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Critical analysis of two research studies includes the evaluation of the potential of non-prescription stimulants in terms of enhancing the academic performance of the university students. Clinicians and the research community require attaining thorough insight regarding the context as well as causative factors related to the addiction pattern of cognitive stimulants in the students' community. Accordingly, proactive measures for controlling the dependence of students on cognitive enhancers require systematic configuration by the healthcare professionals. Evidence-based research literature describes conflict-of-interest as an individual intent that significantly interferes with the professional judgement thereby leading to the development of mistrust and bias (IOM, 2009). The authors of both research interventions do not exhibit any rational basis for their conflict-of-interest in relation to the undertaking of their respective studies and associated evidence-based findings. The esteemed researchers possess valid credentials for conducting research interventions in the field of psychology and obtained their projects funding from respective authorized (governmental/non-governmental) agencies.

Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students - a qualitative approach. BMC Medical Ethics, 15(1), 23-23. doi:10.1186/1472-6939-15-23

Authorship

Evidence-based intervention by (Hildt, Lieb, & Franke, 2014) evaluated the context of utilization of psychostimulant drugs by the university students. The authors are affiliated with the Department of Philosophy of Johannes Gutenberg University of Mainz and Department of Psychiatry and Psychotherapy of the University Medical Centre. The academic profile of the authors makes them eligible for conducting research studies on psychology and human behaviour.

Research Aims

The research study by (Hildt, Lieb, & Franke, 2014) evaluated the causative factors attributing to the utilization of psychostimulant drugs by university students for their academic enhancement. Research intervention not only attempted to evaluate the outcomes of these pharmacological interventions on the academic performance of the users, but also explored their subjective experiences and motivational factors leading to the pattern of drug dependence and associated adversities.

Population

University students with overall normal health pattern

Intervention

Psychostimulants and prescription drugs

Comparison

University students with normal executive function

Outcomes

Students’ experiences, addiction pattern, causative factors and cognitive changes

Evidence-based research literature affirms the influence of psychotropic drugs on the cognitive enhancement of adolescents and children affected with executive function disorders (Hosenbocus&Chahal, 2012). Research intervention by (Ryan, et al., 2013) evidentially describes the pattern of relationship between the cognitive scores and mental functionality of individuals in the setting of executive function disorders. The analysis by (Vrecko, 2013) advocates the requirement of evaluating the subjective experiences and emotional states of the users of stimulant medications with the objective of tracking the influence of these drugs on their psycho socio-somatic well-being.

Research Aims

Design

Hildt, Lieb, and Franke (2014) utilized face-to-face (semi-structured) interview sessions for evaluating the subjective experiences/requirements of 22 healthy students in the context of utilization of psychoactive drugs. The interview sessions subjectively evaluated the causative factors of the psychoactive drug intervention and its self-perceived outcomes (i.e. cognitive and academic enhancement) among the treated students. Semi-structured interview strategy is a method of choice and prevalently deployed by the healthcare professionals in qualitative research studies (Jamshed, 2014). The administration of open-ended questions through semi-structured interviews assists the research professionals in recording the subjective responses of the participating candidates.

Findings

Evidence-based findings retrieved by (Hildt, Lieb, & Franke, 2014) successfully explored the broader perspectives of the non-medical utilization of psychostimulants and prescription drugs in the student community. Causative factors of stimulants utilization attributed to the requirement of acquiring motivation, cognitive coping skills, memory enhancement and maximization of consumption duration among the treated students. Majority of students consumed psychotropic stimulants with the objective of balancing their leisure and study times. The findings of this research intervention systematically comply with the evidence-based notion that signifies the influence of a range of factors on the utilization of psychotropic stimulants by the student community (Zuvekas&Vitiello, 2012). These factors evidentially include, but are not limited to the geographical locations, study stress, family income, ethnicity, race, age, psychosocial circumstances as well as academic and cognitive requirements of the developing students (Zuvekas&Vitiello, 2012).

Subjective interpretation of student’s experiences could have confounded the study results to an unknown extent. The sample size remained small and therefore, the results require further authentication through prospective research interventions. However, various measurement attributes proved advantageous in terms of understanding the true potential of academic performance enhancer drugs in student community.  

Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 65, 250-257. doi:https://dx.doi.org/10.1016/j.addbeh.2016.08.023

Authorship

The research analysis by (Munro, Weyandt, Marraccini, & Oster, 2017) explored the potential of non-prescription stimulants in terms of enhancing the executive functioning and resultant academic outcomes among the university students. The authors of this research intervention hold reputable positions in University of Rhode Island and Brown University.

Research Aims

The research intervention by (Munro, Weyandt, Marraccini, & Oster, 2017) attempted to evaluate the influence of NMUPS (non-medical use of prescription stimulants) on the executive function (and resultant academic performance) of the university students with normal cognition, in comparison to the individuals with reduced cognitive capacity.

