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Student nurse dropout rates tackled in national study


Student nurses are more likely to drop out either before their course starts or following graduation than at other points during their training, early findings from a national study have indicated.

The research has so far found students are also more likely to leave if there is a “lack of commitment” between them, universities and trusts providing placements.

“We are losing students even before they are started on their programmes. There is also quite a drop-off at the point at which they qualify”

John Clark

People chose not to start training despite gaining a place on a course because they sometimes felt the university was “not interested in them”, according to workforce planning body Health Education England, which is leading the research.

They said universities that maintained contact with students after offering them a place had better retention rates.

Universities with buddying systems – in which third years students are paired up with first year trainees to provide support – and where mentors and lecturers deliver training in eachother’s settings also have improved retention rates.

The two-year study, called Reducing Pre Registration Attrition and Improving Retention (REPAIR), is looking at the experiences of nursing, midwifery and therapeutic radiography students from the point they apply up until the end of their first year in practice.

It will collect data on attrition rates from more than 50 universities for the cohort of students that completed training in the academic year 2013-14.

Meanwhile, interviews with students, lecturers and placement providers this year are already being carried out to determine trends and potential reasons for poor retention.

The chair of a major assessment of nursing education and training commissioned by HEE – called the Shape of Caring review – last year called for action to tackle high national attrition rates in England, of around 20%.

John Clark, director of education and quality at HEE South of England, who is leading the REPAIR project, said this was the first time there had been a coordinated approach to driving down student attrition at a national level - despite local work having been ongoing for many years but without significant improvements.

“We are looking at attrition not just through the programme but at the point they apply, right the way through into that transition year into practice,” he said.

“The reason we’ve done that is because through some of the conversations we’ve been having already its really clear to us there are some peaks at different points in that pathway,” said Mr Clark.

“One of the peaks is between applying and getting a place and actually arriving in a university. So we are losing students even before they are started on their programmes. There is also quite a drop-off at the point at which they qualify,” he added.

“Retaining students is a shared agenda for universities, HEE, service provers and students regardless of [changes to student funding]”

John Clark

Results from the data collection and full findings from the interviews will be published once the programme completes in summer 2017.

When asked by Nursing Times, Professor Clark said HEE was not including questions during interviews about how the removal of bursaries from 2017 would affect student attrition. But he said HEE was asking students about how finances had an impact on their studies.

He said the project’s steering group, which is chaired by former chief nursing officer for England Christine Beasley, had an “industrious” debate following the funding reform announcement in November about whether to continue the project.

“The group unanimously felt we should continue. The reason we felt this was that retaining students is a shared agenda for universities, HEE, service provers and students regardless of the funding.

“We recognise there are going to be implications for all stakeholders, and most likely the students, following the [bursary announcement]…If anything it is more important to make sure students get a good experience post the funding reforms,” said Professor Clark.


Readers' comments (10)

  • This is very true so many student nurses drop out because they are not supported at all by either the university or placement provider. Once you are on placement some universities just abandon you they don't care at all . The placement provider bully and use you to the bone they don't teach u anything bcz they don't care as long as they cover the gaps

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  • I'm glad my daughter trained in the philippines. And the above reasons is why I said to her not to work in the NHS as it will put you off nursing for life

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  • I would like to say big thanks to all the staff at Southampton University. I know you guys are there while I'm on my placement and I know that every question will be answered. Buddy system is not great, but the contact with our Uni mentors is really working. On the other hand: it is the UNIVERSITY therefore, you have to learn a lot of stuff on your own. Library is conveniently open 15h/24h, internet 24h.

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  • I'm in my middle 30''s. ...worked in the NHS for years, then after in the middle east. The Middle East has better working conditions than UK. I'm already planning to change Careers....Nursing doesn't pay well, it's not valued, There is no opportunity for development, Managers really do not care and I have been put off it for Life. I absolutely dread going back to UK and working as a nurse again.

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  • Maybe if they had a better idea of what they were getting into they wouldn't join up in the first place and the ones who did would stay. Hardly anybody dropped out in the far-off dark ages when it was an apprenticeship system, when we saw the hours and the work and the conditions right from the first day on the wards. The academic side has so little to do with reality that it's no wonder that it's a shock to the system. And yes, I do know that a well-educated nurse will do a better job than an ignorant one.

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  • Couple of things...

    With reference to support for students on placement and placement mentors, in over 25 years of supervising/mentoring/whatever word we use this week students on placement in both community and ward settings I can count on the fingers of one hand the number of times I spoke to, let alone met, a student's tutor...And this includes many final placement students...The only "support" I ever got as a mentor was the frankly useless annual "mentor update".

    And how much of the loss of students at graduation is occurring in trusts who have decided NOT to offer permanent contracts to newly qualified nurses, as has been the case in quite a few areas?

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  • Yes, Universities just want money and some placements just want cheap labour and don't care about the students. NHS money going to the BIN, pathetic !

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  • I have always had brilliant support from UWE. However, sometimes the issue is with the teams that we're on placement with. Often they're unsure of how they can utalise a student nurse, and they leave us to it. I imagine more student nurses drop out due to lack of support from practice placements, rather than from the universities. Maybe i have been lucky in the university i chose, because they're a great support.

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  • Anthony Johnson

    I hope that they're investigating if students are dropping out from poor mental health as I feel like that is something that they refuse to talk about. Obviously it would mean admitting that they'd admit forcing students to pay for the privilege of working is not going to improve their stress levels...

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  • I think it is time applicants were screened properly, and not just seen as 'making up' the numbers on a cohort at Uni. It's a degree programme, costing a lot of money, and no secondments in the future. Universities taking up the training have removed the 'belonging' that we nurses who trained in Schools of Nursing, attached to a hospital had. We felt pride in being selected to train at a hospital- there was a degree of competition between hospitals. Hospitals wanted staff to stay once qualified. I trained at St Bartholomew's in London, not some huge University. I am proud of my training, the standards I have attained. Proud to be a 'Barts' nurse. Nursing is tough, its hard work, its rewarding, but if you want to be rich- don't sign up. I've worked in the NHS since 1981 but never been out of a work.

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