Supportive Peer Research Articles

Introduction to the Coproduction of Supervision Standards for Digital Peer Support: Qualitative Study.

Digital peer support enhances engagement in mental and physical health services despite barriers such as location, transportation, and other accessibility constraints. Digital peer support involves live or automated peer support services delivered through technology media such as peer-to-peer networks, smartphone apps, and asynchronous and synchronous technologies. Supervision standards for digital peer support can determine important administrative, educative, and supportive guidelines for supervisors to maintain the practice of competent digital peer support, develop knowledgeable and skilled digital peer support specialists, clarify the role and responsibility of digital peer support specialists, and support specialists in both an emotional and developmental capacity. Although digital peer support has expanded recently, there are no formal digital supervision standards. The aim of this study is to inform the development of supervision standards for digital peer support and introduce guidelines that supervisors can use to support, guide, and develop competencies in digital peer support specialists. Peer support specialists that currently offer digital peer support services were recruited via an international email listserv of 1500 peer support specialists. Four 1-hour focus groups, with a total of 59 participants, took place in October 2020. Researchers used Rapid and Rigorous Qualitative Data Analysis methods. Researchers presented data transcripts to focus group participants for feedback and to determine if the researcher's interpretation of the data match their intended meanings. We identified 51 codes and 11 themes related to the development of supervision standards for digital peer support. Themes included (1) education on technology competency (43/197, 21.8%), (2) education on privacy, security, and confidentiality in digital devices and platforms (33/197, 16.8%), (3) education on peer support competencies and how they relate to digital peer support (25/197, 12.7%), (4) administrative guidelines (21/197, 10.7%), (5) education on the digital delivery of peer support (18/197, 9.1%), (6) education on technology access (17/197, 8.6%), (7) supervisor support of work-life balance (17/197, 8.6%), (8) emotional support (9/197, 4.6%), (9) administrative documentation (6/197, 3%), (10) education on suicide and crisis intervention (5/197, 2.5%), and (11) feedback (3/197, 1.5%). Currently, supervision standards from the Substance Abuse and Mental Health Services Administration (SAMHSA) for in-person peer support include administrative, educative, and supportive functions. However, digital peer support has necessitated supervision standard subthemes such as education on technology and privacy, support of work-life balance, and emotional support. Lack of digital supervision standards may lead to a breach in ethics and confidentiality, workforce stress, loss of productivity, loss of boundaries, and ineffectively serving users who participate in digital peer support services. Digital peer support specialists require specific knowledge and skills to communicate with service users and deliver peer support effectively, while supervisors require new knowledge and skills to effectively develop, support, and manage the digital peer support role.

A Daily Breathing Practice Bolsters Girls’ Prosocial Behavior and Third and Fourth Graders’ Supportive Peer Relationships: A Randomized Controlled Trial

ObjectivesIn order to promote mindfulness in primary school, the Breathing Break Intervention was developed. This collection of short daily breath-based mindfulness practices was introduced to 15 teachers who delivered them up to 3 times a day to their students.MethodIn a randomized controlled trial, 146 third and fourth graders (49% female) either received the intervention (n = 81) or participated in the active wait list control group (n = 65). Students were asked to nominate prosocial peers and to report on supportive peer relationships in their classrooms before (pretest) and after (posttest) the 9 weeks of the Breathing Break Intervention, and in a follow-up 5 months later.ResultsMixed multilevel models indicated a group × sex × posttest interaction (t(211) = 2.64, p < 0.01) suggesting that girls in the intervention group were rated to be more prosocial by their peers at posttest than at pretest and than girls in the active control group when children’s age and parents’ education were accounted for. Supportive peer relationships in the active control group deteriorated between pretest and posttest, which occurred immediately before the second school lockdown due to the COVID-19 pandemic, whereas they remained the same in the intervention group (t(223) = 2.56, p < 0.05). Both effects were not maintained at follow-up, probably due to children’s irregular school attendance during the lockdown.ConclusionsIntroducing a short daily breathing practice in primary school classrooms seems to be effective in maintaining supportive peer relationships and in stimulating girls’ prosocial behavior.PreregistrationThe study was preregistered at aspredicted.org (#44925).

