, in Russian). Odessa: Izdatalstvo KP OGT.

Mescheryakov, B. G., Zinchenko, V. P. (Eds.). (2007). Bol’shoi psikhologicheskii slovar’ (The Big Dictionary of Psychology, in Russian). Saint-Petersburg: Praim-EVROZNAK.

Mukhina, V. S. (2000). Vozrastnaya psikhologiya (Developmental Psychology, in Russian). Moscow: Akademia.

Naumenko, L. I. (2003). Identifikatsiya (Identification, in Russian). In A. A.Gritsanov (Ed.) Sociology: Encyclopedia (p. 344). Minsk: Interpressservis; Knizhnyi dom.

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Unveiling the hidden struggle of healthcare students as second victims through a systematic review

• José Joaquín Mira 1 , 2 ,
• Valerie Matarredona 1 ,
• Susanna Tella 3 ,
• Paulo Sousa 4 ,
• Vanessa Ribeiro Neves 5 ,
• Reinhard Strametz 6 &
• Adriana López-Pineda 2  

BMC Medical Education volume  24 , Article number:  378 ( 2024 ) Cite this article

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When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training.

This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies.

A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered.

Ensuring healthcare students’ resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.

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Introduction

Students in healthcare disciplines often witness or personally face stressful clinical events during their practical training [ 1 , 2 ], such as unexpected patient deaths, discussions with patients' families or among healthcare team members, violence toward professionals, or inappropriate treatment toward themselves. When this occurs, the majority of students talk to other students about it (approximately 90%), and less frequently, they speak to healthcare team members or mentors (37%) [ 2 ]. This is because they usually believe they will not receive attention, will not be understood, or fear negative consequences in their evaluation [ 1 , 2 ].

A particular case of a stressful clinical event is being involved in an adverse event (AE) or making an honest mistake [ 2 ] due to circumstances beyond the student's control. Approximately three-quarters of nursing or medical students witness some AE during their professional development (clerkships and training in healthcare centers) [ 2 , 3 ] and studies show that 18%-30% of students report committing an error resulting in an AE [ 4 , 5 ]. Some of them may even experience humiliation or verbal abuse for that error [ 6 ]. The vast majority (85%) of these occurrences lead to a second victim experience [ 7 , 8 ]. Consistent with what we know about the second victim experience [ 9 , 10 , 11 ], it is common for students in these cases to experience hypervigilance, acute stress, and doubts about their own ability for this work [ 12 , 13 ]. These emotional disturbances are usually more intense among females than males [ 14 ] and people with high values in the personality trait of neuroticism [ 15 , 16 ].

They also observe the impact of clinical errors on other healthcare professionals, influencing their response [ 3 ]. All these situations affect their well-being and can shape their future professional practice style [ 17 , 18 ]. For example, they may develop defensive practices more frequently [ 5 , 17 ] or avoid informing patients in the future after an AE [ 4 ]. Educators should not overlook the emotional effects of AEs on students/trainees [ 19 ]. Indeed, patient safety topics, including the second victim, mental well-being, and resilience, are neglected in undergraduate medical and nursing curricula in Europe. Furthermore, over half (56%) according to the responses from the students they did not ‘speak up' during a critical situation when they felt they could or should have [ 20 ].

Recently, psychological interventions to promote resilience in students facing stressful situations have been reviewed [ 21 ]. These interventions are not widely implemented, and approximately only one-fourth of students report having sufficient resilience training during their educational period [ 2 ]. In the specific case of supporting students who experience the second victim phenomenon, we lack information about the approach, scope, and method of possible interventions. The objective of this systematic review was to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience (second victim) of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training.

The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 22 ]. The study protocol was registered at PROSPERO (International prospective register of systematic reviews) [ 23 ] under the registration number CRD42023442014.

Eligibility criteria

The research question and eligibility criteria were constructed using the PICO method as follows (see Supplemental material 1 ):

Population: Students of healthcare disciplines

Intervention: Any method or intervention addressing the second victim phenomenon

Comparator: If applicable, any other method or intervention

Outcomes: Any measure of impact

Eligible studies included those reporting any method or intervention to prevent and address the second victim experience among healthcare students involved in or witnessing a mistake causing adverse events during their clerkships or training. Additionally, studies reporting interventions addressing psychological stress or reinforcing competences to face highly stressful situations, enhancing resilience, or increasing understanding of honest errors in the clinical setting were also included. Regarding the study population, eligible studies included healthcare discipline students (e.g., medical, nursing, pharmacy students) enrolled in any year, level, or course, both in public and private schools or faculties worldwide. All quantitative studies (experimental, quasi-experimental, case–control, cohort, and cross-sectional studies) within the scope of educational activities, as well as all qualitative studies (e.g., focus groups, interviews) conducted to explore intervention outcomes, were included.

The exclusion criteria were interventions and data regarding residents or professionals as trainees, analysis aimed at preparing the curriculum content or evaluating academic performance (including regarding patient safety issues), and any type of review study, editorials, letters to the editor, comments, or other noncitable articles (such as editorials, book reviews, gr ey literature, opinion articles or abstracts). Conference abstracts were included if they contained substantial and original information not found elsewhere.

