Health education for classical musicians

Could compulsory health education at UK conservatoires improve the health and wellbeing of classical musicians? Dr Raluca Matei of Birkbeck’s Centre for Sustainable Working Life shares the findings of a recent study conducted with Jane Ginsborg, Juliet Goldbart, and Stephen Broad.

Picture of classical musicians

Despite rating job satisfaction very highly, many classical musicians also suffer for their art. In the largest survey to date (Fishbein et al., 1988), 76% of players reported a medical problem severe enough to impair performance. The most prevalent were musculoskeletal, affecting the shoulder, neck and back, however, they also reported acute anxiety, depression, and sleep disturbances.

More recent research shows that musicians experience hearing loss (O’Brien et al., 2014), visual problems (Beckers et al., 2016), and eating disorders (Kapsetaki and Easmon, 2017). There is a higher prevalence of insomnia and psychological distress among musicians than in the general population and they may be more likely to use psychotherapy and psychotropic drugs such as sedatives, antidepressants, hypnotics and/or medication for attention deficit hyperactivity disorder (ADHD) (Vaag et al., 2016a,b,c).

Compulsory health education for music students

Our study sought to find out if we could empower musicians to improve their health through a conservatoire-based health education course. The course was delivered to first-year undergraduate music students at a UK music conservatoire. The aims of the study were:

  • To explore students’ hearing and use of hearing protection
  • To design an evidence-based health education course
  • To assess the effects of the course on primary outcomes (perceived knowledge of course content and knowledge and awareness of potential risks to health) and secondary outcomes (including general health, health-related quality of life, health-promoting behaviors, self-efficacy, emotional state, perceived stress, frequency and severity of playing related musculoskeletal disorders (PRMDs), and perceived exertion)
  • To identify the topics within the course that were most salient to students

Unlike previous studies, which provide little information as to how curricula were designed and whether formative methodologies were used, the course curriculum was informed by findings of research on music performance anxiety (MPA) and PRMDs; the findings of evaluations of other courses designed to improve musicians’ health; theories and models deriving from health psychology (Taylor, 2012); discussions with the Acting Head of Undergraduate Studies at the institution where some of the authors are based; and members of the Healthy Conservatoires Network.

The course formed the major component of a module entitled Artist Development 1, compulsory for all first-year students at a tertiary-level music conservatoire in the UK. The module took place over the first and second terms of the academic year and consisted of ten weekly 1-hour lectures delivered to the whole cohort (104 students) and eight weekly 1-hour seminars delivered to ten small groups of 10–15 students. The course covered not only physical and mental health, but also effective strategies for practicing, memorizing and rehearsing, and life skills and behavior-change tools inspired by health psychology.

Students were required to submit a portfolio of assessments including a 1,000-word essay in response to both the following questions: (1) Looking back on the Health and Wellbeing component of Artist Development 1, what new information, useful for your own music-making, have you learned from one lecture or one workshop/seminar?; (2) How have you been able to put this information into practice when making music (e.g., practicing, rehearsing, performing or studying more generally)?

Course evaluation

A mixed-methods approach to evaluation was adopted: quantitative analyses of data gathered at baseline and post-intervention, and between-group data (intervention vs. controls); and qualitative, semi-structured interviews (unpublished).

In terms of hearing, tinnitus and hyperacusis were reported by both groups of respondents, with a higher incidence in the (third-year) control group than in the (first-year) intervention group. Ten percent of the intervention group had been diagnosed with hearing loss, although minorities of respondents in both groups reported having had hearing tests in the previous ten years.

Although respondents were more likely to use hearing protection when rehearsing with others and attending concerts, comparatively few members of either group used hearing protection, or, if appropriate, the mute on their instrument, while practicing alone. This could affect hearing, since private practice can cause over-exposure to risky levels of sound.