Second language learning role-play: effects of patient and doctor roles on motivation and competence.

Role-playing has motivated foreign language learners for decades. In doctor-patient medical consultation role-plays, the doctor role has always been considered an important learning opportunity, whilst the patient role remained obscured. Our study, therefore, had a dual focus. We first explored how intrinsic motivation changes medical second-language (L2) learning through the lens of self-determination theory. We subsequently examined if playing the role of the patient provides additional value to medical L2 learning. We performed a mixed-methods study using a one-group pretest-posttest design. Participants were 15 student volunteers learning medical Dutch through peer role-play in medical consultations. Students completed a questionnaire before and after the course that measured changes in their intrinsic motivation to experience stimulation (IMES), feeling of relatedness, and feeling of competence. We also measured students' competence through a peer-rated checklist and the final course grades. At the end of the course, the students participated in semi-structured interviews to discuss their experience acting as patients. The data were subjected to the Wilcoxon signed-rank test and a thematic analysis. The pre- and post-questionnaires revealed that students' IMES as well as their feeling of relatedness increased. Their self-perceptions, feeling of competence, peer assessments, and final course grades demonstrated that students were competent in medical L2. Our thematic analysis led to the identification of five themes of the role-play exercise for medical L2 learning: (1) motivational experience, (2) supportive peer interaction, (3) setting up a role-play environment for medical L2 learning, (4) utilizing the patient role to benefit medical L2 learning, and (5) a novel patient perspective on the doctor's role. Our study found that role-play, by enhancing students' intrinsic motivation, feeling of relatedness, and competence development, aids the medical L2 learning process. Interestingly, playing a patient role in medical consultation was also found to support this process. We welcome future controlled experiments to confirm the positive impact of playing the role of the patient in medical consultation.

Social Media Use for Cancer Support Among Young Adults with Cancer.

Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.

Medication as a social prosthesis: People with Parkinson's negotiating medication

In this article we describe the emotions, responses, and reactions inherent in everyday life, enabled through medication use (mainly levodopa) by people with Parkinson's disease. Ethnographic observations revealed that, rather than taking levodopa on a prescribed schedule, participants learned how and when to take supplemental doses in order to feel and function naturally as they did pre-Parkinson's. Participant observation was conducted with 25 individuals with Parkinson's disease. Data included interviews, observations, photos, and videos. Constructivist grounded theory analytic procedures generated a three-phase process with a theoretical core of Medication as a Social Prosthesis, using “prosthesis” metaphorically. First, Grasping the Situation, is a process of reading bodily symptoms, learning personal and physical constraints, understanding the limits of medication, and finding supportive peer consultations. During the second phase, Gaining Competence, participants learned to synchronize medications with planned activities to counter their symptoms. This behavior was risky and required backup plans for accessing emergency medication. The last phase, Embodying Medication, describes the integration of medication into each person's identity and enabled social functioning despite advancing disabilities. In this way, the frequency and dosing of the medication was controlled by each person, and not the medical prescriber, according to personally defined needs to preserve self.

“I just need a little more support”: A thematic analysis of autistic students’ experience of university in France

BackgroundWhilst little is known about the experience and needs of autistic students in France, limited research has explored the experiences of autistic students in French higher education. The current study sought to fill this gap in the literature using a qualitative research design to ask: how do autistic students experience higher education in France? MethodSemi-structured interviews were conducted with 15 autistic students (8 female, 2 male & 5 ‘other’). ResultsThematic analysis identified four themes: Searching for belonging, Autism identity and disclosure, Managing anxiety and fatigue, and Working with others. The analysis describes the complex journey that participants faced when accessing and completing higher education in France. Whilst the journey was often characterized by intense anxiety and fatigue, the experience of university could also facilitate access to new academic interests, and the opportunity to connect with likeminded individuals perhaps for the first time. ConclusionsResults from the current study can contribute to the development of policy and practice that aims to better support autistic students in higher education. Of note, autistic students highlighted their elevated risk of drop-out owing to anxiety and fatigue caused by: difficulties planning and managing workload, sensorial overwhelm and administrative stress. Participants therefore highlighted the need for proactive personalized support and the need for supportive peer relationships.

