This article review will critically evaluate Combat College: Cognitive Fatigue as a Challenge in Iraq and Afghanistan War Veterans with Traumatic Brain Injury: Pilot Study Survey Results that was written by Dan Smee, Sandra Buenrostro, Thomas Garrick, Shoba Sreenivasan and Linda E. Weinberger. Smee et al’s (2013) hypothesis for this article is that many Iraq and Afghanistan war veterans with Traumatic Brain Injury (TBI) who face high intensity cognitive demands may result in cognitive fatigue which is more than likely to act as a barrier to college success (p.25).
The type of research that was being used to produce the results for this study was qualitative research. The method Smee et al (2013) used for participants taking part in the study was a pilot study survey with open-ended questions designed to gather information that was specific to the individual participants like the academic struggles that many veterans had experienced since returning home from one of the conflicts (p.28). Smee et al’s (2013) pilot study survey also included questions that were related to cognitive fatigue symptoms (p.28). The analysis Smee et al (2013) conducted for this pilot study survey analysed whether or not many participants had the symptoms of cognitive fatigue after concentrating on an academic task (p.28). According to Smee et al (2013), these symptoms included feeling mentally drained; experiencing severe headache; becoming irritable or short-tempered; and feeling worn out physically (p.28).
Smee et al (2013) found that Eighty-six per cent of the veterans reported maths as the most difficult subject whilst only thirteen per cent of veterans reported English to be their most difficult subject (p.28). Smee et al’s (2013) results show that the majority of those surveyed experienced symptoms of cognitive fatigue that included being mentally drained (sixty-nine per cent); experiencing severe headache (fifty-six per cent); irritability/short-temper (sixty-nine per cent); feeling worn out physically (sixty-two per cent) (p.28). Smee et al (2013) found an additional symptom that was experienced by many of the participants included light-sensitivity that was beyond the symptoms experienced by those who suffered from cognitive fatigue (p.28). Smee et al (2013) suggest that because of the impact TBI had on participants, twenty-five per cent of participants dropped out of college as a result of their ability being impaired to complete their courses (p.28). What was also interesting about Smee et al’s (2013) results was that fifty-seven per cent of chat room and/or electronic participants did not bother attending college for a quarter or semester because of a TBI issue (Smee et al, 2013, p.28). Finally, Smee et al (2013) found that forty-three per cent of those veterans in the eighteen-twenty-five age range who were in the nationwide peer support chat room group indicated that they were not connecting with other peers (p.28).
Therefore, one of the strengths behind this study is that it demonstrates that the results are reliable to a certain extent. Smee et al’s (2013) results show that veterans with TBI who suffer from cognitive fatigue have a significant impact upon veterans when they are trying to conduct high intensity college tasks (p.29). As a result of the strengths behind the external validity of this study in showing how real the condition is for many veterans, the study’s results can now be applied to other people. Smee et al (2013) suggest this can include college programs and services to meet veterans’ needs such as de-stigmatising TBI by educating veterans about the relationship between TBI and high intensity cognitive demands that can ultimately lead to academic failure (p.29).
Smee et al’s (2013) other suggestions that have been put forward to help veterans as a result of the strengths behind the external validity of this study includes a veteran buddy system that can assist Iraq/Afghanistan war veterans on how to navigate academic requirements and college resources through the use of cooperative learning strategies as well as resilience builders which are marketed to veterans by stressing the benefits of cognitive strength rather than addressing weaknesses (p.30). The results of Smee et al’s (2013) pilot study survey found an additional factor that impacted upon those suffering from cognitive fatigue: the reluctance of veterans to admit that they have a disability due to the ‘warrior weakness’ of many veterans who perceive themselves as warriors rather than feeling weak in having a disability (p.29).
This study was conducted using a method of triangulation as there were multiple observers throughout this study instead of one. This was one of the strengths behind Smee et al’s (2013) survey as it allowed the authors to examine multiple factors that can affect veterans with TBI such as cognitive fatigue and the impact that this has on academic success (p.27). As a result of there being multiple observers and factors explored, the strength behind the study was that it allowed multiple theories to help those with TBI instead of just one theory. Smee et al’s (2013) theories included helping educators to become aware of combat-based brain injuries and assisting them with their time management and organisation through weekly schedules of research papers, tests and quizzes (p.31).
Despite being a pilot study, this study had certain strengths that can be applied to future studies and has many implications for those who want to gain a better education. However, there were certain weaknesses behind the study being a pilot one which led to many problems behind the internal validity of the study. In order to improve its internal validity, a larger sample size would be needed in the future and improved surveying methods such as interviews that allow participants to talk about their personal experiences rather than putting them under academic pressure as Smee et al (2013) acknowledge (p.31). Due to a lot of veterans experiencing stigma about having TBI, the sample size for Smee et al’s (2013) study was not large enough and that is why it might be an advantage in the future to identify colleges and universities that have large numbers of veterans with TBI and using presentations at such institutions to stress the importance of having participants in these studies (p.31). Despite being only a pilot study, this study has the potential in the future to be advantageous to exploring the effects of TBI on war veterans and by improving factors like methods used and sample sizes, the results of future studies may be a lot better.
The conclusions that the Smee et al (2013) have reached is that the mental discipline veterans learn in the army gives them the advantage to do very well in their academic studies (p.32). However, due to the effects cognitive fatigue has on veterans, Smee et al (2013) recognise that it reduces their ability to do well academically and that is why it is essential for veterans to have programs adapted to their needs to help them do well at college and university (p.32). These conclusions are suitable based on the critique of this article. That is because the internal validity of this pilot study shows that many veterans with TBI experience problems in admitting that they have a disability that can impact upon their ability to study when they took part in the survey even though the sample size was very small due to it being a pilot study. The reliability of Smee et al’s (2013) results showed that many veterans had suffered from symptoms like short-temperedness, headaches and being mentally drained that impacted on their ability to study (p.28). That is why the conclusions Smee et al (2013) have reached are suited to the critique of this study because programs like SALUTE can really help veterans improve their time management and organisational skills through online resources that can aid them with time management (p.31).
Smee, Dan, Buenrostro, Sandra, Garrick, Thomas, Sreenivasan, Shoba and Weinberger,
Linda E. (2013). Combat College: Cognitive Fatigue as a Challenge in Iraq and Afghanistan War Veterans with Traumatic Brain Injury: Pilot Study Survey Results. Journal of Applied Rehabilitation Counselling, 44 (4), 25-33.