Reassuringly, respondents reported increased knowledge of the topics covered in the course, including the sound intensity levels associated with hearing loss and how to deal with the health and safety issues associated with learning and playing a musical instrument. They also reported increased awareness of performance factors related to potential musculoskeletal injuries. The ratings of students who had taken the course and those who had not did not differ significantly, perhaps because the control group had had informal exposure to the other topics covered in the course, with the possible exception of life skills and behavior change techniques.

Students who had taken the course also rated their ability to deal with relevant health and safety issues significantly higher than controls.

In contrast, the only desired secondary outcome to increase significantly from baseline to post-intervention was self-efficacy, which may or may not have been the result of the course. Other significant increases were in the wrong direction: sleep problems, distress and lack of vitality all increased significantly from baseline to post-intervention, and controls experienced more severe depression, distress and lack of vitality.

We attribute these negative findings to the cumulative pressure on students over time. The first time the intervention group completed the questionnaire, they were in their second week at the conservatoire; post-intervention, they were facing deadlines for assignments to be submitted and recitals to be given. They may, however, have fared better than the control group simply by virtue of being a year younger. What we cannot know is the extent to which the health education course may have mitigated the demands perceived by the students in the intervention group.

Finally, from the topics covered in student assignments, it appears that managing MPA and behavior change techniques are of most interest or relevance to them at this point in their studies.

Conclusions

In the absence of a national curriculum for health, all institutions of higher education must develop their own approaches to health education, as do many university music departments and music conservatoires. The questions posed by Ralph Manchester in 2006 remain pertinent: “Who will develop this course? What topics will be included in the syllabus? Who will teach it? Will it be offered to freshmen or seniors, or can it be taken during any year? Can one course meet the needs of performance majors, music education majors, and others? Should we develop some minimal national requirements?” (Manchester, 2006, pp. 95–96).

Further questions could be asked, such as: When can a course be considered successful? What are its desired outcomes? How should they be measured? Once the content and delivery of a course have been evaluated, how should they be adjusted, if necessary? To what extent should students’ requirements and feedback be taken into consideration, given the available evidence and the need, on occasion, to challenge their beliefs? Very few health courses have been formally evaluated to date, and reports of those that have been evaluated do not say how the course was improved as a result.

Although it has been argued for the last 25 years that health education for musicians should be evidence-based (Zaza, 1993), the declarations and recommendations fail to mention the importance of evidence-based teaching. There is now a wealth of research on musicians’ playing-related health problems, and their management, but unless this is disseminated effectively to senior managers and educators, instrumental and vocal tutors, and students, there is a risk that conservatoires will maintain traditional practices rather than responding systematically to the best evidence available.

The topic of how music students, too, can be convinced that health education is a vital part of their training remains largely unexplored. Framing the objectives of health education courses as “performance-enhancing” rather than “preventative” is likely to be more attractive to students.

Although the course described in the present study did not have the hoped-for impact on secondary outcomes including reported health-related behaviors, reduced PRMDs and stress, it was associated with improvements in primary outcomes relevant to health education, namely the perceived knowledge of topics covered in the course and awareness of health risks.

Furthermore, the study itself is the first evaluation of a health education course for musicians that documents the process of designing the course on the basis of a rigorous assessment of the available evidence, and its incorporation in the “real world” context of a music conservatoire.

Further Information

Share
. Reply . Category: Business Economics and Informatics . Tags: , , , , , , , , , , , , , , , ,

BEI Research Year in Review

2019 was a busy year for the School of Business, Economics and Informatics. Here are some of our research highlights.

BEI Research Year in Review

Improving Diversity on Sport Boards

Improving diversity on sport boards

Dr Richard Tacon and Dr Geoff Walters from the Department of Management worked with Sport England to improve the diversity of board members in the sport and physical activity sector. The programme, unveiled in September, follows a series of studies demonstrating that sports governance lacks diversity, particularly with regards to ethnicity and disability.

