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)

Final Report: Leicester Ageing Together (LAT): Evaluation Report

Executive Summary According to the Office for National Statics (2018) the UK population has been steadily getting older and this trend is projected to continue. In 2016, there were 11.8 million UK residents aged 65 years and over, representing 18% of the total population – 25 years before, there were 9.1 million, accounting for 15.8% of the population. Linked to these statistics over 9 million people in the UK – almost a fifth of the population – say they are always or often lonely, but almost two thirds feel uncomfortable admitting to it (British Red Cross and Co-Op, 2016) and over half (51%) of all people aged 75 and over live alone (ONS, 2010). The Leicester Ageing Together partnership, known as LAT, has been working since October 2015 to reduce isolation and loneliness in older people in Leicester. So far, they have reached almost 6,000 older people, nearly half of whom were aged 80 years plus. This large and extensive programme recruited over 1,300 volunteers, as well as funding local jobs worth £1.5 million. LAT is part of Ageing Better, a programme set up by The National Lottery Community Fund, the largest funder to date of community activity in the UK. Ageing Better aimed to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. It was one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aimed to make people’s lives healthier and happier. This report commissioned by the LAT board in December 2018 was conducted by De Montfort University and reports the findings of a qualitative evaluation conducted at the end of the funding stream for the programme. The evaluation aimed to gauge the views and experiences of beneficiaries, stakeholders and provider organisations who were involved in the delivery of the programme. This evaluation was conducted over a four month period in early 2019 and where possible aimed to gain insights from across a range of ethnic groups, contexts and viewpoints. In total 50 participants shared their experiences of the programme, for which the evaluation team at De Montfort and LAT are extremely grateful. This report should be read with the understanding that the views shared in this report are not necessarily the views of everyone involved in the programme. They are time specific based on hindsight offering a snap shot of views at the end of the programme rather than throughout. The findings relate to data collected over a months in 2019 involving 50 participants who were at the time of data collection actively engaged in an activity as a beneficiary or were delivering programmes as a provider. The majority of the views shared in this report are generated from the 35 older people classed as the LAT programme beneficiaries with a further 15 interviews undertaken with provider and stakeholder organisations. This evaluation did not seek the views of the LAT board members. Ageing Better, the Big Lottery funders or organisations that were no longer offering LAT funded activities. The findings and therefore the recommendations are solely based on the evidence gathered during this evaluation exercise and it would be useful for these to be considered in light of the other extensive evaluations that have been commissioned not just for the Leicester programme but others commissioned across the sector. For example at the time of submitting this final report we understand there is an ongoing national evaluation by the Big Lottery which is anticipated to have cross cutting themes to other local evaluations. It would be wise, therefore, to review these in the context of Leicester and other UK Cities and similar programmes aimed to support loneliness and social isolation amongst older people (those aged over 50) and the communities to which they live. The report findings aim to capture the essence of the LAT programme including highlights, strengths and opportunities for future learning for similar programmes of activity

Education and Social Relationships between Museums and Older People: A Scoping Review

open access articleRapidly ageing population increases the demand for activities with learning and social stimulation. Museums are well placed to provide such a function. Objective: How and in what form are museums engaging with older populations. The review will focus on three aspects: (1) Identifying the frameworks and tools being used by and in museums with older people. (2) Assess variables used in research and in areas that supports knowledge creation. (3) Identify evidence in relation to the interactions between museums and older audiences. A review of 8 databases and 2 university repositories (English and Portuguese language). The 2 ANAIS DO MUSEU PAULISTA – vol. 30, 2022. search retrieved 810 potential sources (2002-2020), 39 sources met the inclusion criteria. They focused on the educational aspects of museums and were produced by disciplines like psychology and gerontology, museology, arts and education. Museums play an important role on health (emphasis on psychological and physical wellbeing), socialization (discussing stereotypes, reducing isolation, redefining social roles), socioeconomic aspects (with local focus on services, partnerships) and on creative aging (promoting non-formal education with lifelong learning at different levels)

Turkey is not just for Christmas! A shared appreciation for research conducted in care homes during the Covid-19 pandemic.