Population

Population

University students with reduced executive function

Intervention

NMUPS

Comparison

University students with normal executive function

Outcomes

Alteration in the executive function and cognitive abilities of the participating subjects

Evidence-based research literature documents the prevalent utilization of prescription stimulants among undergraduate students for their cognitive enhancement (Herman, et al., 2011). However, this non-medical utilization leads to the development of drugs addiction behaviour in the students’ community. The research analysis by advocates the capacity of prescription stimulants in terms of enhancing the executive function of individuals irrespective of their cognitive statuses. Prescription drugs administered for treating ADHD elevate the executive potential of mentally fit individuals, as revealed by the study findings (Smith & Farah, 2011). Arria and DuPont (2010) describe the utilization of non-prescription stimulants among the college students in terms of a complex psychosocial behaviour requiring analysis in a broader context. Limited research interventions comparatively analysed the NMUPS behaviour among students with normal as well as reduced cognitive potential. This evidentially justified the need for the research intervention by (Munro, Weyandt, Marraccini, & Oster, 2017).

Design

Munro, Weyandt, Marraccini, and Oster (2017) utilized the qualitative SSQ (stimulant survey questionnaire) intervention for comparatively analyzing the outcomes of NMUPS between the mentally fit subjects and the participants affected with executive deterioration. SSQ utilization was substantiated by its capacity of accurately accessing large group of individuals for generating statistically relevant outcomes (Jones, Baxter, & Khanduja, 2013). Executive functional outcomes of the participating subjects were calculated on BDEFS (Barkley Deficits in Executive Functioning) scale. BDEFS scale is evidentially utilized in various psychological studies with the objective of evaluating the executive function constructs and associated cognitive factor scores (Vélez-Pastrana, et al., 2016). This rationally justifies the systematic utilization of BDEFS tool in the research intervention by (Munro, Weyandt, Marraccini, & Oster, 2017). Undergraduate students (N=308) from six American Public Universities (located in geographically diverse regions) were included in the research study. The study by (Munro, Weyandt, Marraccini, & Oster, 2017) utilized ANOVA tool for evaluating the pattern of reciprocal relationship between NMUPS administration, cognitive function and academic outcomes of the participating candidates. Evidence-based research literature describes ANOVA scale as a standard tool utilized for retrieving the precise mean values for the systematic comparison of the attributes of two different groups in various clinical interventions (Kim, 2014). This substantiates the requirement of utilizing ANOVA strategy for the reciprocal enhancement of the statistical outcomes.

Findings

The findings by (Munro, Weyandt, Marraccini, & Oster, 2017) rationally revealed the ineffectiveness of NMUPS in terms of enhancing the cognitive and academic level of the participants affected with sustained executive function deficits. The study findings indicated the academic enhancement requirement as the preliminary cause of the elevated prevalence of NMUPS in the student community. This study results comply to the evidence-based finding that rationally confirms the elevated predisposition of university/college students towards acquiring the pattern of NMUPS across the community environment (Arria, et al., 2017).

Intervention

The disproportionate sample size deployed for undertaking the research study might challenge the authenticity of the findings on a wider scale. The participants did not entirely represent the student community affected by the non-medical consumption of prescription enhancers. However, the study assessed the pattern of self-reported utilization of cognitive stimulants through twenty different parameters extended by stimulant survey questionnaire.  

Discuss the barriers for the application of evidence in practice

The greatest barrier to the utilization of evidence in clinical practice includes the time factor. The absence of sufficient timeframe for evaluating the study outcomes evidentially constraints its systematic administration by the research professionals (Bahadori, Raadabadi, Ravangard, &Mahaki, 2016). The absence of time further restrains the development of new thoughts that could substantially improve the pattern of clinical interventions and associated healthcare outcomes. Another barrier to the application of evidence in healthcare practice includes the inappropriate information technology (IT) and statistical skills of researchers, physicians and nurse professionals (Majid, et al., 2011). The inaccessibility (of the clinicians) to the IT-enabled statistical tools hinders the acquisition of accurate findings from various medical and research interventions. Accordingly, clinicians find limited scope in utilizing evidence-based findings in complex clinical scenarios (Majid, et al., 2011). The inability of the medical professionals in terms of systematically analysing and researching the clinical literature, patient values and previous clinical experiences challenges the systematic exploration of knowledge gaps and subsequent configuration of relevant research questions (Majid, et al., 2011). Eventually, the thorough implementation of evidence in clinical practice is hindered under the sustained influence of these barriers in evidence-based practice.

Discuss how closely the research studies provided align with the PICO question/elements

The research study by (Munro, Weyandt, Marraccini, & Oster, 2017) systematically aligns with the elements of the PICO question that comparatively analyses the influence of the NMUPS on the executive outcomes on the mentally stable as well as cognitively deteriorated university students. The findings of this study intervention also evidentially address each element of the PICO question, thereby leaving no room for re-evaluation of the authenticity of the study results on an equivalent scale.