The search was conducted on August 5, 2023, in the following electronic databases: MEDLINE, EMBASE, SCOPUS and APS PsycInfo. The reference lists of relevant reviews and other selected articles were explored further to find any additional appropriate articles. Last, recommended websites (gray literature) found during the comprehensive reading of publications were included if they met the inclusion criteria.

Controlled vocabulary and free text were combined using Boolean operators and filters to develop the search strategy (Supplemental Material 1 ). The terminology used in this study was extracted from the literature while respecting the most common usage of the terms prior to initiation of this screening. No limitations were imposed regarding language or the publication date.

Study selection

The selection process was conducted through Rayyan [ 24 ]. After removal of duplicates, two researchers (JM and VM) independently screened the titles and abstracts of all retrieved publications to determine eligibility. Discrepancies were resolved by an arbiter (AL), who made the final decision after debate to obtain consensus. Afterwards, screening of the full texts of the preselected articles was carried out in the same manner.

Data extraction

After final inclusion, the following characteristics of each study were collected by two reviewers: publication details (first author, year of publication), country of the study location, aim/s, study design, setting, type of study participants, and sample size. Separately, the following information of the included studies was collected: the description of methods, support programs or study interventions to address the second victim phenomenon, the findings on their effectiveness (competences and attitudes changed) and participants’ views or experience, if applicable, and whether a ‘second victim’ term was used.

Quality appraisal

We used the critical appraisal tools of the Joanna Briggs Institute [ 25 ] to assess the risk of bias of the included studies, according to the study design. Those studies that did not meet at least 60% of the criteria [ 26 ] were considered to have a high risk of bias. The critical appraisal was performed by two independent reviewers, and the overall result was expressed as a percentage of items answered with “yes”. Additionally, the number of citations of each article was collected as a quality measure [ 27 ].

Data synthesis

A descriptive narrative synthesis of the studies (approaches and outcomes) was conducted comparing the type and content of the methods or interventions implemented. Before initiating our literature search, we drafted a thematic framework informed by our research objectives, anticipating potential themes. This framework guided our evidence synthesis, dynamically adapting as we analyzed the included studies. Our approach allowed systematic integration of findings into coherent themes, ensuring our narrative synthesis was both grounded in evidence and reflective of our initial thematic expectations, providing a nuanced understanding of the topic within the existing research context. All data collected from the data extraction were reported and summarized in tables. The main findings were categorized into broad themes: (1) Are students informed about the phenomenon of second victims or how to act in case of making a mistake or witnessing a mistake? (2) What do students learn about an honest mistake, intentional errors, and key elements of safety culture? (3) What kind of support do students value and receive to manage the second victim phenomenon? (4) Strategies for supporting students in coping with the second victim phenomenon after making or witnessing a mistake. We considered the effectiveness (measurement of the achieved change in knowledge, skills, or attitudes) and meaningfulness (individual experience, viewpoints, convictions, and understandings of the participants) of each intervention or support program.

A total of 1622 titles were identified after the initial search. After removing duplicates, 1354 studies were screened. After the title, abstract and full text review, we identified and extracted information from 18 studies. The selection process is shown in the PRISMA flow diagram (Fig.  1 ).

PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources

The articles included in this review are shown in Table  1 in alphabetical order of the first author, detailing the characteristics and overall result of the quality assessment (measured as the percentage of compliance with the JBI tool criteria) of each study. Most studies were conducted in the USA ( n  = 7) [ 19 , 21 , 28 , 29 , 30 , 31 , 32 ], followed by Korea ( n  = 2) [ 33 , 34 ] and Australia ( n  = 2) [ 35 , 36 ], and the rest were carried out in Denmark [ 37 ], China [ 38 ], Italy [ 39 ], the United Kingdom [ 40 ], Georgia [ 41 ], Brazil [ 42 ], and Canada [ 43 ] ( n  = 1 each). The included studies cover a publication period that ranges from 2011 to 2023, with four of them being published in 2020. All these investigations were conducted within the academic setting, with the exception of one study, which took place in the Western Sydney Local Health District. Regarding the study participants, eleven studies were exclusively focused on medical students, six specifically targeted nursing students, and one included both medical and nursing students. In terms of study design, quasi-experimental ( n  = 8), cross-sectional ( n  = 2) and qualitative designs ( n  = 6) were used, and two studies used a mixed-methods design.

Supplementary Tables  1 , 2 and 3 show the quality assessment of quasi-experimental, cross-sectional, and qualitative studies, respectively. Four of the included studies [ 19 , 28 , 41 , 44 ] did not meet at least 60% of items and were considered to have a high risk of bias. The five studies of highest quality [ 32 , 35 , 37 , 38 , 43 ] met 80% of the items. The study of Le et al. (2022) [ 30 ] did not have enough information to assess the risk of bias, as it was a conference abstract. The study cited the most is the Hanson et al. study, conducted in 2020 [ 35 ].