Friends, peers and safeguarding

Friends, peers and safeguarding

Digital health innovation to prevent relapse and support recovery in young people with first-episode psychosis: A pilot study of Horyzons-Canada

Digital health innovations may help to improve access to psychosocial therapy and peer support; however, the existence of evidence-based digital health interventions for individuals recovering from a first-episode psychosis (FEP) remains limited. This study aims to investigate the feasibility, acceptability, safety, and pre-post outcomes of Horyzons-Canada (HoryzonsCa), a Canadian adaptation of a digital mental health intervention consisting of psychosocial interventions, online social networking, and clinical and peer support moderation. Using a convergent mixed-methods research design, we recruited participants from a specialized early intervention clinic for FEP in Montreal, Canada. Twenty-three participants (mean age = 26.8) completed baseline assessments, and 20 completed follow-up assessments after 8 weeks of intervention access. Most participants provided positive feedback on general experience (85%, 17/20) and the utility of Horyzons for identifying their strengths (70%, 14/20). Almost all perceived the platform as easy to use (95%, 19/20) and felt safe using it (90%, 18/20). There were no adverse events related to the intervention. Participants used HoryzonsCa to learn about their illness and how to get better (65%, 13/20), receive support (60%, 12/20), and access social networking (35%, 7/20) and peer support (30%, 6/20). Regarding adoption, 65% (13/20) logged in at least 4 times over 8 weeks. There was a nonsignificant increase in social functioning and no deterioration on the Clinical Global Impression Scale. Overall, HoryzonsCa was feasible to implement and perceived as safe and acceptable. More research is needed with larger sample sizes and using in-depth qualitative methods to better understand the implementation and impact of HoryzonsCa.

Early adolescents' perspectives on factors that facilitate and hinder friendship development with peers at the time of school transition

Supportive peer relationships are fundamental for mental health and well-being. Hence, peers and friends are a valuable resource, especially at the time of transition from primary to secondary school. Yet, current literature lacks both novel approaches to studying friendship development and how to involve early adolescents in research that is being conducted about them. Within the present study we used novel participatory research methods involving early adolescents who were active in the analysis of their own generated data. We aimed to better understand their perspectives on factors that facilitate and hinder friendship development with peers during the time of school transition between primary and secondary schools. A total of 916 pupils (Mage = 10.44 years, range = 9–16) participated in 54 participatory workshops that were conducted in Austria. We used reflexive thematic analysis to analyze qualitative data from portions of a large series of participatory workshop activities. Moreover, we actively involved participants in the analysis of their own generated data. Themes were structured into personal, interpersonal, and external factors. We found that early adolescents valued kind peers that (a) give them a feeling of safety, (b) show supportive and empathic actions, (c) manage conflicts, (d) avoid negative behavior, (e) spend time with them, and (f) communicate in the offline and online environments. Although shared norms of behavior can support friendship development, friendship jealousy and tolerating bigger friendship groups were identified as important potential barriers. Additionally, external factors (i.e., given circumstances), such as similarities, physical proximity, and duration of acquaintance were included in our data but were perceived as less important by early adolescents. Our results supplement the existing peer relationship literature by showing which factors early adolescents themselves chose as most relevant for friendship development. We conclude with a discussion regarding the implications for school psychology practice and future research.

Optimizing Workplace Support for Breastfeeding in Female Worker; A Narrative Review

Introduction: The increasing participation of women in the labour market has led to a growing trend of female employment. This has a significant impact on women’s roles as mothers, particularly breastfeeding mothers. Objective: This review aims to discuss the benefits and challenges of breastfeeding faced by female workers in the workplace and how to counter itDiscussion: Breastfeeding in the workplace has several advantages for mothers, which may act as an incentive to combine breastfeeding and work. The advantages include reduced absenteeism, increased productivity, and decreased turnover rates. However, breastfeeding in the workplace presents several challenges, including the lack of research on the topic, the lack of support from employers, distance between home and work, the lack of lactation facilities on-site, and reduced milk production during work hours. This situation drives the development of a lactation promotion model that can support breastfeeding in the workplace. The lactation promotion model, comprised of seven major components, can be implemented in the workplace to increase exclusive breastfeeding and boost female worker productivity. Conclusion: It is recommended to give workers with under-6-month children the option of working part-time or returning home earlier and for companies to provide lactation support staff, educational materials, and peer support groups to help working mothers breastfeed at work. The role of company occupational doctors takes a very important place in this lactation promotion model to achieve high breastfeeding rate in female workers.

