Factors affecting the programme completion of pre-registration nursing students through a three year course: a retrospective cohort study

© 2017 Students who leave pre-registration nurse education having failed to complete remain a concern for higher education institutions. This study identifed factors influencing completion using a retrospective cohort analysis to map student characteristics at entry against Year 3 completion data. The study was set in a nursing faculty in a higher education institution in northern England. Data were collected between 2009 and 2014 with five cohorts of students participating (n = 807). Multinomial logistic regression was used to model the dependent variable Progression Outcome with categories of; completion and non-completion (academic and non-academic reasons). Predictors included cohort, programme, branch, gender, age on entry, ethnic group, disability status, domicile, change of home postcode, change of term-time postcode, entry qualifications, previous experience of caring, and dependents. Age on Entry and Domicile or alternatively Dependents and Domicile emerged as statistically significant (p  <  0.05) in the multivariable analysis. Older students were less likely to be lost from the programme, as were students who lived locally at all times and those with dependents. There is currently little reliable, consistent information on nursing student attrition, progression and completion. This study contributes to the evidence base by identifying some of the factors that may contribute to successful programme completion

Fit for purpose: traditional assessment is failing undergraduates with learning difficulties. Might eAssessment help?

Recent years have seen unprecedented growth in the size, diversity and academic orientation of undergraduate student populations. There is evidence that the use of innovative pedagogies using information and communications technology has the potential to address such student diversity by offering opportunities for a more personalised student learning experience. However, ways of assessing student work in such personalised learning contexts have remained a challenge for most English universities, dominated by traditional high stakes, timed exercises. Being almost always text-intensive, these can prove particularly stressful and disadvantageous for the growing numbers of students with specific learning difficulties (SpLD). Such challenges are examined in relation to national requirements and exemplified in the SpLD strategies developed in two faculties of an English university. The paper defines key principles and practices to be realised in order for assessment to be considered fit for purpose. Using these as criteria, traditional assessment is compared to new ways of evaluating student progress that are personalised, integral to and embedded in the learning process. It is concluded that computer-based assessment (eAssessment) offers fairer and more inclusive ways of monitoring, diagnosing, supporting learning and reporting students' achievements

Silk garments plus standard care compared with standard care for treating eczema in children: A randomised, controlled, observer-blind, pragmatic trial (CLOTHES Trial)

© 2017 Thomas et al. Background: The role of clothing in the management of eczema (also called atopic dermatitis or atopic eczema) is poorly understood. This trial evaluated the effectiveness and cost-effectiveness of silk garments (in addition to standard care) for the management of eczema in children with moderate to severe disease. Methods and findings: This was a parallel-group, randomised, controlled, observer-blind trial. Children aged 1 to 15 y with moderate to severe eczema were recruited from secondary care and the community at five UK medical centres. Participants were allocated using online randomisation (1:1) to standard care or to standard care plus silk garments, stratified by age and recruiting centre. Silk garments were worn for 6 mo. Primary outcome (eczema severity) was assessed at baseline, 2, 4, and 6 mo, by nurses blinded to treatment allocation, using the Eczema Area and Severity Index (EASI), which was log-transformed for analysis (intention-to-treat analysis). A safety outcome was number of skin infections. Three hundred children were randomised (26 November 2013 to 5 May 2015): 42% girls, 79% white, mean age 5 y. Primary analysis included 282/300 (94%) children (n = 141 in each group). The garments were worn more often at night than in the day (median of 81% of nights [25th to 75th centile 57% to 96%] and 34% of days [25th to 75th centile 10% to 76%]). Geometric mean EASI scores at baseline, 2, 4, and 6 mo were, respectively, 9.2, 6.4, 5.8, and 5.4 for silk clothing and 8.4, 6.6, 6.0, and 5.4 for standard care. There was no evidence of any difference between the groups in EASI score averaged over all follow-up visits adjusted for baseline EASI score, age, and centre: adjusted ratio of geometric means 0.95, 95% CI 0.85 to 1.07, (p = 0.43). This confidence interval is equivalent to a difference of −1.5 to 0.5 in the original EASI units, which is not clinically important. Skin infections occurred in 36/142 (25%) and 39/141 (28%) of children in the silk clothing and standard care groups, respectively. Even if the small observed treatment effect was genuine, the incremental cost per quality-adjusted life year was £56,811 in the base case analysis from a National Health Service perspective, suggesting that silk garments are unlikely to be cost-effective using currently accepted thresholds. The main limitation of the study is that use of an objective primary outcome, whilst minimising detection bias, may have underestimated treatment effects. Conclusions: Silk clothing is unlikely to provide additional benefit over standard care in children with moderate to severe eczema. Trial registration: Current Controlled Trials ISRCTN77261365

Staying the course.