Table 2 shows educational interventions, support strategies and any method reported in the scientific literature to help healthcare students cope with the emotional experience (second victim) of being involved in or witnessing a mistake during their clerkships or training. Due to the heterogeneity of retrieved studies regarding the type of design, the intervention type and outcome measures, a statistical analysis of the dataset was not possible. Thus, the evidence was summarized in broad themes.

Are students informed about the phenomenon of second victims or how to act in case of making a mistake or witnessing a mistake?

Some authors focus on the identification and reporting of errors, assuming that this process helps to cope with the emotional experience after the safety incident. Their studies [ 19 , 33 , 34 , 41 , 44 ] reported information on trainings given to medical or nursing students based on how to disclose errors, without addressing the second victim phenomenon specifically. In 2011, Gillies et al. reported that a medical error apology intervention increased confidence in providing effective apologies and their comfort in disclosing errors to a faculty member or patient [ 41 ]. It included online content with interactive tasks, small-group tasks and discussion, a standardized patient interview, and anonymous feedback by peers on written apologies. In 2015, Roh et al. showed that understanding, attitudes, and sense of responsibility regarding patient safety improved after a three-day patient safety training. This study involved medical students who were instructed on error causes, error reporting, communication with patients and caregivers and other concepts of patient safety. They used interactive lectures with demonstrations, small group practices, role playing, and debriefing [ 34 ]. In 2019, Ryder et al. reported that an interactive Patient Safety Reporting Curriculum (PSRC) seems to improve attitudes toward medical errors and increase comfort with disclosing them [ 19 ]. This curriculum was developed to be integrated into the third-year internal medicine clerkship during an 8-week clinical experience. It aimed to enable students to identify medical errors and report them using a format similar to official reports. Students were instructed in the method of classifying AEs developed by Robert Wachter and James Reason's Swiss cheese model [ 12 , 45 ]. A 60-min session included demonstrating the system model of error through a focused case-based writing assignment and discussion. In 2019, Mohsin et al. showed that clinical error reporting increased after a 4-h workshop where in addition to other concepts, the importance of reporting errors was discussed [ 42 ]. Other authors [ 30 , 33 ] focused on students' ability to report these AEs with curricula and syllabi employing methods such as the use of standardized patients, facilitated reflection, feedback, and short didactics for summarization. These studies also reported that this type of education program seems to enhance students’ current knowledge [ 36 ] and abilities to disclose medical errors [ 30 , 33 ].

Only the educational intervention suggested by David et al. in 2020, based on the World Health Organization (WHO) Patient Safety Curriculum, addresses the consequences and effects of the second victim phenomenon [ 29 ]. A 3-h session that consisted of the presentation of an AE in the form of a video or narrative, a discussion of case studies in small groups, where students have the opportunity to share their personal experiences related to these situations, and a list of practical application measures such as conclusions, improved knowledge, application skills, and critical thinking of students.

What do students learn about honest and intentional errors and key elements of safety culture?

Most training for both medical and nursing students focuses on how to identify the occurrence of a medical error since students, when asked about it, show little confidence in their ability to recognize such errors because they are little exposed to clinical procedures during their learning, which makes it difficult for them to differentiate errors from normal practice. In addition to teaching them how to identify them, interventions have also focused on how to prevent these AEs before they happen, as well as how to talk about them once they occur [ 29 , 40 , 41 , 44 ]. None of the training mentioned in the studies included in this review incorporated education on honest or intentional errors. However, a patient safety curriculum for medical students designed by Roh et al. (2015) [ 34 ] and a medication safety science curriculum developed by Davis & Coviello (2020) [ 29 ] for nursing students were based on the WHO Patient Safety Curriculum [ 13 ], which includes key aspects such as patient safety awareness, effective communication, teamwork and collaboration, safety culture, and safe medication management.

What kind of support do students value and receive to manage the second victim phenomenon?

Students stated that the greatest support comes from their peers, followed by their mentors and, finally, their families and friends [ 32 , 37 , 38 , 39 , 42 , 43 ]. Most hospitals and some universities have support programs specifically tailored for such situations, offering psychological assistance [ 39 ]. However, as these are mostly voluntary aids, many students do not make use of them, and if they do, the support they receive is usually limited. Mousinho Tavares et al. (2022) found that the students did not know about the organizational support or protocols available to students who become second victims of patient safety incidents [ 42 ]. In 2020, in the USA, interactive sessions exploring the professional and personal effects of medical errors were designed to explain to medical students the support resources available to them [ 31 ].

