Feet under the table: Students’ perceptions of the effectiveness of
learning support provided during their first year of study on health and
social care programmes
Steve May, BEng, MSc, Cert. Ed.
Senior Researcher, Kingston University
E-mail: s.may@kingston.ac.uk
David Hodgson, BA (Hons), MA, LLM
Principal Lecturer and Faculty Teaching and Learning Strategy Coordinator, Kingston
University
Di Marks-Maran, BSc, MA
Visiting Professor of Nursing
Kingston University
Paper presented at the Society for Research into Higher Education Conference, University
of Edinburgh, 13-15 December 2005
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Abstract
This paper shows how research projects undertaken at Kingston University have impacted
on university policy related to student support in a widening participation agenda, and the
student support practices of one faculty within that university.
As part of the move to integrate the university's learning and teaching strategy with its
widening participation strategy a number of funded projects have been undertaken. These
projects have, in turn, influenced university widening participation and learning and
teaching policies. The focus of this paper is on three such projects (which are related to
each other): the University Retention Project, the Study Skills Weekends project and the
Supportive Learning Environment Project (undertaken within the Faculty of Health and
Social Care Sciences). For each, a case study approach was used, influenced by a
Realistic Evaluation framework (Pawson & Tilley 1997).
The paper explores how the University Retention Project has impacted on the widening
participation agenda at Kingston University and on how the Health and Social Care
Sciences faculty has addressed, and is addressing, the student support issues that arose
from the study through follow -up projects, in particular - the Faculty Supportive Learning
Environment Project (SLEP). This is an action research project that brought together
students, academic staff and practice colleagues in the fields of health care and social
work. Using focus group methodology, a rich picture has emerged of the issues within a
supportive learning environment and the practices that lead to such an environment for the
faculty, especially in year 1. Three project groups have been established to initiate
innovations that emerged from this data in health and social care student support. Each
project group is made up of students, academic staff and colleagues from health and
social care practice. As well as leading the implementation of each innovation, the groups
designed each project to include an evaluative research component. This paper presents
the current state of the SLE project and the findings and issues that are emerging for the
faculty.
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Introduction
Kingston University has a strong widening participating (WP) ethos, but there is a
recognition in policy of two realities: firstly, that enabling students from non-traditional
backgrounds to succeed at university raises important issues and consequences at
different stages in the student life cycle (HEFCE 2001); secondly that widening access has
implications for the learning experience of all students. Figure 1 highlights the different
stages in which learning support may be available to students (prior to entry, during
induction, through the first year , during subsequent years and while embarking on a postuniversity career).
Figure 1
Student Life Cycle (adapted from HEFCE 2001)
1.
Aspiration raising
6. Employment
2. Pre-entry advice and
guidance
5. Easing progression
through the programme
3. Admissions
4. First year experience
Alongside university-wide WP initiatives, each Faculty at Kingston University has engaged
in local projects to address challenges of widening participation at different stages of the
student life cycle. This paper presents a case study of how one faculty, the Faculty of
Health and Social Care Sciences utilised findings from university-wide research on student
retention and withdrawal and developed a series of projects responsive to the ongoing
evaluation student experiences. The faculty-based initiatives began with the formation of
the Initial Learning Experiences Group, a cross-faculty forum for information sharing and
project development. The Group initiated the Pre-Entry Study Skills Weekends Project,
focusing on pre-entry learning support and monitored school-based work to improve the
experiences of first year undergraduate students. The Supportive Learning Environment
Project (SLEP) is a ground-up action research project designed to draw together the
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perspectives of students, university staff and professional practice colleagues to inform
projects designed to improve student experience within and beyond the first year, including
practice placements.
The relationship between these elements is illustrated in Figure 2. The diagram highlights