Richard and Geoff have designed and implemented training materials as part of the initiative, which will identify and develop a pool of suitable candidates from under-represented groups. The intention is that sports organisations will then be able to turn to these people when recruiting for new board positions.

Diagnosing Gaming Disorder

Gaming

Researchers led by Bruno Schivinski, Lecturer in Marketing, developed the first psychological test to check for ‘gaming disorder’, a new type of mental illness now recognised by the World Health Organisation.

Now accessible online, the test provides participants with feedback on their video game habits in comparison with the rest of the population. Research is ongoing to understand the point at which gaming becomes a health problem and the factors which contribute to the development of gaming disorders to promote responsible gaming.

Sticking up for Parents in the Performing Arts

Paloma Faith is among those calling for better support for parents in the performing arts

Academics from the Department of Organizational Psychology developed a survey of workers and work-life balance in the performing arts in partnership with Parents and Carers in Performing Arts (PiPA).

Over 2500 UK workers from the performing arts, including 1000 parents and carers, took the survey. It found that 43% of performing artists who left their careers did so because they became parents. Carers pay a significant penalty in terms of well-being and remuneration in order to maintain a career in the performing arts and are far more likely to leave the industry than non-carers, leading to a drain in talent and reduced diversity in the arts. Professor Almuth McDowall, Head of Department, added her voice to the call for change alongside leading figures in the sector such as actor Cate Blanchett and singer Paloma Faith.

Understanding Text Data

Researchers from the Department of Computer Science and Information Systems developed a tool to simplify the process of understanding and using data from text. Called Samtla API, the new service can automatically annotate words and phrases from digital text documents with named entities and sentiments using machine learning and text mining technologies.

Spearheaded by Dr Mark LeveneDr Martyn Harris, and Dr Andrius Mudinus, the initiative grew in response to the growing need for easily understandable annotations on the large volumes of text data, generated by media, businesses and individuals all over the world.

A Prizewinning Contribution

Dr Alexey Pokrovskiy was awarded the European Prize in Combinatorics

In August, Dr Alexey Pokrovskiy from the Department of Economics, Mathematics and Statistics was awarded the European Prize in Combinatorics. The prestigious award is made once every two years, recognising excellent contributions in Combinatorics, Discrete Mathematics and their Applications by young European researchers aged 35 or under.

Adapting to Climate Change

Strategic management experts from the Department of Management and the Cass Business School at City, University of London found that greater collaboration between the insurance industry and state policy makers could improve society’s ability to recover from disasters linked to climate change.

Using insurance is a step away from crisis towards risk management, strengthening socio-economic resilience under a changing climate. Birkbeck’s Dr Konstantinos Chalkias, the Cass Business School’s Professor Paula Jarzabkowski and their co-authors put forward seven recommendations to the Global Commission on Adaptation to maximise the benefits of insurance for climate adaptation.

Supporting Sustainable Return to Work following Mental Ill-health Absence

Dr Jo Yarker from the Department of Organizational Psychology and Professor Karina Nielsen from the University of Sheffield have been researching how to support employees who are returning to work following mental ill-health absence.

In the UK alone, stress, anxiety or depression accounts for 57% of all working days lost to ill-health in 2017-18. Yarker and Nielsen developed a toolkit for employees, colleagues, line managers and HR professionals to support individuals to return to and stay in work.

Further information:

Share
. Reply . Category: Business Economics and Informatics . Tags: , , , , , , , , , , , , , ,

Managing the ‘always on’ culture – a myth buster and agenda for better practice

Professor Almuth McDowall (Department of Organizational Psychology) shares her research into worklife balance and calls on employers to take responsibility for their organisation’s culture.

Break, Business, Business People, Businesswoman, Cafe

There is much being written and said about the ‘always on culture’ and how we are increasingly glued to our digital devices – whether at work or at home. Some of my own research has also concerned itself with this topic. My colleague and friend Gail Kinman and I had the results from a practice survey published in 2018 as we wanted to know what organisations are doing about the changing world of work, and the use of information and computer technology.