Strategies for supporting students after making or witnessing a mistake

In 2019, Breslin et al. developed a 2.5-h seminar on resilience for fourth-year medical students (in the USA) consisting of an initial group discussion about the psychology of shame and the guilt responses that arise from medical error [ 28 ]. During this first group discussion, students had the opportunity to share their experiences related to these concepts encountered during their medical training. Following this, students formed small groups led by previously trained teachers to enhance their confidence in discussing shame and to further explore the topics covered in the group seminar. This training improved confidence in recognizing shame, distinguishing it from guilt, identifying shame reactions, and being willing to seek help from others. In 2020, Musunur et al. showed that an hour-long interactive group session for medical students in the USA increased awareness of available resources in coping with medical errors and self-reported confidence in detecting and coping with medical errors [ 31 ]. A 2022 Italian cross-sectional study on healthcare students and medical residents as second victims found no data on structured programs included in medical residency programs/specialization schools to support residents after the occurrence of an adverse event. The study also found that it might be interesting to design interventions for posttraumatic stress disorder (PTSD) for this type of student, as the symptoms of second victims are similar to those of this disorder. Similarly, this study proposes a series of interventions that could be useful, such as psychological therapy, self-help programs, and even drug therapies, as they have been proven effective in treating PTSD [ 39 ].

Few training interventions exist to support healthcare students cope with emotional experiences of being involved in or witnessing a mistake causing harm to a patient during their clerkships. These interventions are scattered and not widely available. Additionally, there's uncertainty about their effectiveness.

In 2008, Martinez and Lo [ 3 ] highlighted that during students' studies, there are numerous missed opportunities to instruct them on how to respond to and learn from errors. This study seems to confirm this statement. Despite some positive published experiences, the provision of this type of training is limited. Deans, school directors, academic and clinical mentors, along with faculty members, have the opportunity to recognize the needs of their students, helping to prepare them for psychologically challenging situations. Such events occur frequently and are managed by professionals who rely on their own capacity for resilience. These sources of stress are not unknown to us, as they are a regular part of daily practice in healthcare settings. However, they do not always receive the necessary attention, and it is often assumed that they are addressed without difficulty [ 3 ].

Currently, we are aware that students also undergo the second victim experience [ 8 , 37 , 46 ], and it has been emphasized that this experience may impact their future professional careers and personal lives [ 39 ]. There is a wide diversity in training programs and local regulations regarding the activities that students in practice can undertake. Although there is a growing interest, the number of studies has increased since 2019, there are still many topics to address, and the extent of the experiences suggests that these are isolated initiatives without further development informed in other faculties or schools.

Over one-third of the studies have employed quasi-experimental designs with pre-post measures, although most studies have relied on qualitative methodologies to explore students' responses to specific issues [ 19 , 28 , 29 , 31 , 33 , 34 , 41 , 44 ]. These investigations do allow us to assert that we understand the problem, have quantified it, and have ideas to address it, but we lack a consensus-based and tested framework to ensure the capacity to confront these situations in the students. Moreover, similar to what occurs in the study of training in resilience or to face the second victim phenomenon in the case of healthcare workers [ 2 , 21 , 28 , 35 , 47 , 48 ], all of the studies have been focused on medical and nursing students. Other profiles (such as pharmacy or psychology students) have not been included until now.

The first study on the impact of unintended incidents on students in healthcare disciplines dates back to 2011. Patey et al. (in 2007) identified deficiencies in patient safety training among medical students and designed an additional training module alongside their educational program [ 6 ]. Other experiences have also focused on providing patient safety education [ 6 , 29 , 33 , 35 , 39 ].

The majority of studies included in this review focused on training students in providing information and apologies to patients who have experienced an AE (due to a clinical error). These studies have been conducted on every continent except Africa, and while they have different objectives, they share a similar focus: enhancing the skills to disclosure and altering defensive or concealment attitudes. Many students had difficulty speaking up about medical errors [ 49 ]. This fact poses a threat to patient safety. The early formative period is the optimal time to address this issue, provide skills, and overcome the traditional and natural barriers to discussing things that go wrong.

Students preparing for highly stressful situations in their future careers face a contrast between the interest in their readiness and the observed figures of clinical errors during practices. A 2010 study [ 37 ] in Denmark reported that practically all students (93% of 229) witnessed medical errors, with 62% contributing to them. In Belgium (thirteen years after), up to 85% of students witness mistakes [ 17 ], while US and Italy studies (2019–2022) showed lower figures. Among 282 American students, only 36% experienced AEs, and Italian nursing students reported up to 37% [ 4 , 8 , 10 ]. Students are witnessing 3.8 incidents every 10 days [ 48 ], although there are students who do not report witnessing any errors during their clinical placements, indicating difficulties with speaking up. Preparing students for emotional responses and reactions from their environment when an adverse event occurs seems necessary in light of these data.

Although the information is limited (a total of 125 students were involved), the data provided by Haglund et al. (in 2009) suggest that being involved in highly stressful situations contributes to reinforcing resilience and represents an opportunity for their personal growth [ 48 ]. Training to confront these stressful situations, including clinical errors, helps reduce reactive responses, although it does not guarantee maintaining the previous level of emotional well-being among students [ 21 ]. In this sense, the model proposed by Seys et al. [ 50 ], which defines 5 stages, with the first two focused on preventing second victim symptoms and ensuring self-care capacity (at the individual and team levels), could also be applied to the case of students and, by extension, to first-year residents to enhance their capacity to cope with an experience as a second victim.