Adolescent mental health in military families: Evidence from the Canadian Health Behaviour in School-aged Children study.

To investigate the association between physical and mental health symptoms in adolescents and having a parent in the Canadian Armed Forces and the moderation of these associations by various sources of social support. We used data on a nationally representative sample of 18,886 adolescents (11-15years) in the 2017/18 Canadian Health Behaviour in School-aged Children study (HBSC). Survey assessments included multi-item scales of mental and physical health symptoms and sources of social support (peers, families, classmates, and teachers). Poisson regression was used to estimate incidence rate ratios (IRR) of weekly symptoms in military versus non-military youths. Moderation of differences between these groups were tested using interactions of variables representing support and military families. Military youth, compared to non-military youth, reported more mental health symptoms (IRR = 1.20; 95% CI 1.08, 1.33) but only marginally more physical symptoms (IRR = 1.15; 95% CI 1.00, 1.33) in the previous week. These associations were stronger in youths who reported lower levels of peer support (IRR = 0.99; 95% CI 0.98, 1.00 [mental health symptoms]; IRR = 0.98; 95% CI 0.97, 1.00 [physical health symptoms]). Support from families, classmates and teachers did not moderate differences in mental or physical symptoms. Canadian adolescents in military families have increased risk for experiencing poor mental health. Peer support may play a protective role, however further research is needed to guide clinical interventions for this unique population.

PrEP and HIV prevention decision-making among social network members of women who have experienced incarceration: a qualitative study

ABSTRACT Incarceration and HIV are a syndemic for US women, yet very few women who have experienced incarceration use pre-exposure prophylaxis (PrEP) for HIV. We conducted semi-structured interviews with 32 participants recruited by women who have experienced incarceration from their social networks, informed by the modified social ecological model for PrEP. Emergent themes from the interviews included individual-level (low personal HIV risk assessment, personal responsibility for HIV prevention, and decisions in addiction versus recovery), network-level (influential sex partners and the importance of trust, supportive treatment peers, and high-risk but indifferent drug use networks), community-level (stigma, and mitigation of stigma in supportive substance use disorder treatment environments), and public policy-level (incarceration and PrEP cost and access) determinants. PrEP interventions for women who have experienced incarceration and their networks will need to incorporate contingency planning into HIV risk assessment, navigate complex network dynamics, and be situated in trusted contexts to address structural barriers.

Intergenerational Transmission of Child Abuse Among Married Women in South Korea: A Multigroup Analysis of Empathetic Communication (TSL: Thanks, Sorry, and Love).

Intergenerational transmission of child abuse (hereinafter referred to as ITCA) has been continuously reported. Supportive relations with others have also been discussed as a protective factor to prevent this cycle. However, research has mainly investigated supportive adult and peer relationships formed in childhood, with little discussion of the impact of supportive partner relationships formed after becoming an adult. This study examined whether empathetic communication (hereinafter referred to as TSL: "Thanks, Sorry, and Love") attenuates the transmission of married women's child abuse experiences to subsequent generations mediated by intimate partner violence (hereinafter referred to as IPV). TSL is a communication strategy that promotes positive communication between intimate partners. We expected TSL to promote positive communication between couples through a process of self-transformation. Data from 1,122 married women were obtained from a nation-wide survey conducted in South Korea. All the survey respondents lived with partners and their own children simultaneously. For this study, structural equation model multigroup analysis was conducted to determine whether the pathways would be attenuated by TSL levels, showing that a high level of TSL communication attenuated the ITCA mediated by IPV. However, this process was maintained in the low-level TSL group. TSL is thus a protective factor against the ITCA. The findings suggest that healing processes can occur not only through childhood relationships but also through those formed after adulthood. Ultimately, to help victims recover, it is necessary to expand communication programs such as TSL that help victims learn how to express their feelings through healthy relationships with their partners.

