Students with Visual Impairments’ Self-esteem: Comparisons between Their and Their Teachers’ Evaluations, Before and After Participation in the Cycle of Internalized Learning Program

By Itay Hess and Shunit Reiter

Itay Hess, PhD, is a faculty member at the Levinsky College of Education, Israel.

Shunit Reiter, Professor (Emerita), is a faculty member in the Department of Special Education at the University of Haifa, Israel.

Abstract

A group of twenty-nine students and their five form teachers from a boarding school for adolescents with visual impairment (VI) and blindness in Israel participated in a special educational teaching program. The program is based on the principles of the Cycle of Internalized Learning (CIL) model (Reiter, 2016). The program consists of a teaching guide in line with constructivist principles of teaching and learning. The program aimed to enhance students’ self-esteem and attitudes towards their disability. The program was followed along by research, in which students and their teachers filled in questionnaires that evaluated these aspects and compared between them. The major findings indicated that at the end of the program the students’ exhibited higher scores on the social self-esteem scale and on their attitude towards disability scale. Teachers’ reports did not show any significant difference on their evaluations over time; however, at the end of the program positive correlations were found between the students’ and the teachers’ evaluations. The correlations between the students’ self-evaluations and the teachers’ evaluations were higher at the end of the program than they were at the beginning. A possible explanation can be that students learnt and internalized the perceptions of their teachers or, vice versa, the teachers might have internalized the perceptions of the students.

Keywords

Students with visual impairments, Cycle of Internalized Learning (CIL Model), self-esteem

Introduction

Until the beginning of the 21st century, the principles underlying the support systems for students with visual impairments (VI) and blindness were based on the medical model and were derived from the visual dysfunction approach (Corn, 1983). According to this approach, the most important aim of their education was to improve their ability to deal with their sight limitations. The role of teachers was thus to improve students’ functioning in their environment despite their sight limitations. This improvement was achieved, amongst other methods, by medical treatment that maximized residual sight (Corn, 1983) or by developing compensatory mechanisms by which they increased their ability to understand environmental hints and teaching them to exploit to the maximum unimpaired senses (Hess, 2010).

However, beginning in 2000, a new approach based on the humanistic paradigm was developed. Accordingly, the aim of their education was redefined in a holistic approach emphasizing their overall development and not only on improving their visual functioning (Reiter & Schalock, 2008; Reiter, 2016). The main principle of this new approach referred to the need to understand children and adults as complete entities, their capabilities and not only their disabilities, as well as their ways of interacting both socially and physically with the environment. Only then one should proceed to inquire about the implications of the visual impairment on the individual’s behavior (Hess, 2010; Reiter, 2016).

Enhancing Self-Esteem of Students with Special Needs and Students with VI

The term self-esteem may reflect one’s emotional evaluation of his or her worth and one’s sense of pride. Self-esteem is closely associated with one’s self-consciousness and psychological well-being (Augestad, 2017; Olsen, Breckler, & Wiggens, 2008). The concept of self-esteem combines both a judgment of the self as well as an attitude toward the self. Hence, a person’s self-esteem affects emotional adjustment, quality of life, adaptive behavior, social relations, school performance, and his or her coping with their disabilities (Brooks, 1992; Kupferberg & Hess, 2013; Papadopoulos, Metsiou, & Agaliotis, 2011).

The development of a sense of self-esteem is regarded as the first step in the young person’s readiness for a meaningful life. That applies to students with special needs in general (Field & Hoffman, 2010; Wehmeyer, Palmer, Shogren, Williams-Diehm, & Soukup, 2013) and to students with VI specifically (Augestad, 2017; Senra, Oliveira, & Leal, 2011).

Field and Hoffman (2010) presented five components in an empowerment model for students with special needs, structured hierarchically in the following order: know yourself, evaluate yourself, develop self-esteem, plan, and act to achieve your goals. Wehmeyer et al. (2013) also proposed an empowerment model based on children’s realistic attitudes toward themselves and their capabilities.

In an intervention model proposed by Dubé et al. (2007), and in later programs (Côté, Dubé, St-Onge, & Beauregard, 2013), emphasis is placed on developing students’ self-esteem through feedback from their peers and from professionals.