the chronological development of student support initiatives in tune with the student life
cycle. The foregoing account describes a sequential and layered approach to the attempt
to understand and respond to student experience. A brief description is given of the aims,
methodology and key findings of each project. This is followed by a discussion of the
issues and the consequences of widening participation in Health and Social Care
programmes.
4
Figure 2 :Iterative Processes of Practice Development through Realistic Evaluation
Faculty Initial
Learning Experiences
Group
(ILEG)
Kingston University
Student Retention
Research Project
Faculty-wide PreEntry Study Skills
Weekends Project
and Evaluation
School-based
First Year
Experience
Initiatives
Supportive Learning Environment Initiative
Incorporating Faculty data from KU Retention Project
and Faculty Study Skills Project
Evaluating School-based First Year Experience
Initiatives
Evaluating student experience beyond Year One
Consulting with academic and professional staff
Devising Projects with Evaluative Components
Spreading the
Learning Team
(peer support)
Model
Template for
Placement
Induction &
Support /
incentives for
mentors
Review of
Academic
Tutor Role
and good
practice guide
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University retention project
The University-wide retention project used both quantitative and qualitative data to begin
to probe the reasons for withdrawal at first year undergraduate level. The study was
designed to inform wider University strategies and developing policies on, for example,
widening participation, learning and teaching, human resource development strategy and
student services. On a micro level the study aimed to inform and support faculty based
retention projects and other teaching, learning and assessment development initiatives.
Previous studies of retention issues highlighted the significant of factors associated with
both previous and current learning experiences. In a major study on the issue of retention
in six higher education institutions in the North West (Yorke, 2000), respondents cited
quality of teaching on the programme as a significant factor. There was also a perception
amongst respondents that they had received inadequate staff support outside the
timetabled hours of the programme and that there had been a lack of personal support
from staff; points mirrored in the Kingston Retention study.
Mackie, (2001) investigated the experience of students in the first year of an
undergraduate degree in a faculty of business in a new University. The author notes that it
was not the case that one factor precipitated withdrawal, rather, different forces may
interact with one another in ways which lead some students to feel that they cannot
continue, whereas, for other students, the problems they encounter can become a ‘spur’ to
their determination to progress on the course.
The importance of the quality of the first year experience is, perhaps, particularly strong for
those students who come from families in lower socio-economic groups where there may
be little experience of higher education. A study by Connor et. al. (2001) notes that
students from lower social class groups enter higher education with different expectations
than those from higher social class groups and that students from lower social class
backgrounds were less confident that they would be able to cope with academic pressures
and workload; gaining the entry qualifications and the application process itself.
(Hall et. al. 2001) concludes that the first semester is a crucial time for non traditional
students and that there are key factors, during this initial period of the course, which can
inhibit progression in particular low self esteem amongst students about their academic
capability, fear of the learning process and isolation from other students.
Methodology
The first stage of the Kingston Retention Project involved interviewing staff, recording their
perspectives and gathering admissions data and university records to identify profiles of
students (by age, gender, social class, ethnicity, admissions route, distance from home,
distance from term time accommodation, main entry qualification, faculty and date of
withdrawal). In addition those who had withdrawn were telephoned and asked the reasons
for their withdrawal through a questionnaire, while data on the first year experience of
retained student was gathered from focus groups discussions with samples from each
faculty.
The quantitative and qualitative data collected from withdrawn students was processed
through a purpose designed database along with the university records to allow detailed
analysis of issues and links between issues. Themes arising from the focus group
discussions could then be analysed in the context of the combinations of reasons for
6
withdrawal given by pockets of vulnerable students to give a rich picture of why some
students choose to leave the University.
Findings
The key findings from the university wide study were:

Unmet expectations is the prime reason given by student for withdrawal from the
university

Mature students were more likely to cite financial problems as a reason for
withdrawal.

Students admitted through UCAS clearing were more dissatisfied over the range of
issues than were standard entrants in the first semester, particularly in regard to
expectations not being met, and organisation of the course.

Class size is problematic for many students not used to very large groups although
the quality of teaching was thought generally good by retained students and not
much cited by those who had left.

Friendships and peer support were extremely important for new students. The way
in which they are grouped in tutorials, seminars, to give presentations etc, play an
important part in the first year experience.

Both withdrawn and retained students were highly critical of a lack of course related
information and timetable changes. Those who travel a long distance have part-time
work or other commitments or who have made a significant investment in coming to
university expected high quality provision and particularly resented what they saw
as poor organisation.

Academic support through good quality feedback was greatly valued by students as
a way to encourage and enhance learning. Many have less contact with tutors than
they may have been used to, making written feedback all the more important.

Students saw feedback it as an important way to learn and appreciated assessment
feedback but noted that the amount given was extremely variable between lectures.
In the Faculty of Health and Social Care Sciences focus groups were carried out with
students on DipHe Nursing and BA Social work courses. Details of the main findings from
these groups elaborate on some of the themes listed above.
Induction and the start of the course
Students liked being put into small groups so that they could get to know one another.
Nursing students reported:
“Initially it started off very well, we were sort of very gently eased into university life”
However social work students commented about replication of Summer Schools that they
had already attended and that the transition from induction to the course proper was
problematic:
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"I did the summer school and then I had to repeat everything in Induction week, that was
really frustrating"
"You kind of make relationships in the induction week, but then they were split apart by the
introduction of learning teams, then you had to re-establish."
Support from staff
Nursing students found access to their personal tutors a problem but it seemed to depend
a lot on the tutor. They suggested time-tabled sessions to guarantee access. They realise
that tutors have a heavy workload and feel that they could help each other if they could get
together into groups to discuss assignments.
“…….and then we had terrible trouble finding our tutor after that and I think that being so
new to it and perhaps not understanding or knowing the level of work that might be
expected in the first assignment, we had trouble finding, locating, knowing exactly what
guidance (was available)”
“It does put pressure on tutors to have to see us as individuals, that’s why I think it’s better
if we can work together in student groups and sort of help each other”.
The Social Work students reported similar issues:
"The tutorial was so obviously a token effort. It was like ‘Well we have to give a tutorial so
lets just get everyone in for half an hour, give them a tutorial and forget about it for the rest
of the course.’ It feels like you sink or swim."
Peer Support and friendships
This was very important to both groups of students and they appreciated being split into
small groups at the start of the course.
"Without each other I think there would have been times when there would have been a lot
more of us more of us would have left."
Issues connected with Class size
The Nursing students felt that learning was impeded by very large class sizes which were
usually a new experience. While they appreciated that having such class sizes may be
largely unavoidable for certain purposes, some had problems with note-taking, teaching
methods and attendance monitoring.
“The lecturers try to provoke dialogue which is totally ludicrous because the first three
people in the front row have a dialogue with the lecturer. For the rest of the lecture
everyone’s talking because they can’t hear what’s going on and they’re bored”
Students found that disruption by other students, particularly in the lectures, inhibit
learning. They appreciated that efforts were being made to address this.
“It’s a dual responsibility and that’s where I think there are some good student guidelines
that have been laid down saying OK the student is expected to behave in such a way and
the lecturer is expected to behave in such a way”
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Course Organisation
Nursing students were frustrated by apparent lack of communication between lecturers
and provision of reliable information to students.
“..you have one lecturer who says I don’t know if you’ve covered this before –Yes we have
covered it before but we don’t know what you’re going to tell us! Could you speak to the
other lecturer and actually compare lecture notes”
Social Work also students identified organisational issues
"…I just think it's so badly organised. Because we are mature students we expect a
certain standard for the amount of money you pay and I don't think what they're providing
is good enough."
Learning on placement
Both Nursing and Social Work students said they found placements to be a good learning
and networking experience although this varied depending particularly on the mentor.
“Going out on placement is good. If you’re put on a ward with someone else you might not
have spoken to them before, you do have quite an intensive period of being able to meet
new people”.
However the nursing students in particular felt that there was a lack of communication
between practice professionals and university staff.
“I’ve turned up and people haven’t known who I am, whether I was going to be there”
Pre-Entry Study Skills Weekends
The impetus for establishing a study skills weekend prior to entry into health and social
care programmes arose from the Faculty’s Initial Learning Experiences Group (ILEG)
whose remit was to develop improvements in the pre-entry and early university experience
for health and social care students. Originally run as a weekend programme for students
prior to commencing their university programmes, the two day event aimed to increase
awareness, prior to starting at university, of study skills and more general strategies for
managing learning in higher education.
The project included an ongoing evaluation, the purpose of which was to add to the body
of evidence as well as to inform future decision-making about provision of pre-entry study
skills courses.
The objectives of the evaluation were:



To follow up and seek the views of students who attended the study skills
weekends
To follow up those students who did not attend the study skills weekends and
identify how they prepared for the first year experience
To ascertain from personal tutors of first year students the level of student
preparedness for the first year experience with them
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
To identify how future pre-entry support can be developed to help students to better
prepare for their university experience
The concept of pre-entry learning is embraced within HEFCE’s notion of the student life
cycle (HEFCE 2001) which includes two important stages: aspiration raising and pre-entry
support and guidance. The project and accompanying evaluation aimed to test the
hypothesis that the provision of pre-entry workshops related to study skills and coping
strategies would positively impact on the first year experience and would increase student
retention.
From a Faculty perspective, the entry gate had already been widened, partly in response
to health and social care workforce pressures. Thus, recruitment practices departed from
the higher education tradition to recruit those regarded as most able to cope as
independent learners. .
Nearly all Higher Education Institutions provide some form of pre-entry support for
students, dedicating up to 34% of this support through summer schools and courses that
include study skills (University of Bradford 2002). The range in the structure and content
of these courses is varied and extensive and the “discipline specific” approach is favoured
(Durkin & Main 2002).
Methodology
The study skills programme included more than introduction of certain learning and study
skills including maths, writing skills and basis health-related science concepts. It also
offered pre-entry students an opportunity to orientate to the campus and to meet with
“student ambassadors” – existing students who had completed their first year of study.
Measuring the effectiveness of the study skills weekends in relation to quantitative
measures of retention posed methodological challenges that have been reported
elsewhere (Tysome 2003). A qualitative approach to evaluation was chosen, using focus
group discussions and semi structured interviews, alongside formal student evaluation
forms.
Findings
The evaluation highlighted a range of issues associated with expectation and anticipation,
affirmation and confidence, confirmation of choice and enhancement of commitment. All
of these issues were accompanied by varying degrees of anxiety about the impending
experience of university life.
The main theme arising from the participant’s views on the weekends was anticipation
frequently linked to confirmation that the decision they had made to enrol at the university
was right for them to commit to three years of study. Reasons for attending the study skills
weekend were varied but the majority indicated that they came to orientate to the
university and its environment and meet other students and lecturers.
“I’d never faced 200 people before and I thought it would be a good exercise, as well as to
get to know the university, but primarily to meet people, to see some people, to recognise
some people.”
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“I hadn’t made a decision to come to university and I was wavering between whether to
come or not, I would have made that decision based on the two study skills days. I would
have made the decision then if I was wavering…”
For those not attending the study skills weekend a range of reasons were cited including
childcare, other domestic or work-related reasons. Some stated they that had never
received information about the events or had applied but were told the sessions were full.
Some chose not to attend as they were confident that they would learn all they needed to
learn on course
“My attitude was everything I need to know to be a good midwife I will be learning in the
next three years and I am going to learn it step by step…”
Anticipation related to what the participants were expecting when they finally commenced
the programmes they had been recruited to, they were able to evaluate their experience of
the weekend in a positive light in meeting their expectations of the course. Level of
confidence in the light of previous experience emerged as dominant theme
“Maybe peace of mind that you can complete the course and do everything, rather than
worrying that you can’t”
The notion of confidence was associated with age of the participant. The following quote
is indicative of many sentiments expressed by older students:
“I’ve left school a long, long time ago, you know, nearly 20 years, so it was a bit of a big
thing for me to come to university anyway and knowing that seeing people older than me,
I’m not the oldest, seeing people older as well made me a bit more confident.”
The value of the weekends was measured in terms of decreasing anxiety or feeling a
sense of belonging to the university. By listening to contributions from current first year
students they were more reassured about the reality of university life.