AEs are often attributed to professional errors, perpetuating a blame culture in healthcare [ 51 ]. Students may adopt defensive attitudes, risking patient safety. Up to 47% [ 4 ] feel unprepared for assigned tasks, and 80% expect more support than received [ 39 ]. Emotional responses to EAs include fear, shame, anxiety, stress, loneliness, and moral distress [ 1 , 5 , 14 , 17 , 20 , 21 ],. Students face loss of psychological well-being, self-confidence, skills, job satisfaction, and high hypervigilance [ 10 , 13 , 17 ]. While distress diminishes over time, mistakes' impact may persist, especially if harm occurs [ 5 ]. Near misses can positively contribute to education, raising awareness. of patient safety [ 52 ]. Simulating situations using virtual reality enhances coping abilities and indirectly improves patient safety [ 53 ].

In spite of these data, students are typically not informed about the phenomenon of second victims or how to respond in the event of making or witnessing a mistake, including during their period of training in faculties and schools [ 54 ]. They express a desire for support from their workplace and believe that preparation for these situations should commence during their university education [ 4 ]. Students attribute errors to individual causes rather than factors beyond their control (considering them as intentional rather than honest mistakes). There have been instances of successful experiences demonstrating how this information can be effectively communicated and students can be equipped to deal with these stressful situations. Notably, there are training programs aimed at enhancing disclosure skills among medical and nursing students [ 33 , 36 ]. However, the dissemination of such educational packages in faculties and schools is currently limited. This study was unable to locate research where the concepts of honest or intentional errors were shared with students.

Support interventions for second victims should provide a distinct perspective on addressing safety issues, incorporating the principles of a just culture, and offering emotional support to healthcare professionals and teams, ultimately benefiting patients. These interventions have primarily been developed and implemented within hospital settings [ 55 ]. However, comprehensive studies are lacking, and experiences within schools and faculties, as well as extending support to students during their clinical placements, appear to be quite limited. Conversely, there exists a body of literature discussing the encounters of residents from various disciplines when they assume the role of second victims [ 38 ]. These experiences should be considered when designing support programs in schools and faculties. In fact, a recent study has described how students seem to cope with mistakes by separating the personal from the professional and seeking support from their social network [ 37 ]. Models such as SLIPPS (Shared Learning from Practice to Improve Patient Safety) is a tool for collecting learning events associated with patient safety from students or other implementers. This could prove beneficial in acquainting students with the concept of the second victim phenomenon. Interventions in progress to support residents when they become second victims from their early training years could be extended to faculties and schools to reduce the emotional impact of witnessing or being involved in a severe clinical error [ 56 ]. However, it is essential not to forget that healthcare professionals work in multidisciplinary teams, and resilience training for high-stress situations should, to align with the reality of everyday healthcare settings, encompass the response of the entire team, not just individual team members. Moreover, to date, cited studies have focused only on stages 1 and 2 at the individual level. However, we should not rule out the possibility that the other stages may need to be activated at any time to address students' needs.

Recently, Krogh et al. [ 37 ] summarized the main expectations that students have for dealing with errors in clinical practice, including more knowledge about contributing factors, strategies to tackle them, attention to learning needs and wishes for the future healthcare system. They have identified as trigger of the second victim syndrome the severity of patient-injury and that the AE be completely unexpected.

Implications for trainers & Health Policy

Collaboration among faculty, mentors, health disciplines students, and healthcare institutions is vital for promoting a learning culture that avoids blame, punishment, and shame and fear which will benefit the quality that patients received. This approach makes speak-up more straightforward, allowing continuous improvement in patient safety by installing a learning from errors culture. Ensuring safe practices requires close cooperation between the university and healthcare institutions [ 57 ]. Several practical implications of this study are summarized in Supplementary Table  4 .

Psychological traumatizing events such as life-threating events, needle sticks, dramatic deaths, violent and threatening situations, torpid patient evolution, resuscitations, complaints, suicidal tendencies, and harm to patients are in the daily bases of healthcare workers. Errors occur all too frequently in the daily work of healthcare professionals. It is not just a matter of doctors or nurses, but it affects all healthcare workers. Ensuring their resilience in these situations should be a fundamental part of their training. This can be achieved through simulation exercises within the context of clinical practices, as it should be one of the key educational objectives. Specifically, clinical mistakes often have a strong emotional impact on professionals, and it seems that students (future professionals) are not receiving the necessary training to cope with the realities of clinical practice. Furthermore, during their training period, they may be affected by witnessing the consequences of AEs experienced by patients, which can significantly influence how professionals approach their work (e.g., defensive practices) [ 58 ] and their overall experience (e.g., detachment) [ 59 ]. There are proposals for toolkits that have proven to be useful [ 31 , 60 ], and the data clearly indicate that educators should not delay further including educational content for their students to deal with errors and other highly stressful situations in healthcare practice [ 52 ]. Adapting measures within the academic environment and at healthcare facilities that host students in training programs is a task that we should no longer postpone.