In spite of the importance of self-esteem to the development of students with VI,   only a few studies have been done in this area (Halder & Datta, 2012; Mishra & Singh, 2012). Furthermore, the need for continued research in this field emerges from conflicting results of research studies regarding the self-evaluations of students with VI (Senra et al., 2011). Some present findings in which students with VI have significantly lower self-esteem than peers (Lopez-Justicia, Pichardo, Amezcua, & Fernandez, 2001; Mishra & Singh, 2012). Other studies present opposing findings, arguing that students with VI show higher self-esteem then their peers (Datta & Talukdar, 2016). Furthermore, Lifshitz, Hen, and Weisse’s (2007) study found that students with VI had radically more positive self-esteem. They explained this by observing that teachers often use positive superlatives about these students’ work as well as being exceptionally complimentary about them compared to students with sight. Such circumstances distort students’ evaluation radically towards the positive. Another explanation emerges from Beaty’s (1991) approach, which argued that people with special needs are likely to develop ideal self-esteem as a means of defense against feelings of inferiority. Hess (2010) tried to examine realistic self-esteem by examining adjustments between how students evaluate themselves and how their teachers evaluate them. In a study conducted by Hess (2010) using in-depth interviews with visually impaired students, it was found that the students experienced acts of discrimination by others, both in their close milieu and in the more distant social environment. The conclusion was that students with VI who experience much discrimination tend to have distorted self-esteem, whether negative or positive. 

The Cycle of Internalized Learning Program (CIL) for the Empowerment of Visually Impaired Students in a Boarding School in Israel

Students with VI in Israel, who have no other limitations, are included in general education schools (Hess, 2010). Yet, there is one boarding school in the Jewish sector, which is attended only by students with VI who come from all over the country. Most of these students come from under-privileged socioeconomic backgrounds, have demonstrated low academic abilities in public education schools, and have experienced social and academic difficulties in regular school. They come to the boarding school with the goal that after a year or two, they can go back to their communities and re-enroll in their local schools. During one academic year, a special program based on the Cycle of Internalized Learning (CIL) Model was applied in that boarding school.

The main purpose of the program was for students to develop a realistic attitude regarding their visual impairment or blindness, while learning to appreciate their personal capabilities. The program had been carried out among other groups of people and students with special needs and was found to be efficient in enhancing participants’ self-evaluation (Shavit, 2013, August; Reiter, 2016).

The principal underlying the CIL program is that learning is a holistic endeavor. The use of the word cycle indicates that a unique characteristic of the method is its cyclical nature (i.e., repeating time and time again the same topic in different ways) of learning, such as by actual experience outside the classroom, role playing, academic learning, group, and individual learning. The subject matter under study is thus explored using various perspectives. The topic to be taught comes up in discussions and in conversations, it is both a subject studied as a lesson and as an experience. This enables many multi-faceted cyclical experiences, and not just the linear study of a subject to be memorized and tested on later in order to determine academic achievements. Using the cyclical approach, the students are given the opportunity to expand their repertoire of responses to the topic under discussion (Reiter, 2016). 

The CIL Model allows the teacher to work systematically based on the above principles. The assumption is that in order to internalize academic, theoretical, or practical material, learning must be meaningful and stem from the individual life experiences of students. Learning must help them reach an understanding of their environment and themselves, and assist them in forming their value systems. This process is mainly social and develops through interaction with others. Within a supportive group with a shared purpose, individuals in the group can construct an identity, deliberate over their ambitions, and examine their beliefs and values in comparison to those of others (Reiter, 2016). The CIL model is in line with the theory of constructivism in maintaining that the student is an active learner who builds and constructs his learning (Pritchard & Woollard, 2010). He is not seen as an organism reacting to stimuli, but rather as a complex organism coping with a complex environment and striving for meaning. Learners construct their concepts and understandings based on their experiences and in light of their goals. They do not absorb, store, and recycle knowledge; they interpret knowledge, improve their understanding, and examine their analyses. 

The following are the activity steps according to the CIL:

  1. Opening stage - Introducing the Subject
    The teacher/educator introduces a subject chosen for study by referring to two sources: the learners’ world and needs, and the school curriculum. In response to this selection, participants raise their own relevant personal experiences and associations. Their response is subjective and concrete. At this stage they express an initial, albeit diffusible, personal awareness.

  2. Discussion/Lesson
    At this stage, a lesson takes place, whereby the teacher teaches concepts, definitions, and generalities. This is done by isolating and defining the different components of the subject that relate to the participants’ experiences. In this way, both the teacher and the students enrich their knowledge of the learned subject. Social norms and accepted behaviors are also learned during this stage.