“We were told about the workload. We were told that it won’t be more than college…But
when the guy showed us around he said at some point there is loads. At some point there
is nothing and sometimes you cannot balance it out. Sometimes you can’t type the thing
because it all comes at once and it has to be in on the same day, and sometimes you can
scatter it around and do bits when you haven’t got much to do. It’s just knowing things like
that and being prepared in your mind.”
Some neutral or negative effects of the study skills weekends were also voiced.
“I was quite worried about whether I would be OK with the science aspect of the course
and there wasn’t particularly anybody that could reassure me with that…”
Lecturers who staffed the weekends had described a tendency among attendees to
express increasing anxiety as the weekend progressed. This was characterised in
discussions as the “Oh my God” phenomenon with reference to specific academic skills
“Well, I went away from that realising I needed to really have a good think about my maths
and so in got someone to go through a lot of it with me, but I did find that the teacher went
a little bit too fast and I felt a bit panicky.”
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It was concluded that there was some evidence of anxiety from attending the study skills
weekend, although participants also emphasised that they experienced reassurance from
meeting the peer group on the weekends.
“I’m still always thinking to myself, do I really deserve to be here you know? Am I taking up
someone else’s place? Can I, if they have got so much faith in me, can I give that back to
them as well?”
Students said that the study skills weekends did not prepare them for the real experience
of practice placements. This was particularly an issue for nursing and midwifery students
who begin practice placements early in their first year. These participants said that they
would have valued more opportunity during the study skills weekends to discuss these
issues with the first year students in attendance. Questions such as travel to and from
placements, organising childcare and managing shift working were overlooked or there
had not been enough time to explore them.
Faculty initiatives to aid on-course support and guidance for students
Alongside the cross-faculty study skills initiative, a range of developments within individual
schools were pursue in response to the findings of the Retention Project. Some of these
are summarised below in order to illustrate the variety of response regarded as
appropriate to local circumstances.
Midwifery and Nursing
A specialist lecturer now from FE sector was brought in to enhance bridging support on
study and academic writing skills identified through formative assessment (in additional to
the usual mechanisms, e.g. personal tutors, module leaders, cohort leaders, mentors and
clinical liaison lecturers).
Nursing
The way in which students are inducted has been reviewed redesigned to emphasise
small group work rather than large group plenary events
Small group work is being used on the Common Foundation Programme (based on
different branches / specialisms) to promote group identity and support.
Extended inductions are now given for practice placements and liaison lecturers provide
regular surgeries in clinical placement areas.
Physiotherapy
Further development and initial evaluation of group-based peer-assisted learning
programme is underway to address increased student group size, address critical thinking
skills and promote collaborative approach to learning.
The introduction of Peer Learning in the Clinical Setting - each 1st year student is placed
with a 3rd year student for half day visits for clinical orientation.
Radiography
Introduction and review of ‘ice-breaking’ sessions to stimulate student social interaction
during induction
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Increased tutor access and development of Blackboard (VLE) use for individual and small
group support
Social Work
Learning Teams – The learning contract format has been revised with a new emphasis on
continuity of tutor group and personal tutor throughout UG studies.
A Social work Student Academic Mentors (SSAMs) scheme is now part of mainstream
provision following successful pilot scheme. (The scheme is based on US Model, 2 nd & 3rd
year students trained and supported to provide academic assistance to 1 st year students –
including induction activities, one-to-one email and personal advice and support for groupbased assignment preparation.
The personal tutor support in year one has been intensified with the tutor retained
throughout the course and fulfilling a parallel role in relation to practice placement
Supportive Learning Environment Project
The Faculty Supportive Learning Environment Project focussed specifically on what
students perceive to be a supportive learning environment in year 1 and beyond.
Commencing in early 2004 it aims were to define what is regarded as “supportive” from
students’ perspectives, to identify specific measures currently in place that are perceived