October 11th 2021 was Canadian Thanksgiving Day and LTCCOVID also hosted an international seminar on care home research. This enabled us both to discover similarities between the UK and Canada (Turkey for celebrations!) and connections through our research work in the care home sector through the pandemic. The seminar enabled three research teams to share their findings from recently completed studies delivered by researchers (@livinginhope @EWolverson @SallyBlonde1 @carolinannwhite @dist_care @HinsliffK @Jayne_NurseProf @SarahCGriffiths @SALTY_LTC). All three studies, two conducted in the UK (at Hull and DMU) and one based in Atlantic Canada, had one central theme; to understand the experiences of the care home sector during the pandemic and imposed lockdowns or lockouts

Corrigendum: Accessing care services after sexual violence: A systematic review exploring experiences of women in South Africa

No abstract available

Education and Social Relationships between Museums and Older People: A Scoping Review

Rapidly ageing population increases the demand for activities with learning and social stimulation. Museums are well placed to provide such a function. Objective: How and in what form are museums engaging with older populations. The review will focus on three aspects: (1) Identifying the frameworks and tools being used by and in museums with older people. (2) Assess variables used in research and in areas that supports knowledge creation. (3) Identify evidence in relation to the interactions between museums and older audiences. Areview of 8 databases and 2 university repositories (English and Portuguese language). The search retrieved 810 potential sources (2002-2020), 39 sources met the inclusion criteria.They focused on the educational aspects of museums and were produced by disciplines like psychology and gerontology, museology, arts and education. Museums play an important role on health (emphasis on psychological and physical wellbeing), socialization (discussing stereotypes, reducing isolation, redefining social roles), socioeconomic aspects (with local focus on services, partnerships) and on creative aging (promoting non-formal education with lifelong learning at different levels)

An ethnographic evaluation of a specialty training pathway for general practice nursing in the UK

open access articleAims: The aim of the study was to evaluate the implementation and impact of the General Practice Nurse – Specialty Training (GPN-ST) programme across seven sites in one geographical location in the UK. The objectives were to understand, describe and evaluate: 1) the implementation of the ‘proof of concept’ training scheme; 2) the learning undertaken during the training; and 3) the impact of the training scheme on individual nurses. These objectives offer the opportunity to describe the potential return on investment for General Practices supporting nurses new to General Practice through the programme. Background: General Practice Nurses (GPNs) play a vital role in delivering primary and community care. In the UK there is a shortfall in the GPN workforce. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. An ethnographic evaluation was undertaken of a one-year speciality training programme (GPN-ST). The programme, aimed at nurses new to General Practice, included formal higher education training and funded supported learning and mentoring whilst in practice. Methods: A qualitative ethnographic evaluation was undertaken. Observations were conducted of programme implementation, network and education meetings in the scheme. In-depth, semi-structured, interviews and focus groups were conducted with a wide range of professionals (n = 40) including nurse mentors, nursing students, academic providers, commissioners and the programme managers. These data were supplemented by documentary analysis of meeting notes, learning materials, internal student feedback and locally collected evaluation material in line with ethnographic approaches to research. Kirkpatrick’s model for course evaluation and complimentary inductive emergent thematic analysis was used. Findings: There is evidence of learning at every level of the Kirkpatrick model from reaction through to changes in behaviour and results in practice for patients. The speciality training route offered opportunities for deep learning for GPNs. The scheme offered a comprehensive career pathway to General Practice nursing which in turn benefited General Practices. Practices benefitted from confident, independent nurses who were able to contribute to patient care, practice safely and also contributed widely in the long-term for example in research, workforce development and mentoring. Conclusions: General Practice needs to invest in developing a workforce of GPNs, there are significant benefits to investing in the development of GPNs through a training pathway. This scheme provides scope for application in other clinical settings as well in other countries where there is a gap in career progression into GP practices. Tweetable abstract: GPNs play a vital role in delivering primary and community care. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. There are significant benefits to investing in the development of GPNs through a training pathwa

‘Art for art’s sake’ or a research methodology to engage vulnerable and often underrepresented groups in healthcare education and research.

