Failure is not an option: learner persistence amongst Access to Higher Education learners on a DipHE/BSc nursing programme

Since the late 1990s, the UK Government has a policy to support Widening Participation (WP) measures in UK universities. These measures aimed to increase the demographic and socio-economic profile of the undergraduate student population across all UK universities. The target for these measures includes a focus on mature applicants, women entrants, and ethnic minority representation. Latest data (2010/2011) from the Higher Education Statistics Agency (HESA) indicates whilst by far the largest proportion of full-time entrants to undergraduate places are the ‘traditional’ 19 year entrant with A level qualifications (288,590). By comparison a further 77,155 entrants are mature, those aged over 21, who have gained a variety of accepted entry qualifications. One such recognised qualification is that of an Access to Higher Education Diploma. The Access programme is usually undertaken by mature students, with no previous qualifications, who after successful completion of a one-year full-time course are then able to apply for an undergraduate course. It is estimated that one in four mature entrants will enter a university course with an Access qualification (HEFCE, 2006). Against a backdrop of a changing and more diverse student population, a discourse has emerged around the retention of HE students. Current data suggests that one in every twelve undergraduates will leave their university programme in the first year of study (Thomas, 2012a). The attrition of students who have entered university is not only an economic cost to the institution and the individual but is considered a wider social cost. Within the body of work on student retention there is an emerging focus on pre-registration nursing programmes, which were traditionally delivered in nursing schools attached to hospitals but since the 1990s are now delivered in HE institutions. Historically there have been concerns about the levels of student attrition from all nursing programmes and this has continued to the present day with individual Schools of Nursing and the Department of Health trying to address the issues around retaining pre-registration nursing students. Concerns around student retention have given rise to a prolific and substantive body of work around HE student retention both in the UK and wider afield, with much of this work underpinned by the seminal work of Tinto (2002, 1993). Studies on student retention agree that understanding and addressing the issues of student retention is complex, with multiple reasons why students leave early. The largest proportion of research undertaken on UK pre-registration nursing programmes have focussed on the reasons why students leave pre-registration nursing programmes rather than what makes them stay. The research questions asked in this thesis are not around student retention, although this phenomenon provides a backdrop to the study, but around learner persistence by mature Access entrants on UK pre-registration nursing programme. This research raises important questions about what is enabling mature entrants to persist on their programme, since data indicates that mature entrants account for 46% of all nursing students who enter pre-registration nursing programmes in the UK. This study is located in one large UK School of Nursing that attracts over 19% of their student cohort as mature Access entrants. This study follows nine individuals through their second year of a three-year programme to understand their transition, through this mid-point year, as an understanding of the transitions for these mature entrants is currently lacking in the literature. The nine participants were recruited via an electronic survey and were interviewed on three occasions throughout their 2nd year of a DipHE/BSc pre-registration nursing course in order to gain an understanding of their lived experiences as mature Access entrants. Data analysis in this study utilised Glaser and Strauss (1967) classic grounded theory (CGT) methodology. The findings from this CGT study indicate two phases in the participants’ journey enabling them to successfully complete their pre-registration nursing programme: Phase One - pre entry to university and participant journey towards their current course and Phase Two – continued journeys in the first 2 years of nurse training with 5 main categories metaphorically described as: ‘Home Territory’, ‘No Man’s Land’, ‘I Can See Land, ‘Lost Bearings’ and ‘Wearing the Uniform’. These metaphor categories describe a journey that is undertaken from when participants left school and made their early career decisions, through to participants exploring opportunities of further study and gaining an Access qualification to participants been accepted onto a DipHE/BSc pre-registration nursing programme. The study findings indicate that despite the known transition hurdles that result in some student nurses leaving their course early, the nine participants in this study were able to persist successfully on their programme. The study findings suggest that there are significant factors that have enabled these nine mature Access entrants to have a ‘persistent’ approach. These are the ‘learner profile’, ‘On-programme’ and ‘Environmental’ factors and are presented as a framework for a grounded theory of mature learner persistence directly taken from the lived experiences of the nine individuals in this study. These significant factors for a theory of learner persistence include an overarching ‘profile of the learner’ that enters a pre-registration programme and includes their entry qualification, age, career aspiration, and previous experience of nursing. Whist ‘on-programme’ factors aid learners’ ability to overcome the transitions into university and the clinical practice requirements of the programme. The skills and experiences gained through obtaining an Access qualification and the preparation for higher-level study is a significant factor in enabling the study participants to overcome the difficulties that they experienced over their first two years of their DipHE/BSc programme. An additional factor for their persistence was a strong career motivation, a desire to become a nurse. This career motivation underpinned the reasons why participants choose an Access programme, provided a route into university and enabled them to focus on their DipHE/BSc pre-registration nursing programme. UK Schools of Nursing who offer pre-registration programmes are required to attract and retain the very best student nurses. This presented theory of mature student learner persistence raises important questions about the policy for selection, recruitment, and retention by all HE providers and policy makers of nurse education. The findings demonstrate how different factors enable learners to persist and recommends that these should be incorporated into the recruitment stage and furthermore how to support learners during the 3-years of a pre-registration nursing programme. [N.B. Figure 3 - Research activity planning - is not on page 94 but after page 276 (p. 291 of the PDF)