Improving Student Retention on Nursing Courses at a UK Institution Quallington, J., Donnelly, E. and Cartwright, A.

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Cost of Attrition costs Impact on the individual Lost income to University Lost investment Loss to other potential applicant Impact on other students

1. Pre entry Attributes 2. Personal Goals and Commitments 3. External Commitments 4. Institutional Experiences 5. Social academic and Practice Integration Research by Tinto (1993),Yorke (2004) and Pascarella et al (2004) suggests that there are 5 consistent variables that contribute to whether or not a student remains on a programme of study

Student Characteristics Pre entry attributes Personal characteristics of applicants Personal Goals and Commitment at the point of entry These have been the subject of a different, but related, project aimed at assessing, selecting. and recruiting individuals who have the potential to succeed.

Aims  Increase student retention by 2%  Improve by 50% the return of students who intercalate  Increase student retention by 2%  Improve by 50% the return of students who intercalate By addressing the remaining two variables 1.Enhance the institutional experience of students who commence the course 2. Improve social, academic and practice Integration

Demographic Data Analysis

What we did Methods Analysis of paper based data. We held Focus groups with Students (current) Nurse Educators Practice Facilitators Mentors Service Users Telephone interviews with students who had withdrawn Issues for discussion What qualities are essential for success? Why do students leave? How well does the current programme support students to succeed? When are the difficult times? What would help students to get over the difficult times?

Interviews with former students Former students’ reasons for withdrawal

Interviews with former students Types of support accessed by students before making their decision to withdraw

Interviews with former students Current activities of former students

STUDENTS Underestimated the personal resources needed to succeed Competing pressures Transition from University to practice is stressful Formal support networks are important Personality, Motivation and Informal support networks from peers essential for course success Need to feel that they matter Help needs to be available when crises occur Morale and encouragement of the people they meet has an impact.

Mentors and Practice Facilitators Better preparation Students need to have more realistic expectations Better preparation for practice and come equipped with some skills Better information Visits prior to commencement and information about the learning environment and what they hope to achieve there Need for closer links with the University Support structures Students need peer support ‘they look after each other’ Support structures should be more overt

Nurse Educators Need perseverance, common sense and humour Willingness to learn, be enthusiastic and be prepared to ask for help Need to understand that this is not like other University based courses Students had unrealistic expectations Need for University to value role of personal tutors Develop stronger relationships with personal tutees Better support in meeting diverse needs Better links between University and Practice Development of clinical skills to better prepare them for practice Need to maintain contact with tutees whilst in practice Maintain links when students are intercalating

Service Users Characteristics Motivation and dedication Confidence Ability to reassure Sensitivity and empathy Observations Basic skills lacking Communication skills lacking Nurses that succeed are able to look outside themselves and can make you feel ‘looked after’ Need to be respected

Student Characteristics at Worcester 56% mature 89% female Mostly recruited from local region Few live on campus Many have parental responsibilities University systems and structures and social functions are developed around undergraduates on non-professional programmes

Additional Factors that Impact on Students Undertaking Nursing Courses Emotionally challenging course Long periods of practice away from University Unsocial hours Requirement to undertake assessments whilst on practice

Key activities arising from focus groups Making the right choice- potential candidates and university Developing realistic expectations Improving integration Better preparation for demands of different aspects of the course Improved support structures

Improving Pre-entry Information Taster sessions pre-application Interviews Winter/summer school with existing student volunteers Virtual networking and Information site. Glossy newsletters Parmar and Trotter (2005) found those courses with highest retention rates provided the most pre entry information.

On Entry Refocused induction with a key aim of establishing group relationships and developing social and academic support networks rather than just primarily as an information giving exercise. Closer links with Students Union Study skills support Induction to practice in small groups with Practice Facilitators Increase in accessible practice based information (FAQs) Timetabled group tutorials through out first year

Preparing for Practice Simulated Practice and Skills Development Additional information available regarding placements Talking Heads Videos IT and Virtual Learning Environment support Database of Buddies

Academic Practice Development Team Developing support in the practice learning environment in liaison with Practice facilitators to ensure that ‘learning’ rather than experience is the primary focus. Investment in: Academic Practice Development Manager Two senior practitioners seconded to work in academic practice development Refocusing the role of three Senior Lecturers to practice development Senior Lecturer Student Disability Support in Practice Work Based Learning Support Office Manager

Academic Learning Study skills Increase in virtual learning materials which enable additional/ flexible learning E-resource pilot to make literature resources more accessible Increase reassessment opportunities without retaking a module which required intercalation Project bid won to review assessment Project to support transition at point of entry and throughout the first year

Maintaining Contact Essential to maintain contact with students whilst on practice  Virtual networks  Contact with Personal tutors Essential to maintain contact with students who are intercalating.  Newsletters  s from Personal Tutors  Opportunities for care work in partner Trusts

Progress Practice team in process of appointment Personal tutor system revised Pre-entry and admission activities implemented Induction reviewed Talking heads videos developed Buddy database established Leaflets published Placement information revised and updated Reassessment opportunities implemented Agreements with Trusts to help intercalating students to gain relevant care work

Project Outcomes Percentage of cohort choosing to intercalate or withdraw from their studies at the end of the first semester

Evaluation Initial evaluation of activities has occurred Potential recruits and new students rate taster days, summer schools and reviewed induction processes very highly. Students report feeling better prepared for practice Students like timetabled group personal tutorial meetings Opportunities to meet with students in tutorial meetings from other years Too early to identify whether there has been an impact on attrition.

Thank You Any Questions?