Healthy teachers, higher marks report

This literature review, undertaken by us in partnership with The Work Foundation, focusses on the relationship between teacher health and wellbeing and student educational outcomes. 

Executive summary

In the current educational environment where schools are trying to increase student attainment with a diminishing budget, it is essential that schools make the most from their key resource: teachers.  Consequently, investigating if there is a link between teacher health and wellbeing and student outcomes is timely.

From an organisational perspective, employee wellbeing is an important factor in quality, performance and productivity.  Wellbeing is strongly related to work stress, a key player in employee absence.  Consequently, developing and maintaining ‘healthy workers’ for good quality work, reduced sickness absence and positive performance outcomes is of great importance.

Although a widespread expectation between positive teacher wellbeing and student attainment exists, there is very little direct evidence suggesting that teacher wellbeing has a positive impact on student outcomes:

  • Briner and Dewberry (2007) found a statistically significant positive relationship between staff wellbeing and student SAT outcomes; however methodological limitations meant that the causal relationship could not be determined.

  • Ostroff (1992) reported a significant link between job satisfaction and performance, but as the study was not longitudinal it was not possible to assign causality.

  • Bricheno et al., (2009) stated all the respondents in their interview study reported that teacher wellbeing has an impact on student outcomes, however less than a quarter were able to reference any support for their belief.

Teacher absence is sometimes used as a measure of teacher health and wellbeing, and the use of supply teachers to cover absence can have an impact on student outcomes.  A report by Estyn (2013) provides a number of reasons for this including: supply teachers not knowing the needs and abilities of the students, setting unchallenging work and having limited time to develop meaningful relationships with students to identify where their strengths and weaknesses lie.

Even though a number of studies have provided evidence that support the widespread expectation, each had methodological limitations.  Consequently, there remains a need for further research to be conducted examining whether a causal relationship between teacher wellbeing and student outcomes exists.

A comparison is drawn with healthcare, a sector which has many similarities to teaching (both involve high professional-to-client’ interaction, have high reported levels of absenteeism and have Government quality standards to reach) and where the relationship between staff health and wellbeing and patient outcomes has been extensively studied, providing stronger causal links between staff health and wellbeing and positive patient outcomes.

Boorman (2009) conducted a thorough review of the health and wellbeing of National Health Service (NHS) staff and found that NHS staff display high levels of sickness absence, with nearly half of these resulting from musculoskeletal disorders and more than a quarter from stress, depression and anxiety.  The analysis found a clear relationship between staff health and wellbeing and patient outcomes (based on data sets such as patient satisfaction surveys, infection rate levels and the Annual Health Check ratings).

Since the Boorman (2009) review, workplace guidelines have been developed addressing issues seen as important for NHS staff.  In NHS organisations where wellbeing interventions were implemented, improvements in staff health and wellbeing were reported, however little research has directly examined whether the interventions directed at staff also improved patient safety outcomes.

Further evidence suggests that when staff are engaged in developing service improvements, staff were less likely to suffer from work related stress and more likely to report their health and wellbeing highly.  Additionally, in NHS organisations where staff engagement was high, patient satisfaction and quality of service were significantly higher, and mortality levels reduced.

As with teaching, sickness absence in the NHS has been reported as particularly high.  Research has indicated that the use of temporary staff (particularly agency staff) to cope with sickness absence can have negative implications for patient outcomes.  For example, temporary staff may not have the correct departmental experience, may not receive a ward induction or have the necessary (or up to date) training and have no knowledge of the ward environment, delaying patient care.  Additionally, temporary staff may add to the already mounting pressures on permanent staff, resulting in added stress and further negative staff morale.

The relatively limited research into teacher wellbeing and student educational outcomes highlights the need for further research in the area to ascertain whether the strong links regarding staff health and wellbeing and patient outcomes in the NHS are replicated in teaching.

Read the Literature Review in full