Future research directions

Individual differences in reactions to stress can modulate the future performance of current students and condition their resilience capacity [ 61 ]. This aspect should be studied in more detail alongside gender bias regarding mistakes made by man and woman [ 62 ]. The student perception of psychological safety to speak openly with their mentors [ 63 ], is also a crucial aspect in this training phase. Additionally, their conceptualization of human fallibility [ 63 , 64 ] needs to be analyzed to identify the most appropriate educational contents.

Both witnessing errors with serious consequences and being involved in them can affect their subsequent professional development. Analyzing the impact of these incidents to prevent inappropriate defensive practices or dropouts requires greater attention. Future studies could link these experiences to attitudes towards incident reporting and open disclosure with patients.

Limitations of the study

This review was limited to publications available in selected databases and might be subject to publication bias. The selection of studies could have been biased by the search strategy (controlled using a very broad strategy) or by the databases selected (controlled by choosing the four most relevant databases). Despite employing a comprehensive search strategy, relevant studies not indexed in the chosen databases may have been omitted. In the case of three articles, access to the full text was not available. There were no language limitations since there was no restructuring of the search. On the other hand, selection bias was controlled because the review was carried out by independent parties and with a third party for discrepancies. Regarding the results, the included studies exhibited considerable variability in design, interventions, and outcomes. This heterogeneity reflects the diverse educational settings and methodologies employed to address the second victim phenomenon but limits the generalizability of findings. In addition, most of the studies were conducted in high-income countries, which may not reflect the experiences or interventions applicable in low- and middle-income settings.

In conclusion, students also undergo the second victim experience, which may impact their future professional careers and personal lives. Interventions aimed at training healthcare discipline students to address the emotional experience of being involved in or witnessing mistakes causing harm to patients during their clerkships are currently scarce, scattered, and do not yield conclusive results on their effectiveness. Furthermore, most studies have focused on medical and nursing students, neglecting other healthcare disciplines such as pharmacy or psychology.

Despite some positive experiences, the provision of this type of training remains limited. There is a need for greater attention in the academic and clinical settings to identify students' needs and adequately prepare them for psychologically traumatizing events that occur frequently attending complex patients.

Efforts to support students in dealing with witnessing errors and highly stressful situations in clinical practice are essential to ensure their resilience and well-being of the future generation of healthcare professionals and ensure patient safety.

Availability of data and materials

The authors verify that the data supporting the conclusions of this study can be found in the article and its supplementary materials. However, data regarding the quality assessment process can be obtained from the corresponding author upon a reasonable request.

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Identity Representation Of The Russian Germans Of Omsk Region In The Literature

Recent process of globalization leads to the development of generally accepted laws, standards, and values, on the one hand. On the other hand, it stipulates the necessity of preservation of different ethnic groups’ history, culture, and language. Investigating ethnic and regional identity is a continuing concern of ethnologists, historians, sociologists, and linguists. The past few decades of philological research have seen an increasing interest in “transnational literature”. We suppose that “transnational literature” evinces the perception of the author’s identity, namely, its ethnic and regional aspects. The objective of our research was to identify and describe regional and ethnic identity elements represented in the literature of Russian Germans when describing their life in Omsk region. According to the data of sociological and ethnographic investigations, the Russian Germans on the territory of Omsk Region are mainly villagers. Most studies of German traditions and language preservation are carried out in rural districts. An interdisciplinary approach integrating discourse, contextual and semantic analyses, as well as linguocultural interpretation, is applied. Investigations of ethnic groups’ identity and literature studies of the Russian German authors living in Omsk region became a theoretical basis of our research. The analysis allows us to conclude that regional and ethnic identity is presented mostly in the description of Omsk region as a native land. We identified four thematic groups: territorial, social, language, cultural. Every group consists of both regional and ethnic identity components. Regional identity prevails in territorial and social semantic groups, while ethnic identity predominates in language and cultural ones.

Keywords: ethnical identity , regional identity , transnational literature , Russian Germans' literature , Omsk Region

Problem Statement

The analysis of the literary works of the Russian Germans of Omsk region will reveal the linguistic representations of the authors’ ethnic and regional identity. We believe that the elements of the regional identity are manifested mostly in describing the territorial, social and everyday components of the native land image. The ethnic identity is reflected in the description of cultural and linguistic components of the image.

Research Questions

This research seeks to address the following questions: 1) What are the markers of the Russian Germans ethnic group? 2) What are the composition and genre peculiarities of the literary works of the Russian Germans of Omsk region? 3) What features of life in the Omsk region do the literary works convey? 4) How are the elements of the ethnic and regional identity represented in the literature of the Russian Germans of Omsk region?

Purpose of the Study

The main purpose of this study was to determine and describe the elements of regional and ethnic identity verbalized in the literary works of the Russian Germans living in Omsk region. In this regard, our research tasks are as follows:

1. To define the characteristic features of the Russian Germans ethnic group.

2. To determine content and genre characteristic features of the literary works of the Russian Germans of Omsk region.

3. To describe the components (thematic groups) of the native land image.

4. To define the elements of regional and ethnic identity in the components of the native land image.

Research Methods

The study uses an interdisciplinary approach including the methods of discourse, contextual and semantic analysis, the elements of linguocultural interpretation.