The analysis by (Hildt, Lieb, & Franke, 2014) does not implicate much on the comparator element of the PICO question. However, the study findings evidentially match with the outcome parameter of the PICO question that attempts to evaluate the influence of the psychostimulants/prescription drugs utilization on the pattern of mental health and cognitive performance of the university students.

Comparison

Conclusion

The findings of both research studies indicate the ineffectiveness of cognitive enhancers in terms of improving the pattern of academic performance of the student community. Non-prescription stimulants are prevalently utilized by the students affected with executive function disorders in the context of enhancing their consumption time, life experiences as well as academic performance. The dependence pattern of the student community on cognitive stimulators exhibits deleterious influence on their quality of life and predispose them towards acquiring adverse outcomes across the community environment. Healthcare professionals must deploy counselling and education sessions for the university students with the objective of reducing their inclination towards prescription drugs consumption. The improvement in academic performance is governed by several factors that influence the psychology and behavioural outcomes in the affected students. The subjective experiences of students during the consumption of cognitive enhancers vary considerably and therefore, require further exploration by research professionals in the context of evaluating their true potential in improving the academic performance of school going students.  

References

Arria, A. M., & DuPont, R. L. (2010). Nonmedical Prescription Stimulant Use among College Students: Why We Need To Do Something and What We Need To Do. Journal of Addictive Diseases, 29(4), 417–426. doi:10.1080/10550887.2010.509273

Arria, A. M., Geisner , I. M., Cimini, M. D., Kilmer, J. R., Caldeira, K. M., Barrall , A. L., . . . Larimer , M. E. (2017). Perceived academic benefit is associated with nonmedical prescription stimulant use among college students. Addictive Behaviors, 27-33. doi:10.1016/j.addbeh.2017.07.013

Bahadori, M., Raadabadi, M., Ravangard, R., & Mahaki, B. (2016). The barriers to the application of the research findings from the nurses’ perspective: A case study in a teaching hospital. Journal of Education and Health Promotion. doi:10.4103/2277-9531.184553

Herman, L., Shtayermman , O., Aksnes , B., Anzalone , M., Cormerais , A., & Liodice , C. (2011). The use of prescription stimulants to enhance academic performance among college students in health care programs. The Journal of Physician Assistant Education, 22(4), 15-22. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22308929

Hildt, E., Lieb , K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students – a qualitative approach. BMC Medical Ethics, 1-10. doi:https://doi.org/10.1186/1472-6939-15-23

Hosenbocus, S., & Chahal, R. (2012). A Review of Executive Function Deficits and Pharmacological Management in Children and Adolescents. Journal of Canadian Academy of Child and Adolescent Psychiatry, 223-229. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413474/

IOM. (2009). Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK22926/

Jamshed, S. (2014). Qualitative research method-interviewing and observation. Journal of Basic and Clinical Pharmacy, 5(4), 87-88. doi:10.4103/0976-0105.141942

Jones, T. L., Baxter, M. A., & Khanduja, V. (2013). A quick guide to survey research. Annals of The Royal College of Surgeons of England, 95(1), 5-7. doi:10.1308/003588413X13511609956372

Kim, H. Y. (2014). Analysis of variance (ANOVA) comparing means of more than two groups. RDE, 74-77. doi:10.5395/rde.2014.39.1.74

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229-236. doi:10.3163/1536-5050.99.3.010

Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 250-257. doi:10.1016/j.addbeh.2016.08.023

Ryan, K. A., Vederman, A. C., McFadden, E. M., Weldon, A. L., Kamali, M., Langenecker, S. A., & McInnis, M. G. (2013). Differential executive functioning performance by phase of bipolar disorder. Biporal Disorder, 14(5), 527-536. doi:10.1111/j.1399-5618.2012.01032.x

Smith, M. E., & Farah, M. J. (2011). Are Prescription Stimulants “Smart Pills”? - The Epidemiology and Cognitive Neuroscience of Prescription Stimulant Use by Normal Healthy Individuals. Psychol Bull, 137(5), 717-741. doi:10.1037/a0023825

Vélez-Pastrana, M. C., González, R. A., Cardona, J. R., Baerga, P. P., Rodríguez, A. A., & Levin, F. R. (2016). Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-language version in a community sample of Puerto Rican adults. Psychological Assessment, 28(5), 483-498. doi:10.1037/pas0000171

Vrecko, S. (2013). Just HowCognitive Is “Cognitive Enhancement”? On the Significance of Emotions in University Students' Experiences with Study Drugs. Ajob Neuroscience, 4(1), 4-12. doi:10.1080/21507740.2012.740141

Zuvekas, S. H., & Vitiello, B. (2012). Stimulant Medication Use among U.S. Children: A Twelve-Year Perspective. The American Journal of Psychiatry, 169(2), 160-166. doi:10.1176/appi.ajp.2011.11030387.

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