Well, precious little is the answer. Over half of our respondents said that their organisations don’t have a relevant policy in place and don’t offer any guidance or training. Somewhat worryingly over 40% thought that it should be up to individuals to manage the issue, rather than their line managers or human resources.

Why would people choose to be ‘always on’ outside formal working hours?

Working unpaid during leisure time does not make logical sense! We gift the UK economy billions in unpaid overtime year on year, as research by the Trade Unions Congress has revealed. Our systematic review with colleagues Svenja Schlachter, Ilke Inceoglu and Mark Cropley pointed to a complex picture.

People have different motivations, influenced by issues such as what everyone else does (social norms), what the expectations in the job are, how committed people feel to their job, how they value ‘switching off’ and recovery and whether this is supported in their environment. One key issue which came out of this review is the ‘empowerment enslavement paradox’. Our digital devices are both an enabler, as they afford flexibility, but also ‘digital leash’ as it’s difficult to say ‘enough is enough’ and switch off. As we all know, screen-time can be very seductive.

Is there any evidence that being ‘always on’ is bad for our health?

A recent econometric analysis shows that ICT infrastructure has a positive impact on population health (the authors measured general health outcomes such as infant mortality etc.). Regarding the impact of social media use, there is evidence that high use is linked to poor sleep quality, anxiety depression and low self-esteem. Of course, such studies cannot tell us whether teenagers who are highly anxious to start off with are more likely to be prolific users.

There is far less robust evidence on the exact effects from the world of work – what happens to you if you are on your phone, tablet or laptop near 24/7? We lack good research to tell us what the exact effects are.

What we do know though is that we need recovery and respite, our systems are simply not programmed to be on continuous overdrive. We also know that leisure activities which are quite different from our work tasks are better for our recovery than doing more of the same. I take this to heart. For instance, I find that reading at night doesn’t help me switch off as academics read rather a lot at work, so I take ballet classes online (and am known to teach the odd one myself!), knit and crochet.

What can organisations do?

Employers have a duty of care and should ensure that people are not overworked and can switch off. Worklife balance research tells us that those who live ‘enriched’ lives have better mental and physical health, important for them, and important for their employer. We should actively support employees by ensuring that:

  • A worklife balance policy is in place as a point of reference; then check processes and structures against this policy
  • Employers review job design and ensure that digital tasks (checking and responding to emails, synchronising devices, remote calls and conferences) are actually captured in people’s workload and tasks – these often fall off the radar
  • There is consultation to ask employees what they need – mutually negotiated boundaries and solutions work much better. Think creatively about flexible solutions!
  • Everyone, including senior leaders and managers, role models good behaviours. People need time to switch off, so don’t expect your staff to be available outside normal working hours
  • Staff are offered training and development. Managing in an increasingly digital workspace requires up-to-date management and leadership skills
  • Employees look out for implicit expectations and ‘rumours’. “I check my emails on holiday because this is what is expected of me”. Really? Question such assumptions as they can often take on a life of their own

Finally, if in doubt, ask a psychologist. The Department of Organizational Psychology is keen to work with organisations to establish, consolidate and evaluate best practice.

Further information:

Share
. Reply . Category: Business Economics and Informatics . Tags: , , , , , , , , , ,

The proposed ‘right to disconnect’ after work hours is welcome, but not enough

This post was contributed by Professor Gillian Symon, member of the Digital Brain Switch project. Involving a multi-disciplinary team of UK researchers (including Birkbeck’s Dr Rebecca Whiting), the project explored the ways in which mobile communication technology  affects how we switch between different aspects of our lives. This article was originally posted on The Conversation on 23 March 2016.    

Changes proposed to France’s famously inflexible employment laws by French president François Hollande have prompted an outcry among students and unionists and even the barricading of schools by pupils. But among the raft of changes to working practices is the liberating notion that employees should have the right to disconnect: to ignore emails from employers during evenings and weekends so that time with friends and family is not affected by work distractions or feelings of guilt.