Human–AI collaboration enables more empathic conversations in text-based peer-to-peer mental health support

Advances in artificial intelligence (AI) are enabling systems that augment and collaborate with humans to perform simple, mechanistic tasks such as scheduling meetings and grammar-checking text. However, such human–AI collaboration poses challenges for more complex tasks, such as carrying out empathic conversations, due to the difficulties that AI systems face in navigating complex human emotions and the open-ended nature of these tasks. Here we focus on peer-to-peer mental health support, a setting in which empathy is critical for success, and examine how AI can collaborate with humans to facilitate peer empathy during textual, online supportive conversations. We develop HAILEY, an AI-in-the-loop agent that provides just-in-time feedback to help participants who provide support (peer supporters) respond more empathically to those seeking help (support seekers). We evaluate HAILEY in a non-clinical randomized controlled trial with real-world peer supporters on TalkLife (N = 300), a large online peer-to-peer support platform. We show that our human–AI collaboration approach leads to a 19.6% increase in conversational empathy between peers overall. Furthermore, we find a larger, 38.9% increase in empathy within the subsample of peer supporters who self-identify as experiencing difficulty providing support. We systematically analyse the human–AI collaboration patterns and find that peer supporters are able to use the AI feedback both directly and indirectly without becoming overly reliant on AI while reporting improved self-efficacy post-feedback. Our findings demonstrate the potential of feedback-driven, AI-in-the-loop writing systems to empower humans in open-ended, social and high-stakes tasks such as empathic conversations. AI language modelling and generation approaches have developed fast in the last decade, opening promising new directions in human–AI collaboration. An AI-in-the loop conversational system called HAILEY is developed to empower peer supporters in providing empathic responses to mental health support seekers.

The Social Side of Sleep: A Systematic Review of the Longitudinal Associations between Peer Relationships and Sleep Quality.

In adolescence, peer relationships become crucial since youths start to rely on their peers for support. Thus, multiple facets of adolescents' well-being are affected by their peer relationships. In this vein, one of the central well-being aspects that could be affected by the peer relationships of adolescents is sleep quality. Nevertheless, it is still unclear how multiple peer relationship factors (i.e., positive, negative, emotional, and behavioral issues related to peer relationships) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to summarize longitudinal studies to uncover how the interplay between peer relationship factors and adolescents' sleep quality unfolds over time. Nineteen longitudinal studies involving a total of 21,232 adolescents were included. Overall, findings from this review showed that (a) positive peer relationships and sleep quality were not associated over time; (b) negative peer relationships and sleep quality were bidirectionally associated over time; (c) few studies evaluated the bidirectional relations between emotional and behavioral issues and sleep quality, showing links with sleep schedule and duration, but not with sleep quality. Meta-analytic results were discussed, considering their implications.

Behind the Scenes of Flexible Classrooms: Higher Education Students Supporting Peers

It is a reality that the abrupt changes in the educational delivery in higher education had been challenging to all stakeholders, particularly the students. This compelled not only academic but also social support to find alternative platforms to reach out to the students amid new limitations and opportunities. Hence, this study looked into the nature of higher education students’ peer support in the context of flexible learning delivery. A phenomenological design was employed and data were gathered through semi-structured individual interviews with five students. Studies found that peer support in the context of flexible learning 1) offers the same content in new platforms; 2) reinforces the cycle of support through new challenges; 3) requires sacrifice through sharing of time; and 4) builds character and competence. Online platforms provide new spaces for students to support peers, in recognition of shared struggles and adjustments in the flexible delivery mode. This is highly important for students especially as flexible learning makes new demands on the student’s time and responsibility for learning. These findings could inform the HEI’s development of student support policies to help perpetuate this culture of peer support for mutual success. Keywords: peer support; online learning; distance learning; higher education