There are a large number of published studies in Russia dealing with the problems of ethnic identity from ethnological and historical viewpoints ( Drobizheva, 2010 ); through sociological and psychological aspects ( Stefanenko, 2009 ). Ethnic identity is defined as the consciousness of the community of people based on the ideas of the nationality, language, culture, history, territory, interests, and the emotional attitude towards them. Under certain conditions, this community is ready to act guided by these ideas ( Drobizheva, 2010 ). At the same time, the ethnic group as a psychological community should be successful in performing man's key functions: orientation in the world around and provision of well-structured information; setting universal life values; defending and being responsible for social and physical well-being ( Stefanenko, 2009 ). We believe that ethnic identity is a common system of representation of ethnic and cultural world components integrating an individual with a community ( Namruyeva, 2018 ).

Interdisciplinary studies, mainly linguistic ones, contribute to the investigation of ethnic identity issues. Literature has always been used to convey peoples’ life and reflect the specific world perception by different ethnic groups. In this regard, the study of transnational literature is becoming increasingly important in linguistics. Transnationalism becomes “a structural bridge” between the beyond borders of a single nation and state from the point of view of international migration and the borders of the “other” state, thus becoming a space where transcultural experience is doubled ( Kim, 2017 ). At the same time, transnational literature investigation is characterized by “subfield conglomeration including multicultural, world, postcolonial, diasporic, and borderline one” ( Jay, 2021 ). The works of the Russian scholars view transnational literature as a layer of literature that cannot be unambiguously referred to this or that culture ( Bakhitireeva et al., 2018 ).

‘The Russian sector’ of German transnational literature attracts both Russian and foreign scientists. In their literary works, the Russian Germans convey the stereotypes about the Russian and German cultures. In this case, with a certain degree of irony some of the authors describe the relative character of culture stereotypes and narrow-minded perception of culture based on them. The others focus readers’ attention on negative features of Russian culture ( Barbashina, 2003 ).

The given study analyzes the literary works of the Russian Germans whose lives are connected with Omsk region in of the latter half of the 20th and the beginning of 21st century. They are V. Geynts, A. Genshel, V. Gergenreder, A. Iordan, V. Kaizer, G. Tsilke, E. Mater, A. Raizer, M. Rot, S. Felde, V. Shtrek, V. Eisner, P. Blume, A. Vaits, E. Gamm, A. Tsilke, A. Vormsbexer. Most authors are not widely-known among the readers. However, we believe that literature discourse of regional self-identification presents itself in the literary works of the regional writers representing local perception of the worldview ( Bahor et al., 2017 ). When the authors belonging to the same ethnic group are considered, it is possible to talk about the literary discourse of ethnic identification.

Analyzing literary works, we distinguished four groups of components describing the life of the Russian Germans in Omsk region (Table 01):

1. Territorial (a native land, a place of living, the nature)

2. Social (activities, daily routines).

3. Language (communication).

4. Cultural (traditions, customs, religion)

The spatial component is represented by the images of a house, village, nature, weather. The Siberian region in the perception of Russian German authors is their homeland, a favorite place, a beautiful place. This aspect is expressed in such word combinations as. Empathy is expressed with the help of diminutive words (diminutives), possessive pronouns, evaluative connotations. Due to the diminutives and specifying adjectives, the authors emphasize that their homeland is not a huge space but a small place in Siberia. For instance,Bilingual authors create an image of their native land both in Russian and in German:The image of the Siberian village is specified through such toponyms as the names of villages indicating geographical location. For instance,. The name of the Irtysh River is also an element of regional identification. For example,The manifestation of regional identification can also be traced in the description of nature, i.e. the names of the plants: a birch, a fir-tree, a maple, a poplar:; the birds and animals () typical of Omsk region. The authors describe the weather phenomena (rain, snow, wind) in different seasons, the landscape..

Thus, the regional identity can be clearly traced in this component; the names of the villages where a large number of Russian Germans live also indicate the ethnic identity.

The social and household component is mainly represented by a description of everyday work and leisure time (elderly people sit on the benches in the evening, the residents like visiting each other, singing a lot, dancing, boys steal apples, men go fishing). Many memories of the life in the post-war period contain such events in the life in a Siberian village as going to the banya, the cinema (the films were brought to the country from town, so there was an expression "a movie was brought") or going to the countryside barber's. The work period (and the whole life) in rural areas is determined not only by the time of day but also by the time of the year. In the winter, life subsides; in the spring, a new cycle begins again. In many works, there is a collective image of a shepherd (a boy, a man) who gathers cows into a herd early in the morning, and brings the cows back "Jede Kuh zum eigenen Tor" late in the evening. The characters of the literary works (the villagers) have both German and Russian names (shepherd Ivan, Ivan and Emma, Vasily and Louise). The characters of fairy tales also represent the two cultures. The regional component can also be traced here – in the social conditions of life in Russia, the Germans begin to address each other by their first and patronymic names - Elsa Petrowna Obholz. It should be noted that in the social and household component, not only are the elements of regional identity but also the ethnic ones explicitly expressed. For example, when the banya is described, it is specified that the Russian Germans wash in the banya "thoroughly, in a German way, without Russian dash."