The use of arts based approaches within research and scholarly activity is relatively new but where used with sensitive topics, or with those whose voices are often not heard within dominant healthcare discourse, it is proving an effective method to engage with groups which are largely neglected within research. Methods: One such approach is by use of creative arts based activities to work with groups or individuals (Leavy, 2015), often using external facilitators or researchers who are accustomed to such approaches and methods. In the field of gender based violence researchers are frequently working with very vulnerable groups or individuals who have experienced traumatic experiences and where using conventional methods of conducting research may not provide an appropriate forum for ‘hearing stories of survivorship’ or where those who have experienced abuse may not feel that they have a voice (McGarry & Bowden, 2017). Results: The study team have gained extensive use of using arts based methods to work with survivors of sexual violence and domestic abuse – both in UK and internationally. We will describe the different approaches used by sharing examples of our work over the past 5 years that have been incorporated into healthcare education programmes with digital resources freely available online (McGarry, et al. 2015). Discussion: The overall aim is to present the range of activities involved in this methodology, to share our approach to co-production with survivors of abuse in the development of creative digital educational resources and demonstrate their use in an interactive way with the conference audience. References: Leavy, P. (2015) Method Meets Art: Arts-based Research Practice. New York: The Guilford Press. McGarry, J. and Bowden, D. 2017. Unlocking stories: older women’s experiences of intimate partner violence told through creative expression Journal of Psychiatric and Mental Health Nursing. 24, 629– 637 McGarry J., Baker C., Wilson C., Felton A., Banerjee A, (2015). Preparation for safeguarding in UK pre-registration graduate nurse education. Journal of Adult Protection. 17(6), 371-37

‘We went from understanding, to disappointment, resentment and often grief all in the space of 6 months’ A qualitative study of the stories of family carers of care home residents during COVID-19 pandemic in 2020

When the WHO announced a global pandemic in response to COVID-19, individual countries reacted in a similar way with care homes closing their doors to visits, including visits from family members. The UK was no different, initially they closed to protect care home residents during a period of uncertainty, particularly as many were frail, with complex health needs and classed as vulnerable to the virus. This did however, create a sustained period of uncertainty for family members as well as the wider UK care home community. During 2020, 13 family carers in the UK shared their experiences through this period of COVID related enforced lockdowns, in total 27 interviews were conducted. Our findings and three themes narrate to time points when we were conducting interviews and were often linked to key changes in policy, often in the wider society but not conveyed into care home practices or visiting policies. Three overarching themes are described: Understanding and Acceptance, Disappointment and Resentment, Grief and Sense of Los

Identifying and Managing Frailty: A Survey of UK Healthcare Professionals

Frailty is a common condition that leads to multiple adverse outcomes. Frailty should be identified and managed in a holistic, evidence-based and patient-centered way. We aimed to understand how UK healthcare professionals (HCPs) identify and manage frailty in comparison with UK Fit for Frailty guidelines, their frailty training, their confidence in providing support and organizational pathways for this. An online mixed-methods survey was distributed to UK HCPs supporting older people through professional bodies, special interest groups, key contacts, and social media. From 137 responses, HCPs valued frailty assessment but used a mixture of tools that varied by profession. HCPs felt confident managing frailty and referred older people to a wide range of supportive services, but acknowledged a lack of formalized training opportunities, systems, and pathways for frailty management. Clearer pathways, more training, and stronger interprofessional communication, appropriate to each setting, may further support HCPs in frailty management