Soliciting the right kind of support can help students to complete their training

Choosing to stay: looking at retention from a different perspective

The retention of students presents a challenge to approved education institutions (AEIs) globally. Nursing student attrition is of particular concern owing to the high non-completion rates and financial costs. A survey approach was used in an AEI in the north of England to explore the views of five cohorts of pre-registration student nurses on factors influencing continuation. In total 594 questionnaires were distributed, of which 195 (32.8%) were completed; 52.3% of respondents had considered leaving. ‘Pull’ factors contributing to their decision to stay included support structures (academic/family/peer) and a determination to become a nurse. ‘Push’ factors, which had led students to consider leaving, included financial difficulties, personal pressures, poor placement experience and academic difficulties. The study identified key areas for AEIs to focus their efforts in optimising student retention: enhancing mechanisms supporting students around financial, personal, clinical and academic pressures, and developing curricula that celebrate the uniqueness and value of nursing

Staying the course: factors influencing pre-registration nursing student progression into year 2- a retrospective cohort study

Aims/backgroundThe retention of student nurses continues to concern the education sector internationally. Evidence shows that individual factors are correlated with a high risk of attrition, including age, disability, entry qualifications, financial issues, and placement experience. This paper is a report of a study that aimed to examine factors connected to progression and attrition by mapping student characteristics against Year 1 progression data.MethodThe study used a retrospective cohort design. Students within five cohorts in a single University in the north of England were invited to be included (n = 807). Quantitative data were collected from the University's information system (October 2009–January 2010). Of the total potential participants, 695 were included (13.8% excluded). Multinomial logistic regression was used to ascertain factors that predicted progression.ResultsAs age on entry increased, the likelihood of non-progression from year one became less: i.e. older students appeared to be more likely to progress than their younger counterparts (p < 0.001, likelihood ratio chi-square test). Students who lived away from the local area outside term-time were significantly less likely to progress than those whose term-time and holiday domicile were the same (p = 0.007, likelihood ratio chi-square test). Students with dependents or previous care experience seemed more likely to progress than those without, although this was not statistically significant in a multivariable regression model.ConclusionWith the changing demographic profile of students, the new ‘all-graduate’ programmes need to consider student characteristics that are correlated with likelihood of progression and not just focus on those that precipitate exit

Employment experiences of older nurses and midwives in the NHS

AIM: To examine the employment experiences of older nurses and midwives working in the NHS. METHOD: A total of 27 semi-structured telephone interviews were conducted with nurses and midwives to identify positive and negative aspects of their working lives in the NHS. The interviewees were selected from a potential pool of 87 nurses and midwives who had consented to be involved in an earlier part of the study. Data were analysed using QSR NVivo 7.0. FINDINGS: Positive and negative issues were identified as having an impact on the quality of working life. These included: access to training, change and Agenda for Change (AfC), quality of management, work demands, patient/colleague contact and nursing and midwifery as a career. CONCLUSION: This study highlighted a number of issues relevant to older nurses and midwives that warrant further study and attention. These include access to training and continuing professional development, issues relating to change and AfC, and general work demands including workload, resources and morale. The ability of staff to remain healthy, committed and able to deliver quality care can be compromised in cases where the staff experience is negative

Screening for specific learning difficulties (SpLD): the impact upon the progression of pre-registration nursing students.

The study aimed to explore the impact of screening pre-registration nursing students for an SpLD at entry to an education programme, and the provision of specialist support for those identified as 'at risk'. Progression was monitored using a multiple method approach. 242 (98%) students completed and returned the Adult Dyslexia Check List (ADCL). 69 scored 7 or above (28.5% of responses) and 36 (52%) went on for further assessment. 48% of students who scored 7+ did not go on to contact Disability Services at all. 11% of the cohort was formally identified as having a SpLD at the end of the year compared to 3.9% of students with a declared disability entering pre-registration nurse education in 2007. 54% of the students who scored 7+ successfully progressed into year two, compared with 41% of students with SpLD from a previous cohort