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One in three adult nursing students do not complete course on time

A third of students on adult nursing courses are failing to complete it within the three-year period, according to Health Education England (HEE).

Their report, part of the reducing attrition and improving retention project (RePAIR) investigating the reason why students on nursing and midwifery courses fail to complete, found that 33.35% of students starting an adult nursing course do not complete it within three years.

A total of 22,708 students started adult nursing courses in 2013/14 and 2014/15, with 7,573 failing to complete.

Rates of dropout were highest for learning disability nursing courses, with 39.1% failing to complete, followed by mental health nursing at 34.9%.

When examining the attrition rates by region, they found that learning disability nurse attrition increased in London, the south east and the north relative to other areas. Mental health nursing experienced greater attrition in the south.

Dropout rates were greater during the first year of the programme, for all nursing degree specialties, with HEE using an observed expected attrition rate to approximate rates during each year of a three-year course.

The most common reasons given for leaving a course were finances, with many concerned that they were not earning enough to maintain their studies. Of students who were surveyed as part of the report – all of whom were in receipt of an NHS bursary – 63% said that they would not have applied for the course had they been required to pay tuition fees.

Older students were considerably less likely to have started the course without the bursary than younger students, with 76% of 26-30 year olds saying they would not have applied for the course without it, compared to 44% of 17-20 year olds.

Academic concerns were also frequently cited as reasons for considering leaving the course, particularly during second year, where some felt the workload increased by an unmanageable level. HEE concluded that second year students appear to receive less support than first or third year students.

First year students were more likely to cite experiences on placement as reasons for thinking about leaving the course. Negative placements, including those where the student felt unsupported, were found to impact on the student’s desire to continue with the course.

Data was collected from three sources: higher education institutions, students and other stakeholders, and 16 case study sites across the country. Surveys were sent to students in receipt of an NHS bursary in October 2016 to obtain their thoughts on the course.

The report has led HEE to make a number of recommendations for reducing attrition on nursing and midwifery courses, and improving retention, including look at ways to set up hardship funds to encourage prospective students to study nursing.

Other recommendations include:

  • Institutions developing specific programmes of support for second year students.
  • Institutions mapping out placements for students across the duration of a three-year course.
  • HEE working with institutions to ensure their strategy for supporting students in practice is implemented.

Professor John Clark, regional chief nurse and leader of the RePAIR project at HEE, said that the onus is now on universities and other institutions to work with HEE.

He said: ‘Attrition is everyone’s business. Every individual or organisation providing pre-registration healthcare education or contributing to clinical placement education must ask how they can work together with HEE to respond to the recommendations made in this report.’