Primarily, the linguistic component is reflected in the humorous discourse, and it is a mixture of Russian and German. This component is a bright manifestation of ethnic identity. For instance, A. Iordan's schwanks describe the comic situations in which the representatives of Russian Germans who have a poor command of the Russian language (speaking mainly in dialect) incorrectly perceive or pronounce the Russian words. The Russian expression "I arrived blagopoluchno (safe and sound)" as a result was transformed into "I arrived." The lexeme "blagopoluchno" has a seme "good/blago" meaning ''well". The word "plokhopoluchno" has a seme "bad" (the antonym of the word ''good"). Moreover, the word used by the Russian Germans does not exist in the Russian language. However, the comic nature of this situation led to the fact that the villagers began to form antonyms for the words having this "good/blago" component such as "blagoverny/blessed", "blagolepie/beauty", "blagovonie/incense", "blagozvuchie/euphony" by analogy.

The comic situation in another schwank is based on the consonance of the Russian and German words Lambada und Sex (lambada (dance) and sex) – Lampade, sechs (lampada, six), The example of mixing languages are "Sie faste Mut und sagte:

The cultural component in the analyzed material is represented by several thematic groups, one of which is the old German holidays, for example,. It is noteworthy that this component remains the most preserved one in the minds of the representatives of this ethnic group in its original form (all Russian Germans know these traditions and rituals). As a result, traditions can be traced in the literary sources of all time periods. Rituals also play a big role in preserving identity: weddings, funerals, baptisms, confirmations, wedding ceremonies and communion services (). Most holidays, customs and ceremonies are of a religious nature, which most likely ensures their intactness in the culture of the Russian Germans living in Omsk region.

There are cases of the names of religious nature used in the literary works; namely, the religious movements, the vocabulary pertaining to the church arrangement, for example,

The cultural component of ethnic identity is also manifested in the national cuisine of the Russian Germans. The literary works mention such dishes asThe last dish is an integral element of the wedding ceremony. On the second day of the wedding, the bride and the groom treated the guests to the noodles made by the bride the night before.

A characteristic feature of the cultural aspect is the connection with another Homeland, i.e. Germany. Russian Germans know and respect the German literature. Thus, their literary texts contain the names of such German poets as....

The analysis of the literary works proves the opinion that "the ethnic identity of Russian Germans is multi-component, and its various elements are actualized depending on the environment" ( Kurske & Smirnova, 2011 )

In this article, on the basis of transnational literature written in the latter half of the 20th and the beginning of the 21st century, we have attempted to describe the components of the regional and ethnic identity of the Russian Germans who lived and are living in Omsk region. We presumed that it is local writers and poets whose works are most often thematically autobiographical texts. Those texts not widely- known to the reading public represent the awareness and experience of Russian Germans' identity (ethnic identity) and develop regional self-awareness at the same time.

Despite the ongoing activities to maintain the culture and the language, the researchers note that Russian Germans among whom are those living in Omsk region, are going through a national and cultural crisis – the signs of ethnic identity are being lost, the ritual culture and the national cuisine are disappearing. The German language is also undergoing changes: the dialects are disappearing; the young people are learning German only as a foreign language.

The ethnic identity of Russian Germans is a complex multicomponent phenomenon, the significant features of which are historical destiny, common culture and the German language. It is noteworthy that the genre variety of literary works of Russian Germans is due to the coexistence of the two cultures, the two worldviews. In the literary works of the writers belonging to the same ethnic group and united geographically on the case study of the Siberian region, the elements of regional and ethnic identity were identified. Discourse, contextual and semantic analysis allowed us to determine the following components of this worldview: spatial (native land, place of residence, the nature), social and household (routines, household activities), linguistic (communication), cultural (customs, traditions, religion). In each component, both regional and ethnic identification of Russian Germans are manifested. Regional identification prevails in the spatial and social and household components; ethnic identification prevails in the linguistic and cultural components.

On the whole, the obtained results contribute to the study of “transnational literature” and highlight the need for further investigation of Russian Germans' identity.

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31 March 2022

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https://doi.org/10.15405/epsbs.2022.03.142

978-1-80296-124-9

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Freedom, philosophy, civilization, media, communication, information age, globalization

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Novikova, E. V., Esmurzaeva, Z. B., Evtugova, N. N., Malenova, E. D., & Gatsura, N. I. (2022). Identity Representation Of The Russian Germans Of Omsk Region In The Literature. In I. Savchenko (Ed.), Freedom and Responsibility in Pivotal Times, vol 125. European Proceedings of Social and Behavioural Sciences (pp. 1191-1198). European Publisher. https://doi.org/10.15405/epsbs.2022.03.142

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