to be supportive to students and to identify what additional provision would enhance
support during year 1 and beyond.
This focus on the broader learning environment in supporting students and ways in which
this differs across student groups and settings has been reported elsewhere (Packham &
Miller, 2000; Dix & Hughes, 2004). Laing & Robinson (2003) concluded from their
ethnographic study that consideration must be given to discovering the underlying
characteristics of the teaching and learning environment while MacDonald & Stratta (2001)
argue that while teachers in higher education focussed on helping non-traditional students
adjust to existing higher education ways of working, what is needed is a radical rethink of
how we approach a more diverse student population.
Gidman (2001), explored literature on the role of the personal tutor in enabling nursing
students to achieve and concluded that was no consensus as to the most appropriate
system of providing this support. She also highlighted the need for further research studies
in this area. Clarke et al (2003) in their study of the impact of Practice Placement
Facilitators (PPF), found that students benefited from continuity of support on practice
placements and that practice staff derive benefits from an enhanced understanding of the
needs of learners through the work of the PPF.
The ways in which teaching methods influence the learning environment has also been
explored, for example, by Entwistle (2000), who found that didactic lecture styles can
encourage surface approaches to learning. Rhodes & Nevill (2004) found that both
teaching methods and the friendliness of teaching and non-teaching staff affected student
satisfaction and their propensity to withdraw. Trotter & Cove (2005) found that mature and
younger students on healthcare programmes had differing learning and teaching
requirements, they concluded that as universities widen participation they need to adopt
teaching strategies that are suitable for those who are less familiar with traditional models
of university teaching, in addition to catering for entrants from school.
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Methodology
Phase 1 of the project involved a forum day in June 2004 for students on health and social
care programmes within the Faculty and a second day, in October 2004, for both students
and academic staff from the Faculty. Phase 2 commenced in early 2005 and entails
identifying and undertaking specific project ideas related to increasing student support.
These projects were identified from phase 1. Phase 3 is an ongoing and overarching
evaluative research component.
Figure 3 shows the structure of the Supportive Learning Environment Project and the
aims/activities within it.
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Figure 3
WP Student Support Project 2004-5
Phase 1
Phase 3
Student Forum Event
1) to report on outcomes & findings
from current work on students
initial learning experiences;
2) to enable students
representatives across Faculty
programmes to share
experiences related to support
for learning
3) to devise an agenda & priorities
for action on learning support
(programme and Faculty levels)
that can inform the second (staff
and student) meeting
Staff & Student Event
1) To provide a forum for key staff
across the Faculty, staff involved
in provision of placements in
agencies and students to
consider messages emerging
from research & evaluation of
student support.
2) To identify areas for project work
on student support (including
further research & evaluation)
Phase 2
Implement Project Proposals
1. Spreading the Learning Team
Model
2a. Template for Placement
Induction Programmes
2b. Incentives for Mentors and
Good Practice in Placement
Supervision
3a. Faculty Audit of Tutor Role
3b. Building Relationships Early
Research & Evaluation Components
Co-ordinating and summarising
messages from existing data sets
Constructing framework for
consultation with student groups
Implementing Consultation (s)
Devising further research (in areas
lacking reliable data) & evaluation (of
development project work)
15
The student forum event consisted of a series of focus groups each led by two facilitators
with second and third year students from the Nursing, Social Work and Physiotherapy
schools. The aim was to encourage as open a discussion as possible to get a real sense
of what it was that contributed to or detracted from a positive environment for learning.
They were tape recorded and field notes taken during the sessions.
The second event in October was a consultation and planning day for students, University
staff and staff from placement agencies. The aims of this day were to provide a forum for
key staff across the Faculty, those involved in provision of placements in agencies and
students to consider messages emerging from the research & evaluation of student
support, and to identify areas for project work on supported learning environments for
students (including further research & evaluation). Mixed student/staff discussion groups
were formed and each group discussed the following topics:

Things I/we do that contribute to a supportive environment for learning (at the
University, on placement, connecting the university and placement areas)

Things I/we would like to do that would add to a supportive learning environment (at
university, on placements, connecting the University and placement areas)
In evaluating the project the team was mindful that they were not merely seeking to
answer the questions “What worked?” or “Did it work?” Instead, they aimed to uncover
what worked for whom and in what circumstances. To this end the data collection and
analysis were influenced by the methodology of Realistic Evaluation (Pawson & Tilley
1997) as shown in Figure 4 below.
16
Figure 4
The framework for evaluation of the student learning Environment
project (modified from Pawson & Tilley 1997)
Identifying the contexts,
processes and outcomes related
to a supportive student learning
environment
Conclusions made about
what within student
learning environment
worked for whom and in
what circumstances
Hypothesising what within
the student learning
environment might work and
in what circumstances
Collecting and analysing data
about the context, processes and
outcomes of a supportive student
learning environment (i.e., data
about what worked for whom and
in what circumstances)
17
The projects presented here were undertaken to test the hypothesis (in realistic evaluation
terms) that students from a range of backgrounds might stay and succeed at university if
we better understood their expectations, needs and concerns, adjusting our teaching and
learning support accordingly. The University Retention Project enabled us to begin to
identify these expectations, issues and needs while the Supportive Learning Environment
Project is helping us to test the above hypothesis through “realistic cumulation” (Pawson &
Tilley 1997, p. 117).
Findings
The data from the student focus groups were thematically analysed, giving rise to four
recurring themes:
Academic input and support – enthusiastic lecturers, consistency in the provision of
tutorial support and effective communication between lecturers were sub-themes. In
addition, the types of teaching methods used by lecturers influenced student perceptions
of the learning environment.
“The lecture, if they’re passionate or motivated or actually enjoy what they’re teaching and
their delivery of that has a massive impact on your learning”.
“At the back of the lecture theatre you always see a row of people sleeping and listening to
Walkmans. What’s the point in that?”
“We have personal tutors but it’s a case of ‘hunt them down’
I think personal tutors shouldn’t be people who are head of anything because they haven’t
got time”
“She’s (personal tutor) been an absolute godsend because I had a nightmare of a time and
she was there to help me out”.
Feeling respected – students need to feel respected by, and important to, academic staff
and that lecturers make support available in an organised way
“This is my second year and the University was all new to me you know… and
assignments, exams we don’t get much input from say your personal tutor because there
is no one to turn to”.
“When I was in the branch environment I found that a lot better. The small group
environment works really well….They can see when you’re not understanding something.
You feel comfortable to ask questions”.
“Lack of communications amongst lecturers and people who are providing the timetable is
a big issue as well. You can be waiting half an hour for a lecture. Even though timetable
has been up for months they come and say “No-one told us”. Them strolling in half an hour
late and then rushing through a lesson. That’s not a positive learning environment”.
The physical environment – including space to socialise, access to computers, provision
of the University bus to get from campus to campus, suitable teaching rooms.
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“The room changes at the last moment….The room, the temperature of the room and the
seating….You’re freezing and shivering.”
“Because rooms are cold students are always going out to the toilet and that causes
distractions and because of distraction lessons are all up the creek”.
“When I first started, knowing that there was a bus - that was really positive”.
Peer support – including the Social Work Student Academic Mentor Scheme (SSAMS)
which is a student to student mentoring scheme for students on social work programmes;
the University Peer Assisted Learning Scheme (PAL) and the Faculty’s Study Skills
weekends for prospective students.
“In social work you have a learning contract and individual meeting with your tutor which is
compulsory. My experience of that has been pretty positive but I haven’t felt the need to go
back to my tutor since then but I think that’s a spin off of the fact that we have learning
teams, we have workshop groups, we have seminar groups where you’re working with
other people”.
“On the Social work course SSAMS students came and interacted and talked to us and
that was really useful. And that helps with a positive learning environment, the fact that the
first years and the second years are connected”.
“Now it’s really positive for me - a mentor (SSAMS)...Having to go back and think about
the first year again. And seeing third years -, that people do make it”.
The focus groups also explored specific issues related to the nature of academic support
that students had experienced. The overall picture that emerged was that although
personal and academic tutors were perceived by students to perform a vital function there
were large differences in the quality of this support from the student’s experiences. They
were generally unaware of the different systems of support provided by the schools within
the Faculty. In these focus groups the general consensus was that the Social Work
students seem to have the most effective support but that the numbers of students in
some other schools made it necessary for them to use different systems for providing
support.
Focus group discussions also examined student experiences of support and learning on
practice placements and how this compared with, and linked to, their experiences in the
University. Data from these focus groups show two emerging themes:
The role of the mentor - The keys to a positive learning environment on placement were
having a good practice placement supervisor/mentor and being accepted and respected
by the placement staff team.
“I think it’s really important that you feel confident to go to any member of that team and
say “Look I need a hand” or “Can I watch what you’re doing?”
“I think to be respected; I think that’s a really big issue”.
“One who is prepared to supervise you and check that a task is done. A good mentor is
student friendly, interested in your learning, wanting to help you through”.
19
“They need to provide you with specific learning opportunities, not just telling you to get on
with it.”
Communication between academic and placement staff – There were thought to be
insufficiently close links between University staff and placement staff. The key factor here
was perceived to be communication between the two sets of staff and students.
“I’m in my 4th week of my placement and we didn’t get the placement details until the day
before we left university although the placement people knew we were coming weeks in
advance”.
“You get there and they haven’t even sorted your shifts out
In summary, the message from all focus groups on the student forum day was about the
relationship between communication and support for learning. This included
communication between students (for peer support), between Faculty and students (to
ensure consistency, appropriateness and timing of information to students), between
Faculty staff and placement staff (to enable high quality mentoring) and between staff and
students (to bring about a greater degree of mutual respect).
(findings from Staff groups)
The Staff forum resulted in the emergence of four main themes:




Improving student – student interaction
Improving student – lecturer interaction
Improving student – practitioner/mentor interaction
Developing the tripartite relationship between students, the Faculty and the practice
placement organisations
These four broad themes have led to the establishment of project groups (Phase 2 of the
project) made up of students, lecturers and practice staff who are developing specific
projects within the above themes. Outlines of these are given below.
Student to student (peer) support
The Adaptation and extension to other Faculty programmes of the successful ‘Learning
Team’ model of peer support developed in the undergraduate programme in the School of
Social Work. The project will involve further evaluation of the model and pilot
implementation of this model in one other programme, probably the School of Nursing.
Tutor to student support
This project derives from the variation in student expectations as to the role of personal
tutors and will begin with a survey of procedures and practice in different programmes.
Alongside data from programme handbooks, data will be collected from staff and students
about the operation of the personal tutor system. A report highlighting features of current
practice and areas requiring further attention will provide a basis for recommendations on
practices to be adopted across the faculty.
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Tutor - Practitioner - Student support
A third area of variation identified in consultations with staff, students and representatives
from professional practice agencies was the level and type of support on placements.
Placement induction was identified as a key issue, leading to a specific proposal for the
creation of a cross-Faculty template for Student Induction Packs. The general template
will provide a mechanism to implement common practices in the communication of
important information between university tutors, students and practitioners about specific
roles, expectations, agency protocols, details of programme requirements etc.
The evaluation of these projects will add to our understanding of, and practices related to,
providing a supportive learning environment for health and social care students.
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Discussion
Through identifying factors that tend to increase the likelihood of student withdrawal and
issues that add to or detract from a supportive learning environment combined with an
evaluation of a project designed to address some of the issues and descriptions of other
ongoing initiatives this report represents a transferable case study with potential to inform
policy at University and faculty levels.
Widening participation in health care involves more than increasing the numbers of
traditionally under-represented groups in universities. It is also about ensuring that they
are retained, and that they succeed and progress (Parry 2003). Through an
understanding of what works for whom and in what circumstances, we will be able to
provide specific targeted learning support at these crucial times as Laing & Robinson
(2003) state “A more appropriate model of non-completion must give greater attention to
the underlying nature of an institution’s teaching and learning environment, the manner in
which this environment influences student non-completion and the student perceptions
and expectations that are generated by this environment”.
Our research indicates that a number of factors influence health and social care students
in their decisions to remain or to leave the course including expectations not being met,
peer support, the quality of teaching and their induction into the programme, which was
seen to be a positive experience in our case. The link with retention and the quality and
nature of the induction period in the first two weeks at university has also been highlighted
elsewhere (Trotter & Cove 2005, Tinto 1987; Parmar & Trotter 2005, May & Bousted 2004)
The evaluation of the Study Skills Weekends provided evidence in relation to one way of
ensuring that students start the course with realistic expectations and helped to unpack
some of the underlying issues.
Analysis of the data suggests that students need to overcome anxiety in the experience of
newness. The tension between self-confidence and self-doubt in some of the students
becomes apparent when they question their right to be in university. Participants
highlighted the theme of “confidence” that was manifest in a number of sub-headings. As
Tysome (2003, p 6) points out “confidence as a key part of the study skills package is a
common theme, whatever the academic ability of the student.”
There seems to be a relationship between values or belief systems and their level of
confidence of the students. Some had completed university courses in other subjects
before applying to health-related programmes, others had started a university degree in
other subjects but changed to a more vocational health or social care programme. Some
students had dependents and many had made personal sacrifices to enter their chosen
health programme. It was apparent that the issue of confidence was in part related to
perceptions of academic ability and in part associated with career changes and risk. By
attending the study skills weekend’s participants were seeking confirmation and affirmation
of the decision to commit to the university and career.
The point made by students that the Study Skills weekends did not give preparation for the
clinical placement and the finding that a supportive learning environment in practice
placements, or lack of one, influences students’ experiences, is borne out in other studies.
For example, Van Rhyn & Gontsana (2004) found that students on placement in
psychiatric settings experienced high levels of stress the sources for which included,
ineffective teaching and learning programmes, poor managerial governance of the service,
detachment of professional nurses from their teaching role and poor relationships among
22
staff. This indicates the need for a student introduction to practice placements and for
supportive learning environment in practice placements to include provision of effective
teaching programmes in practice placements, good management of placements and good
clinical staff/student and clinical staff/university staff relationships.
The findings indicate teaching methods influence both student retention and students
perceptions of support and show that lectures, at least in their current form, appear to be
less helpful to student learning while student-to-student methods and learning contracts,
such as the SSAMS approach in social work, are highly regarded by students. This is very
much supported by other studies including Packham & Miller (2000) who report that peerassisted student support had a positive effect on academic performance with regard to
coursework-related activities and Moore et al (2003) who found that retention of
physiotherapy students from traditionally under-represented groups was helped by good
peer learning relationships while Dix & Hughes (2004) found that use of learning contracts
helps nursing students to learn more effectively. These, in addition to peer mentoring, form
an integral part of the SSAMS scheme which was highly rated in our study.
Our data indicates that feeling respected influences both student retention and student’s
perception of being supported. A major part of feeling respected, and therefore feeling
supported, lies in the quality of communication. This is reflected in the findings by Trotter &
Cove (2005) who concluded that university staff need to be more aware of, and sensitive
to, the demands of being a full-time healthcare student with competing commitments of
academic work, placements and personal lives.
Conclusion
In terms of theory development, we seem to be able to make some tentative “generative
causal propositions” (Pawson & Tilley 1997, p. 122) from our research into what works for
whom and in what circumstances. Non-traditional health and social care students at our
University are less likely to leave if there is:

Good student – student interaction (e.g., peer assisted learning; peer support)

Good student – lecturer relationships (e.g., more appropriate teaching methods;
better and more consistent information to students, showing students more respect;
more effective and timely assessment feedback)

Good student – practitioner/mentor interaction (e.g. robust practice-based
mentoring/supervision systems in place; teaching sessions as a part of practice
placements)

Good communication systems between students, the Faculty and the placement
areas
It appears that where positive factors are in place, e.g. peer support systems, these exert
a positive influence on student retention. Where negative factors exist (e.g. lack of care
and respect, poor teaching practices) these exert a negative effect on retention. However,
theory building in realistic evaluation (Pawson & Tilley 1997) involves a constant
interaction between abstraction and specification (or between theory and data). Such
cumulation can only take place over time and with continued evaluation research into what
enables/helps non-traditional students to succeed at university.
23
A picture is emerging about the kinds of support that make a difference to retention, and
the times during the student life cycle when specific support is required by specific student
groups. The projects being undertaken in the second phase of the Supportive Learning
Environment Project are addressing many of these issues.
24
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