Limited interventions of this sort have been put forward in Germany and France before, but this is the first proposal that the right be enshrined in law.

There is much to like about it. First, it recognises the massive impact the widespread use of smartphones and tablets, Wi-Fi and high-speed mobile internet has had on our working lives. In as much as work emails, diaries and contacts are on a smartphone in our pocket, to some extent we are never truly “out of the office”. The proposal seeks to counter this in legislation, not to leave it to corporate custom and practice.

Second, the proposed legislation acknowledges the considerable research that suggests that we need to psychologically detach from work regularly, or risk becoming exhausted and losing our creativity.

Third and most importantly, it makes the employer at least partly responsible for managing this intrusive technology and its effects on employees. There is a recognised paradox, whereby technology allows flexibility over when and where we work, but at the same time acts as a leash that chains us to our (virtual) desks. For too long this has been seen as something employees themselves should manage.

The research into work-life balance my colleagues and I have conducted suggests that achieving the right balance has become another “life crisis”. It is one that is fed by endless media articles and self-help books, and one that is almost certainly unresolvable by the individual as so much of the pressure comes from bosses and colleagues at work. What we’ve found is that there needs to be respect for individuals’ chosen work-life boundaries at all levels within organisations.

So congratulations to the French for taking this particular taureau by the cornes. But is their proposed approach through new legislation the right answer?

It’s not easy, and often employers don’t make it any easier. wongstock/shutterstock.com

As far as it goes

There are three ways digital media and mobile technology have affected our lives that isn’t acknowledged by legislation, which is concerned only with time spent connected to work. In our research we’ve sought to highlight the creeping effects of “digi-housekeeping”: those endless technology maintenance tasks that we engage in – updating software, syncing devices, fighting technical problems – which often takes place outside of office hours and doesn’t appear on time sheets. None of this is accounted for by legislative approaches.

Nor does legislation address the way in which the use of social media for work may intrude into our privacy. When we blog and tweet for our employers, are we exploiting our personal identities for their ends? Are these additional tasks, and the need to maintain our digital presence online, causing us anxiety and increasing our workload without any formal recognition of the effort involved? These sorts of activities go beyond a concern with just maintaining a time boundary between work and life. They represent new tasks required to maintain our digital work lives.

What’s more, because the French legislation presumes an employee-employer relationship, it entirely ignores the anxieties of the self-employed, as those taking part in our research told us. While those working for themselves have always had to work hard, social media has put added pressure on them to be constantly online and accessible to maintain their business. We need more imaginative interventions that will address the needs of specific groups such as these.

What are 21st century working lives like?

The French legislation is important primarily because it makes clear the responsibilities of employers and organisations. However, it’s also rather a blunt-edged tool that doesn’t appreciate the intricacies of our online lives. Legislation like this enforces a strict work-life boundary that may be a thing of the past.

Read the original post on The Conversation

Read the original post on The Conversation

Our research collaborators kept video diaries that captured the complex circumstances of today’s workers in a more revealing way than traditional surveys can do. These video diaries suggest we might be making sense of our lives in radically different ways in the 21st century. We distinguish between online and offline lives rather than work and non-work hours, and we think more about how we prioritise time, rather than how we divide it.

To support flexible working, we may need flexible legislation that is based on other considerations than time alone, including where and how we work best. It’s very unlikely there will be a one-size-fits-all solution; researchers and policymakers are going to have to find more creative 21st century solutions for this very 21st century problem.

So the French government’s move to formally recognise the distraction caused by unfettered technology is welcome, but limited. To improve upon it, we need to understand much more fully the complexities of contemporary digital online lives, what boundaries people now find important, and how the law can best support them.

Find out more

Share
. Reply . Category: Business Economics and Informatics, Categories . Tags: , , , , ,