  3. Open Conversation
    The subject raised during the first meeting is now reviewed, and connected again to the students’ personal experiences and associations. The teacher encourages the students to raise personal issues, relate to themselves and others in a critical manner, and urges them to express personal wishes. Then, the students are invited to suggest ways they can review and relate through a social experience, an item of knowledge, or a performance of the subject studied. The teacher now returns to deal with the subject, while inserting changes and adjustments according to the suggestions and ideas raised by the students.

  4. Repeat Experience
    It is recommended to make this stage the active part of learning by going out on a field trip. If the subject studied is of a theoretical nature, then it is possible to go out on a professional tour. If the focus was on orientation in the community, then it is possible to tour and visit community institutions. If the subject learned relates to culture or leisure, it is possible to go on hikes or to places of entertainment such as shows, a mall, a restaurant, etc. Besides the field trips, it is possible to initiate and conduct special encounters, parties, birthdays, etc. Another way of activating the group is by conducting simulations and dramatic role-plays. It is important to review the subject learned, and use this time to incorporate the changes suggested by the group members.

  5. Repeat Discussions
    Following the actual experience, a repeated group discussion is conducted, this time to learn lessons from reviewing the learned subject. The teacher must now direct the discussion and encourage the participants to form an autonomous perspective and recognize their system of values and priorities (i.e., What is more important to me? What is less important to me?). This is all based on the personally acquired knowledge, the awakening of personal awareness, and the development of social sensitivity. 

  6. Product/Outcomes
    In the CIL, the emphasis is on outcomes and not only on achievements. The most obvious product of social education according to this method is the ability of the individual to activate the values that were internalized and formed during the educational process. Those values now become the student’s own parameters used when judging the situations in one’s own life—values that will be used to choose between alternatives and make independent decisions; values that direct one’s behavior according to personally defined goals and give the individual a sense of confidence in one’s own personal abilities. Among the important personality and value traits that are the desired products of the program are characteristics such as self-esteem, initiative, cooperation, and making concessions while insisting on personal boundaries. Parallel to the fostering of these traits, a range of skills and knowledge is also acquired. In this realm, it is possible to test the student’s achievements in a quantitative manner.

The CIL program that was specially designed for the present study dealt with the development of students’ self-esteem on several dimensions:

  1. The physiological side of disability - Medical tests and functional consequences. Raising awareness of opportunities to receive treatment, ways to improve the use of vision aids, and choosing methods for pain relief.
  2. Life in school - Capabilities and personal orientation. Coping with tests and grades.
  3. Stigma - Ways to deal with social reactions based on stigma and developing new social and interpersonal relationships.

The program was followed with research. The research question was: Following the participation in the CIL program, will the students exhibit higher self-esteem views of themselves and will the teachers raise their evaluations regarding the students’ self-esteem?

The hypotheses of the research were:

  1. Following the participation in the program, the students’ scores on the variables that related to aspects of self-esteem will be higher at the end of the program than at the beginning of the program.
  2. Following the participation in the program, the teachers’ evaluations of the students’ self-esteem as expressed in their interactions in the social area and their emotional reactions will be higher at the end of the program than at the beginning.
  3. Following the participation in the program, the correlations between the students’ self-evaluations and those of their teachers will be higher at the end of the program than at the beginning.

Method

A mixed method was applied in the present study utilizing both a statistical quantitative method and a qualitative method.

Quantitative Part of the Study

Participants

The school for students with visual impairments included thirty-four students. The study involved twenty-nine students age 12 to 17 in five classes, each class led by one teacher. Following the principal decision, five students who had personal difficulties and had to visit their families or be at home frequently, did not participate.

Tools

A. The Student Questionnaire
The questionnaire included the following scales:

  1. Attitude towards blindness and VI (Dodds, Bailey, Pearson, & Yates, 1991).
    The scale included eight items. For each item the students had to mark their level of agreement from 1 (strongly disagree) to 5 (strongly agree). The overall score on the scale comprised the mean score of the eight items. As this score approached 5, the attitude to the disability was more positive.

    Example of an item: “I am satisfied with what I can do; my visual impairment does not hamper me at all.”

    The Cronbach coefficient alpha of the previous study in Hebrew was .94 (Hess, 2010). In the current study, Cronbach’s coefficient alpha was found to be .85.

