The power of exercise (*and community) II

Fergus Mitchell

Half a year, or so, has passed since I wrote part one of this blog for MMI. It’s safe to say that sunny July feels like a distant memory! But within the whirlwind of a year that 2020 has been, I wrote my dissertation focussing on the importance of exercise for veterinary students’ mental wellbeing. The study was kindly supported by MMI, without whom it would not have been possible to conduct.

For those reading now who were enjoying a lockdown-free(?) summer when the first blog was published, then here is a little summary of what our project at the University of Nottingham consisted of:

We invited first year, female vet students, who self-identified as exercising less than the NHS minimum physical activity guidelines for adults, to participate in the study. We offered the students a free, eight-week exercise programme including three sessions of activity per week.

The three sessions included:

1. A circuits session led by the same instructor weekly.
2. An intro to sports session led by individuals from already established sport societies on Sutton Bonington campus (ie netball, badminton, football). The sport changed weekly.
3. A stretch/ reflect session led by myself and another student.

We had 12 participants and each were given a questionnaire at three stages during the programme. Eleven participants fully completed all three questionnaires. We were only  forced to cancel two sessions and a life coaching session was offered too.

Questionnaire 1 (before the programme) consisted of:

• 14 point Warwick-Edinburgh Mental Wellbeing Scale (c) University of Warwick, 2006, all rights reserved.
• Open response questions

Questionnaire 2 (mid-way through) consisted of:

• 14 point Warwick-Edinburgh Mental Wellbeing Scale (c) University of Warwick, 2006, all rights reserved.
• Open response questions
• 5-point Likert Scale Survey focussed on students’ motivations for participation in the programme

Questionnaire 3 (at the end) consisted of:

• 14 point Warwick-Edinburgh Mental Wellbeing Scale (c) University of Warwick, 2006, all rights reserved.
• Open response questions
• 5-point Likert Scale Surveys focussed on:
  • Students’ motivations for participation in the programme
  • Whether the programme met the expectations the students had
  • The impact of the programme on the students

A final wellbeing questionnaire was used six months after the programme, but this was not included in my dissertation due to time.

I represented the quantitative data graphically, and measured the difference in individual’s WEMWBS* scores from the start to the end of the project. I thematically analysed the open response questions and made a thematic map to represent the findings (see Figure 1).

I’d like to highlight the main findings from the study and have chosen three points to focus on in this blog.

1. Exercise and mental wellbeing are positively linked

Ok… so this statement is not revolutionary and I doubt it will come as a surprise to anyone. However, what this programme reiterated is that exercise is beneficial for mental wellbeing. The majority of the participants’ individual wellbeing scores increased (see Table 1) and five increased unequivocally (in accordance with the WEMWBS guide). The 14 point WEMWBS scores can range from 14 to 70 (higher score = better wellbeing).

We cannot dismiss the fact that changes in wellbeing will have been affected by other factors too. As made clear by some of the open response questions, factors such as academic stress, housing issues and other stresses all contributed to increases or decreases in some participant’s mental wellbeing. Yet many commented on how the exercise programme directly impacted their mental wellbeing positively, supporting the positive changes in WEMWBS scores.

Exercise can come in many forms, as illustrated by our programme. Whether it be fully fledged team sport, individual or group exercise, stretching and yoga, a simple walk or even in a consult room, as suggested by the VetFit team! And that it the great thing about it. There are many options (in normal times) to explore exercise and what suits you best.

2. Community matters

The second point is that community was a very important factor for the participants, and it was clear that the exercise programme provided a community for them in which they felt comfortable. Many participants felt as much of an obligation to their peers as they did themselves to complete the programme, demonstrating the importance of the community created.

It is ironic that I’m writing this at a time when community, in its physical form, is very much restricted. However, in the future I believe that it is incredibly important that maximum effort is continued to make  the profession a supportive community for all. Initially, as a first-year vet student, due to an array of stresses from academic to transitional, not everyone lands on their feet with a great sense of community. Although it may happen for some, we should continue to focus on how community can play such a vital role in students’ mental wellbeing. Exercise groups are a great way to aid this. However community is not limited to sports teams, classes, running buddies and so on. Any community within the profession or at universities can help the wellbeing of students, even virtual communities too.

One definition of community from the Oxford Dictionary is:

“The condition of sharing or having certain attitudes and interests in common.”

For me, this definition encapsulates the notion that anything and everything can lead to a community, all that is required is people with commonalities. And that is where the sense of community prevailed in this programme; 12 veterinary students who had a common interest in wanting to participate in an exercise programme and explore how it could impact them.

It is admittedly vague putting the onus on ‘community’ to help achieve better wellbeing, but I believe it is something that should be kept in the back of everyone’s mind as we move forward.

3. Stress

Finally, I wanted to touch on the S word: stress. It is a word bandied about frequently within the profession. In a range of ways it was often referred to by our participants or inferred from their responses when they were asked to comment on their perceived state of wellbeing. Finding a healthy work-life balance, even at such an early stage of a veterinary career, is evidently hard and although this isn’t a new issue, I believe it’s still important to highlight.

The responses from all the questionnaires were submitted before Covid dominated our lives, although it was on the horizon. Therefore, the stresses mentioned do not represent the exacerbated stress reported due to the pandemic. However, on the flipside, despite the many negative effects of the pandemic, there is reason to believe that it may have made us more in-tune with our mental health and what is important to us too. So, we may see a general change in behaviour with regards to wellbeing and mental health on the other side of Covid – but that is purely a hope of mine!!

As a profession we must continue to acknowledge common stresses and continue further research into ways of coping with them. Many participants commented on how the exercise programme gave them structure and a means to combat some of those stresses, which was encouraging to see.

Overall, hopefully my research and two blogs have reiterated the power exercise has to benefit our mental wellbeing. Additionally, I hope they have illustrated the power of community too and as we progress through to the light at the end of the Covid-tunnel, both exercise and community can be of paramount importance for the veterinary profession.

I’d like to take this opportunity to thank everyone within the profession who is making and has made the time to focus on wellbeing and mental health. Exercise for me is a great way to help my mind and body, and I hope that the exercise programme at Nottingham helped a few of my peers see the benefits too.

Unfortunately we were unable to run a parallel programme with members of the first-year, April cohort at Nottingham but I hope similar studies will take place at other universities in the future.

Once again, I’d like to extend my thanks and gratitude to the RCVS Mind Matters Initiative team for help with funding and publishing the blogs, the UoN Sports staff for allowing us to use their facilities at a reduced rate, all the sports societies’ presidents and captains for giving up their time. Georgie Bladon, Sabine Tötemeyer and Amy Sansby who were brilliant support and Caroline Quarmby for her volunteering to lead the circuit sessions. A big thank you to the VetFit team for their inspiration and support too. And of course, thank you to all the participants for giving their time and energy to the programme! 

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Figure 1. Thematic map

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change in score from Q1-Q3 (points)	Wellbeing change	Number of Individuals
8+	Unequivocally meaningful positive wellbeing change	5
3-7	Possibly meaningful positive wellbeing change	2
0-3	No meaningful change	3
(Negative) 3-7	Possibly meaningful negative wellbeing change	1

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*WEMWBS was developed by the Universities of Warwick, Edinburgh and Leeds in conjunction with NHS Health Scotland.