Student discontinuations: is the system failing?

Nurse education: factors associated with attrition

AIM

This paper is a report of a study to identify the factors having an impact on student completion rates in a preregistration programme.

BACKGROUND

Nursing student attrition is an international issue causing concern in many parts of the developed world including Australia, the United States and Europe. In the United Kingdom, nursing student attrition has become a major issue, despite having one of the lowest general university dropout rates in the developed world.

METHOD

A retrospective cohort study was conducted in 2007 using routinely-collected demographic and completion data on four cohorts of nursing students (1259 in total) studying at a large English university.

FINDINGS

Students who were older on entry were more likely to complete the programme than younger students, and those who had only the minimum educational qualifications on entry were less likely to complete than those with higher-level qualifications. There was some evidence of increased risk of resigning from the course in students taking the child branch, and increased risk of discontinuation (involuntary removal) from the course in both male and black/minority ethnic students. There was also some evidence that the healthcare organization responsible for a student's placement could influence completion rates.

CONCLUSION

To improve attrition rates on preregistration nursing programmes, higher education institutions should actively target recruitment at mature candidates; increase the level of qualification required to gain entry; examine course structures for flexibility and provide multi-level student support.

Student nurse attrition: use of an exit-interview procedure to determine students' leaving reasons

This study is part of a research programme at the University of Glamorgan aimed at reducing student nurse discontinuation. A number of methodological limitations in previous studies on attrition have been identified and are addressed in this study. A preliminary picture of attrition within this school is established and the validity of the data examined. The average attrition rate for the school over an 8-year period was 19%, which compares favourably with national rates. Data on students' leaving reasons were obtained through an exit-interview procedure; this achieved high response rates which for exceed those represented in previous studies. Academic difficulties and wrong career choice were among the most commonly reported leaving reasons; this is similar to findings from previous research. However family, health and financial difficulties emerge as equally important categories. The exit form facilitated the recording of multiple leaving reasons for each student, an innovative approach in attrition research. Almost half the students discontinued for at least two reasons; the interrelationships between leaving reasons and possible explanations for the findings are considered. The complexity of factors contributing to attrition are discussed and will be tackled in subsequent stages of the research programme.

Student nurse attrition from pre-registration courses: investigating methodological issues

There has been increasing recent interest in student nurse attrition. Despite a long history of research into the problem, attrition rates remain a cause for concern. This paper presents a review of the research undertaken in the UK, together with an international comparison. The foci of previous studies have been diverse and have included investigation of students' leaving reasons, their experience of stress, and course-related difficulties of students in progress. This review illustrates the complexity of issues surrounding student nurse discontinuation, highlighting a number of methodological limitations of prior research. These include the lack of a common definition of attrition, low response rates in surveys, and the imprecise definition of categories of leaving reasons. There is also a dearth of studies based on the perspectives of students. In the UK there is little documentation of whether measures have been adopted to reduce attrition and there is no evidence of evaluation. If future research is to be aimed at reducing attrition, these conceptual and methodological issues need to be addressed.