  2. The Self-Esteem Scales in the social and emotional areas (Rosenberg, 1965).

    The scale included seven items that measured self-esteem in two areas: four in the social area and three in the emotional area. For each item the students indicated the degree of agreement with each item from 1 (strongly disagree) to 7 (strongly agree). The overall score for the scale is the mean score for the items.

    An example of an item of self-evaluation on the social scale: “I am at least as important as other people.”

    An example of an item in the emotional area: “Sometimes I definitely feel worthless.”

    In a previous study, the Cronbach coefficients alpha of the two scales were.7 and .73 respectively (Hess, 2010). In the current study, Cronbach’s coefficients alpha were found to be .75 and .8 respectively.

B. The Teacher Questionnaire
The questionnaire included the following scales:

  1. Teacher evaluations of student social functioning (Zack & Horowitz, 1985).

    The scale included five items. For each item, the teachers were asked to score the extent of their agreement with the item about the particular student ranging from 1 (strongly disagree) to 4 (strongly agree). The overall score was the mean score for the five items.

    Example of an item: “The student is accepted by his peer group and can establish good mutual relations with them.”

    The Cronbach coefficient alpha for the scale reported for a previous study in Israel was .85 (Hess & Reiter, 2010). In the present study, the Cronbach coefficient alpha for the scale was found to be .75.

  2. Teacher evaluations of student emotional state (Zack & Horowitz, 1985).

    The scale included five items. For each item the teachers were asked to score the extent of their agreement with the item about the particular student ranging from 1 (strongly disagree) to 7 (strongly agree). The overall score was the mean score for the five items.

    Example of an item: "The student is anxious and worries about insignificant occurrences.”

    The Cronbach coefficient alpha for the scale reported for a previous study in Israel was .80 (Hess, 2010). In the present study, the Cronbach coefficient alpha for the scale was found to be .75.

    A summary of the tools used in the study is provided in Table 1.

Table 1: Research Tools Summarized

Variables

Source of Tool

Source of Tool (Hebrew Version)

Cronbach’s Alpha

Cronbach’s Alpha in Current Research

Students’ report: Self-esteem on the social area

The Self-Esteem scale (Rosenberg, 1965).

Hess (2010)

0.8

0.77

Students’ report: Self-esteem on the emotional area

The Self-Esteem scale (Rosenberg, 1965).

Hess (2010)

0.8

0.85

Students’ report: Attitude towards blindness and VI

Dodds et al., (1991).

Hess (2010)

0.9

0.85

Teachers’ evaluations on students’ social area

-

Zack & Horowitz (1985)

0.8

0.82

Teachers’ evaluations on students’ emotional area

-

Zack & Horowitz (1985)

0.8

0.71

To summarize, the use of the student and teacher questionnaires in the present study established the reliability of these tools and their use in the population in this study.

Procedures

After preliminary meetings with the school head mistress, and obtaining her approval and enthusiastic support for the innovative program and the accompanying research, the program began.

As the school year started, three meetings with the school staff took place, each four hours long. Preparations included introducing the program and its approach, as well as explanations about the research accompanying the program with the aim of enlisting their cooperation with filling out the research questionnaires and reports. Then, in the following week, the questionnaires were distributed for the first time to the students and their teachers. The student questionnaires were adapted in certain ways, with the print enlarged, or questions read aloud by the teachers. In addition, each teacher filled out the teacher questionnaire.

Then, the program started and ran for 14 weeks. After 14 weeks, the research questionnaires were distributed again (identical to those given out at the beginning of the program) both to the students and to their teachers. In addition, towards the end of the program a focus group of the five form teachers who participated in the program met.

Research Ethics 

This study was carried out according to the ethical Principles for Medical Research Involving Human Subjects laid down in the Declaration of Helsinki, approved by Helsinki Committee on Human Research at the Research Authority, University of Haifa, Israel. This included omitting all identifying information relating to the students and teachers. The parents (or guardians) of the students who took part in the study signed a consent form for participation. In addition, the students were involved in discussions about the research and gave their permission to participate in the program. 

Results

Hypothesis 1: Following participation in the program, the students’ evaluation of the variables related to aspects of self-esteem will be higher at the end of the program than at the beginning of the program.

In order to examine this hypothesis, paired t-tests were carried out to compare the means scores of students’ evaluations before and after the program. The findings of the analysis are summarized in Table 2.