Lien entre sources proximales de soutien social et désengagement scolaire : le sentiment de privation relative comme signal d’alerte

IntroductionYouth school disengagement is a matter for concern. The contribution of the present argumentation is to articulate research from educational psychology on the links between sources of social support and school engagement with some models from social psychology on social stigmatization in order to propose an integrative view of school disengagement. A section will be devoted to the link between each of the student's proximal sources of social support (teachers, peers, parents and family group memberships) and school engagement. It will then be argued that this link could be mediated by feelings of relative deprivation, i.e., feelings of being unfairly treated compared to more advantaged classmates. DiscussionThe articulation of research in educational psychology and social psychology allows to argue that if a student feels less well treated than his or her classmates by parents, peers, teachers or because of group membership, he or she is likely to withdraw mentally from school (or disengage psychologically) and to disengage academically by engaging in disruptive behaviors. ConclusionThe feelings of relative deprivation experienced by the student who feels deprived in the perceived social support related to his or her school life could serve as a warning signal of school disengagement risk.

Evidence-based Practice among Clinical Nurses in Bahrain: Basis for a Policy Brief

The study aimed to determine clinical nurses' beliefs, knowledge, organizational readiness, and evidence-based practice implementation levels and identify the perceived factors affecting evidence-based practice implementation. A descriptive-correlational in quantitative approach with triangulation was used. Data were gathered through the administration of adapted survey questionnaires along with structured interviews and personal observation to supplement the data. Forty-two voluntarily participated and completed the survey. Frequency, percent, mean, and standard deviation were used to analyze and interpret the participants' demographic profile and evidence-based practice-related variables. Regression analysis was used to identify the predictors from the list of variables. For facilitating and hindering factors in the evidence-based practice implementation of clinical nurses, an open-ended question was asked to triangulate the quantitative data. Most of the nurses are female in their middle adulthood, have completed a bachelor’s degree in nursing, and have worked in the hospital as a senior staff nurse for considerable time. The result shows that nurses somewhat truly believe in evidence-based practice, have acceptable evidence-based practice knowledge, probably consider the culture and organizational readiness, and are interested in implementing specific evidence-based practice tasks. Also, it was found that only knowledge of evidence-based practice is a highly significant predictor of evidence-based practice implementation. Perceived facilitating factors include supportive policies, training opportunities, management, and peer support. At the same time, lack of knowledge and insufficient time were recorded as barriers to implementing evidence-based practice. The salient findings were used in crafting the policy brief.

중학생이 지각하는 사회적 지지와 행복감의 구조적 관계

Objectives The purpose of this study is to verify the structural relationship among middle school student’s social support(parental, peer and teacher support), self-esteem, and happiness.&#x0D; Methods For this purpose, the structural equation modeling was applied to the wave 2 of 1st grade middle school students panel of the Korean Children and Youth Panel Survey 2018(N=2,438) conducted by the Korea Youth Policy Research Institute.&#x0D; Results Result are as follows. While student perception of self-esteem had a significant positive effect on happiness, student perception of social support(parental, peer, and teacher) did not have a significant effect on happiness. And while student perception of parental, peer support did not have a significant direct effect on happiness, it shows a significant indirect effect on happiness through self-esteem as a mediator. Student perception of teacher support did no have a significant effect on happiness both of direct and indirect.&#x0D; Conclusions Based on the results of the study, the implication to improve happiness of middle school students and suggestions for future research are discussed.

Using a Student-Developed Case Study Activity for Online Discussion Guided by a Three-Tier Case Method Model

This qualitative study examines student learning experiences toward a student-developed case study activity for online discussion guided by a three-tier case method model. Forty-five students were recruited from four online adult education courses. Analysis of students’ feedback shows that this activity leads to students’ positive learning experiences, including provoking critical thinking towards the discussion topic and providing unique resources for adult educators. The student-developed case study activity also helps establish a supportive peer relationship and engages students through analyzing a variety of student-developed cases, as well as interacting with the instructor and exchanging ideas with peers. This study furthermore indicates the potential usefulness of the proposed model as a guide for case study activities in the field of adult education and beyond.