Table 2: Paired Samples T-Tests for the Self-Esteem on the Social and Emotional Areas and Attitude Towards Blindness and VI: Before and After the Program

Measure

Means (SD) Before the program

Means (SD) After the program

Means differences

Standard errors

df

t-values

Cohen’s d

Self-Esteem on the Social area

3.7 (1.05)

5.4 (1.28)

1.7

0.11

28

1.72*

1.12

Self-Esteem on the Emotional area

3.9(1.02)

4.1 (1.18)

0.2

0.13

28

0.5

-

Attitude towards blindness and VI

3.07 (1.07)

4.42 (1.31)

1.35

0.25

28

2.9**

1.32

Note:    *p < .05; **p < .01

Table 2 demonstrates that the mean score for self-esteem in the social aspect after the program (M = 5.4, SD = 1.28) was higher than the mean score when measured at the beginning (M = 3.7, SD = 1.05). The difference between the means was statistically significant (t(28) = 1.72, p < .05, Cohen’s d = 1.12). The difference in the mean score for self-esteem in the emotional area after the program (M = 4.1, SD = 1.18) was not more statistically significant than it measured at the beginning (M = 3.9, SD = 1.02), (t(28) = .5, p > .05). In addition, the mean score for attitude towards blindness and VI after the program (M = 4.42, SD = 1.31) was higher than the mean measured at the beginning (M = 3.07, SD = 1.07). The difference was statistically significant (t(28) = 2.9, p < .01, Cohen’s d = 1.32). 

Hypothesis 2: Following participation in the program, the teachers’ evaluations of the students in the social and emotional area will be higher at the end of the program than at the beginning.

In order to examine this hypothesis, paired t-tests were carried out to compare the mean scores of teachers’ assessments before and after the program. The results were found to be statistically non-significant. Therefore, the hypothesis was not supported by the results.

Hypothesis 3: Following the participation in the program, the correlations between the students’ self-evaluations and those of their teachers will be higher than at the beginning of the program.

In order to examine this hypothesis, we calculated the correlations between the scores of the students’ self-evaluations and the scores of the teachers’ assessments, both before and after the program. The findings are presented in Table 3.

Table 3: Correlation Coefficients Between Students’ Self-evaluations and Their Evaluations by Their Form Teachers: Before and After the Program (N = 29).

Students’ self-reports

Teachers’ evaluation

Correlation before

Correlation after

Z for Differences

Social area

Social area

-0.13

.53*

2.02*

Emotional area

Emotional area

-0.16

.48*

1.67*

Note:    *p < .05

It can be seen in Table 3 that whereas before the program there was no significant correlation between the students’ self-evaluation in the social area and the evaluations made by their teachers (r = -.13, p > .05), following the program there was a significant correlation between these variables (r = .53, p < .05). The Z test for the differences in correlations before and after the program was also found to be statistically significant (Z = 2.07, p < .05). Similarly, it can be seen that while there was no significant correlation between the students’ self-evaluation in the emotional area and the evaluations made by their teachers (r = -.16, p > .05), following the implementation of the program there was a significant correlation between these variables (r = .48, p < .05). The Z test for the differences in correlations before and after the program was also statistically significant (Z = 1.67, p < .05). 

Qualitative Part of the Study

The Teachers’ Focus Group 

We convened a focus group to enable teachers to have a free discussion about the influence of the program and other issues they thought relevant. 

Data Collection 

At the end of the program, the teachers were invited to participate in the focus group held in the school conference room, which lasted 90 minutes. The meeting included three parts (Patton, 2002): opening, discussion, and closing. A written record was kept of the entire encounter. During the first part of the meeting, the rationale of the focus group was described to the teachers and their background data reconfirmed. They had similar ages and social backgrounds, coming from the same town with the same training in special education, only having worked for different lengths of time at the school. During the second part, the teachers were encouraged to talk about their impressions of the program and to evaluate its effects, including everything they thought might be relevant. Throughout the meeting, we raised questions for clarification to encourage willingness to make comments and offer opinions freely. The questions were framed neutrally (e.g. "How do you feel?", "Do you feel the same?", and "Do you want to add something?"). Finally, we reiterated the main points of the teachers’ comments and asked if they wanted to add anything further.

Data Analysis 

The processing of the focus group findings was done ​​following Gibbs (2007). For the first phase, the method was based on free thematic analysis (King, 2012). The basic categories were identified by comparative reading of transitional statements by the participants beyond the study topics. Then, utterances were classified into themes (King, 2012). At the end of the process, themes directly related to the study were identified which shed light on aspects other than those tested through the questionnaires. It was also possible to identify meaningful themes that were unrelated, or not directly related, to the research variables. 

Discussion 

The analysis of the statistical part of the study reflected two main benefits of the CIL program regarding the students. First, the correlations between the students’ self-evaluations and the teachers’ assessment of the students were higher following the program. This finding might indicate a rapprochement between students’ evaluations of themselves and their teachers’ view of them.

Although the statistical tests applied to the teachers’ assessments of their students’ performance did not show a significant change in the teachers’ evaluations of their students, notes from the teachers’ focus group revealed that their awareness of their students’ needs did improve.

The analysis of the teachers’ focus group identified three themes relating to the research topics. 

The first theme, dealt with getting to know the students better in various ways: 

"The awareness of the teachers about problems experienced by students was increased." (E) 

"... I think that I am more familiar with his difficulties." (B) 

"I did not know how to relate to it ... now I think I understand her much better." (A)

"... It was new to me ... I did not realize that D knows such good English." (C)

There were also reports of greater class participation: 

"There was almost no need to ask ... everyone spoke ... each in his turn had something to say." (A) 

"After the circle (CIL)…she asked for the booklet ... I told her that after M returns it ... it’s a shame they don’t order more." (D)

The second theme was connected to social and interpersonal relationships. This includes improving students’ behavior towards one another: 

"The program helps resolve disputes such as arguments, how to get along with a student who forces others to accept his opinion. Something happened following the program." (E) 

"The program encouraged them to give feedback to each other." (C)

"Despite the problems and communication difficulties that normally exist in this group, in the ‘Cycle of Internalized Learning’ group sessions they communicated more easily." (B) 

The third theme was related to the significant aspect of the program on coping with stigmas:

"The work on stigmas was comprehensive. By discussing the stigmas of students the subject of stigmas in the family came up, which had not been touched upon much, before the program." (C) 

A second finding was that students’ attitudes towards VI were more positive following the program. Attitude towards VI is one of the factors affecting a sense of being capable and having a better quality of life (Marques-Brocksopp, 2012; Thurston, McLeod & Thurston, 2013). The second theme also dealt with increased student awareness of their visual impairments and the associated consequences. This came up also in their teachers’ comments in the focus group. Some reported that they witnessed increased motivation amongst the students to know more about different aspects of visual impairment: 

"Two students in my class told us about asking their parents to explain more about the problem they have with eyes." (A) 

"Medical issues ... spread over more than one lesson." (D)

The students showed greater self-esteem and were more open to sharing problematic situations that stemmed from their disability: 

"Students showed a greater openness to talk about situations when they encountered difficulties because of the disability." (B) 

"S ... told us what happened to him with the bush (on the way to the bus stop the student turned to a bush that he thought was a human figure I.H.)” (E) 

"... From a discussion about the difficulties of going out to work and independence at work the subject came up of exactly what it is that I want to do, what works best for me and what will I choose?" (C) 

"These subjects occupy their minds." (C) 

In summary, it appears that the program may help to improve the educational climate where it is operated. The principal of the school in which the program was conducted concluded:

“The atmosphere that the program cultivated and the approach it emphasized of mutual respect between the students and the staff, as well as respect amongst the students themselves, together with the respect for the disability, match and enhance the educational philosophy of this school.”

Practical Implications 

Following the study, we suggest that the principles of this program based on the CIL program be incorporated into other programs. This may strengthen students’ social skills and thus may contribute to the development of their quality of life. In addition, the program may also be effective with other special education populations, as it is based on the premise that strengthening the elements of self-esteem should be customized to the individuals’ needs and not to their specific category of disability. The program affords the teacher a better understanding of the students’ unique needs as well as their capabilities. 

One of the strengths of the CIL program is that it is based on a clear model and systematic steps. It is in line with constructivist meaningful teaching methods that enhance not only the learning of data but also students’ creativity, motivation, and autonomic thinking.

Limitations 

The study accompanying the program was not strictly experimental. The lack of a control group, as well as other conditions necessary for making conclusions about causal effects, have implications regarding the generalization of the conclusions about the impact of the program on participants. In addition, the group size was rather small. Therefore, in order to improve trustworthiness of the research findings, further studies are planned to accompany other programs similar to the program presented. As the size of empirical evidence grows regarding the effects of the program, validity of the research conclusions will be strengthened. It is recommended that further research include an evaluation of other variables such as self-determination and self-advocacy.

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